Saturday, July 13, 2019

Midair Collision: Cessna 170B, N8082A and Grumman American AA-5B Tiger, N425AE; fatal accident occurred April 01, 2017 near Massey Ranch Airpark (X50), New Smyrna Beach, Volusia County, Florida

Gary Lee Somerton 

Anne Edmonson

The National Transportation Safety Board traveled to the scene of this accident. 

Additional Participating Entities:
Federal Aviation Administration / Flight Standards District Office; Orlando, Florida
Textron Aviation; Wichita, Kansas


N8082A Aviation Accident Factual Report - National Transportation Safety Board: https://app.ntsb.gov/pdf

N8082A  Investigation Document - National Transportation Safety Board: https://app.ntsb.gov/pdf

http://registry.faa.gov/N8082A 


Location: Edgewater, FL
Accident Number: ERA17FA143A
Date & Time: 04/01/2017, 0846 EDT
Registration: N8082A
Aircraft: CESSNA 170B
Aircraft Damage: Destroyed
Defining Event: Midair collision
Injuries: 1 Fatal
Flight Conducted Under: Part 91: General Aviation - Personal 

On April 1, 2017, about 0846 eastern daylight time, a Cessna 170B, N8082D, and a Grumman American AA-5B, N425AE, were destroyed during an in-flight collision over Edgewater, Florida. The airline transport pilot flying the Cessna and the airline transport pilot flying the Grumman were fatally injured. Both airplanes were owned and operated by their respective pilots as Title 14 Code of Federal Regulations (CFR) Part 91 personal flights. No flight plans were filed, and visual meteorological conditions prevailed at the time of the accident. The airplanes were part of a recreational formation flight that departed from Spruce Creek Airport (7FL6), Daytona Beach, Florida, about 0839 and were destined for Arthur Dunn Airpark (X21), Titusville, Florida.

Three other airplanes were part of the formation flight: a Great Lakes biplane, a Grumman AA-1C (referred to in this report as the Lynx), and an American Champion 8KCAB (referred to in this report as the Super Decathlon). All five pilots participating in the formation flight were members of a pilot group based at 7FL6. On the morning of the accident, the group members were flying to X21 to attend a monthly breakfast event.

The five-airplane formation flight took off from 7FL6. The flight leader was flying the biplane, which took off with the accident Grumman in formation first; the accident Cessna and the Lynx took off in formation next followed by the Super Decathlon. The flight initially formed into a five-airplane "V" formation (see figure 1), with the biplane at the apex, the Grumman in the No. 2 position (to the left and aft of the biplane), the Cessna in the No. 3 position (to the right and aft of the biplane), the Lynx in the No. 4 position (to the right and aft of the Cessna), and the Super Decathlon in the No. 5 position (to the left and aft of the Grumman).


Figure 1 – Example of a 5-airplane "V" formation
 (aircraft pictured not representative of those involved in this accident).

The formation flight then turned south toward X21. Due to the position of the sun, the flight leader decided to change to a left echelon formation (see figure 2), which would have allowed the pilots to avoid the sun glare. In the left echelon formation, the airplanes would be arranged diagonally to the left of the biplane, with each airplane positioned slightly lower than (stepped down), behind, and to the left of the airplane ahead. This formation would require the Cessna and the Lynx to transition across the formation from right to left behind the leader. The Grumman would remain in the No. 2 position to the left and aft of the leader; the Cessna, in the No. 3 position, would be to the left and aft of the Grumman; the Lynx, in the No. 4 position, would be to the left and aft of the Cessna; and the Super Decathlon, in the No. 5 position, would be to the left and aft of the Lynx.


Figure 2 – Example of a 5-airplane echelon left formation
 (aircraft pictured not representative of those involved in this accident).

According to the flight leader, moments after he commanded the Cessna and the Lynx to transition across the formation to the left, he saw at his 7:00 position a "flash" of something white that looked like the bottom of an airplane.

According to the pilot of the Lynx, when the flight leader commanded his airplane and the Cessna to transition to the left, he heard the flight leader state "cleared to cross," and he observed the Cessna start to move to the left "slow and normal." The Lynx pilot stayed with the Cessna, and, when the Cessna was almost on the left echelon bearing line, he saw the airplane move into position behind the Grumman. The Lynx pilot then suddenly saw "parts" coming toward him on his airplane's right side along with what appeared to be "vapor." The Lynx pilot also saw the Grumman abruptly pitch up and go past him above and to the right of his airplane. The Lynx pilot stated that the Grumman looked as if it was entering a loop because the airplane's nose was already past vertical and he could see the top of the airplane. He observed something on the right side of the Cessna move upward before the Cessna's tail began to "slew left," and then the Cessna disappeared from his view.

The biplane and the Lynx then broke formation, with the biplane immediately pulling up and turning hard left and the Lynx entering a 60° left bank. The flight leader could see airplane parts falling to the ground and the Cessna descending "like a falling leaf maneuver" with what appeared to be the airplane's right wing folded over. The flight leader then began to circle the accident site and reported the accident to an air traffic controller at New Smyrna Beach Municipal Airport, (EVB), New Smyrna Beach, Florida. Afterward, the flight leader continued to circle the accident site until emergency responders arrived.

