Accident Piper PA-30-160 Twin Comanche B N847DE,
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ASN Wikibase Occurrence # 74102
 
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Date:Tuesday 27 April 2010
Time:11:35
Type:Silhouette image of generic PA30 model; specific model in this crash may look slightly different    
Piper PA-30-160 Twin Comanche B
Owner/operator:Private
Registration: N847DE
MSN: 30-1634
Year of manufacture:1967
Total airframe hrs:2544 hours
Engine model:Lycoming IO-320
Fatalities:Fatalities: 1 / Occupants: 1
Aircraft damage: Substantial
Category:Accident
Location:Near Childs Avenue, Highway 99, Merced, California -   United States of America
Phase: Initial climb
Nature:Private
Departure airport:Merced, CA (MCE)
Destination airport:Merced, CA (MCE)
Investigating agency: NTSB
Confidence Rating: Accident investigation report completed and information captured
Narrative:
The 88-year-old pilot, who was a property appraiser, departed for the short local flight in the multiengine airplane to perform aerial property observation. Although family members and associates reported normal behavior that morning, witnesses stated that at the airport, he appeared pale, listless, and slightly confused as he attempted to remove his airplane from the hangar. Unable to muster the strength to move the airplane, he enlisted the help of an employee at the fixed base operator. Airport security video captured the airplane’s ground roll and departure; the airplane took twice the normal distance to take off than was required; however, video and radar track data recorded a normal departure from the pattern.

The airplane leveled off shortly after takeoff, and continued to fly at a constant airspeed and appropriate altitude for ground observation. Shortly thereafter, the airplane initiated a descent and made a left turn back toward the airport. The airplane continued to descend during the first portion of the return leg, and the pilot reported over the common traffic advisory frequency that he was experiencing “all kinds of trouble/problems in the cockpit” and that he was returning to the airport. The airplane leveled off about 50 feet above ground level as it approached the traffic pattern. It subsequently struck a wooden communications pole 3 miles short of the runway and then collided with a highway embankment.

A postaccident examination did not reveal any anomalies with the airframe or engine that would have precluded normal operation. The airplane was not configured for landing, and the cockpit controls were not set to any positions that would have indicated that an emergency situation existed.

The pilot had successfully completed a flight review the day before the accident. The flight instructor, who performed the review, stated that the pilot had lost a considerable amount of weight within the last 30 days since he had last seen him and that, although he met the minimum acceptable standards, there was an appreciable degradation in his performance since his flight review the previous year. In particular, the pilot experienced difficulty applying sufficient brake pedal pressure and exhibited symptoms of mild confusion during the taxi and run-up.

The pilot had been diagnosed with prostate cancer 5 years before the accident and non-insulin-dependent diabetes 2 years later. In the few months before the accident flight, his cancer had grown and spread, and was unresponsive to treatment. He had not reported these diagnoses during his FAA medical examinations.

Following the accident, the pilot was initially semi-conscious but in cardiac arrest by the time emergency medical personnel arrived. The autopsy concluded that he died from blunt force trauma but did not identify a traumatic injury which would have resulted in his cardiac arrest. The autopsy confirmed that his prostate cancer had in fact spread. Additionally, large quantities of fluid were removed from his chest cavity during the resuscitation attempt and the subsequent autopsy. The fluid buildup was most likely due to a preexisting condition related to his cancer, rather than from a traumatic injury. Laboratory analysis from the hospital also revealed that he had mild diabetic ketoacidosis.

The cumulative effect of the pilot’s medical conditions would have left him with decreased motor strength, shortness of breath, and declining cognitive function, which would have impaired his ability to cope with any urgent or emergent situations. This, and his advanced age, likely also contributed to his death from injuries that might otherwise have been survivable.
Probable Cause: Pilot incapacitation due to the combined effect of multiple unreported medical conditions.

Accident investigation:
cover
  
Investigating agency: NTSB
Report number: WPR10FA217
Status: Investigation completed
Duration: 3 years and 4 months
Download report: Final report

Sources:

NTSB
FAA register: 2. FAA: http://registry.faa.gov/aircraftinquiry/NNum_Results.aspx?NNumbertxt=847DE

5. https://flightaware.com/resources/registration/N847DE

Location

Revision history:

Date/timeContributorUpdates
28-Apr-2010 01:20 RobertMB Added
28-Apr-2010 01:21 RobertMB Updated [Aircraft type, Narrative]
28-Apr-2010 12:24 gwog Updated [Embed code]
21-Dec-2016 19:25 ASN Update Bot Updated [Time, Damage, Category, Investigating agency]
13-Apr-2017 17:27 Dr.John Smith Updated [Time, Location, Nature, Departure airport, Destination airport, Source, Damage, Narrative]
13-Apr-2017 17:27 Dr.John Smith Updated [Damage]
26-Nov-2017 16:34 ASN Update Bot Updated [Time, Operator, Other fatalities, Nature, Departure airport, Destination airport, Source, Damage, Narrative]

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