Witnesses who were driving on Interstate 95 (I-95) saw the formation flight traveling southbound. They observed that the formation flight was about 1/4 mile west of I-95 when the collision occurred, and they observed part of the wing on one airplane come off and the airplane tumble and rapidly descend tail low until it descended behind a tree line. They also saw the other airplane descend rapidly, almost straight down, until losing sight of it. Further, the witnesses saw parts from both airplanes descend to the ground, with one piece landing in the median between the northbound and southbound lanes of I-95.

The Cessna and the Grumman were equipped with handheld GPS units. The GPS device in the Grumman was impact damaged, and data were unable to be extracted using normal means. The data extracted from the GPS device in the Cessna, a Garmin Aera 510, included data from the day of the accident starting at 0743:55.

According to the GPS data, on the day of the accident, the Cessna took off from runway 23 about 0839:38 and began a turn to the left. Upon reaching the end of the runway, the Cessna was at a GPS altitude of 202 ft. The Cessna flew over residences at a GPS altitude of 220 ft and continued turning until it was on a ground track of about 142°. For about the next 2 miles, the airplane climbed slowly, reaching a GPS altitude of 634 ft at 0841:15. The Cessna continued to climb and, about 7.8 miles later, at 0846:13, the GPS data indicated that the airplane had begun to descend rapidly to the ground near the location of the accident site.

The pilot of the Lynx provided a screenshot from his GPS unit to assist the National Transportation Safety Board (NTSB) in determining the route of flight for the formation flight. A comparison of the GPS data from the Lynx and the Cessna indicated that both airplanes had flown the same route of flight. 



Pilot Information

Certificate: Airline Transport; Flight Instructor; Commercial
Age: 57, Male
Airplane Rating(s): Multi-engine Land; Single-engine Land
Seat Occupied: Left
Other Aircraft Rating(s): None
Restraint Used: 3-point
Instrument Rating(s): Airplane
Second Pilot Present: No
Instructor Rating(s): Airplane Multi-engine; Airplane Single-engine; Instrument Airplane
Toxicology Performed: Yes
Medical Certification: Class 1 With Waivers/Limitations
Last FAA Medical Exam: 02/10/2017
Occupational Pilot: Yes
Last Flight Review or Equivalent: 06/04/2016
Flight Time:  (Estimated) 14620 hours (Total, all aircraft), 4543 hours (Pilot In Command, all aircraft), 135 hours (Last 90 days, all aircraft), 45 hours (Last 30 days, all aircraft) 

According to Federal Aviation Administration (FAA) records, the pilot of the Cessna held an airline transport pilot certificate with a rating for airplane multiengine land and commercial privileges for airplane single-engine land. He also held a flight instructor certificate with ratings for airplane single-engine, airplane multiengine, and instrument airplane; a flight engineer certificate with a rating for flight engineer turbojet powered; and a mechanic certificate with airframe and powerplant ratings. He also held type ratings for the Boeing 737, 757, 767, and 777 and the Beechcraft 1900 and 300. His most recent FAA first-class medical certificate was issued on February 10, 2017, with no limitations. He had accrued about 24,237 hours total flight experience as of March 2017.

According to FAA records, the pilot of the Grumman held an airline transport pilot certificate with a rating for airplane multiengine land and commercial privileges for airplane single-engine land and airplane single-engine sea. She also held a flight instructor certificate with ratings for airplane single-engine, airplane multiengine, and instrument airplane; a flight engineer certificate with a rating for flight engineer turbojet powered; and a ground instructor certificate with ratings for advanced and instrument. In addition, she held type ratings for the Airbus A-330; Boeing 747, 757, and 767; Beechcraft 1900; and Cessna 510S. Her most recent FAA first-class medical certificate was issued on October 19, 2016, with no limitations. She had accrued about 11,368 hours total flight experience as of March 2016. 



Aircraft and Owner/Operator Information

Aircraft Make: CESSNA
Registration: N8082A
Model/Series: 170B UNDESIGNATED
Aircraft Category: Airplane
Year of Manufacture:
Amateur Built: No
Airworthiness Certificate: Normal
Serial Number: 20934
Landing Gear Type: Tailwheel
Seats: 4
Date/Type of Last Inspection: 10/01/2016, Annual
Certified Max Gross Wt.: 1451 lbs
Time Since Last Inspection:
Engines: 1 Reciprocating
Airframe Total Time: 4596.8 Hours as of last inspection
Engine Manufacturer: CONT MOTOR
ELT: C91A installed, activated, did not aid in locating accident
Engine Model/Series: O-300-A
Registered Owner: On file
Rated Power: 145 hp
Operator: On file
Operating Certificate(s) Held: None



Cessna 170B

The Cessna 170B was a four-seat, tailwheel-equipped, strut-braced, high-wing airplane. It was powered by a 6-cylinder, air-cooled, 145-horsepower Continental O-300-A engine that drove a 2-bladed McCauley fixed-pitch propeller.

According to FAA and maintenance records, the airplane was manufactured in 1952. Its most recent annual inspection was completed on October 1, 2016. At the time of the inspection, the airplane had accrued a total of 4,596.8 hours of operation.

Grumman American AA-5B

The Grumman American AA-5B was a four-seat, nosewheel-equipped, fully cantilevered, low-wing airplane. It was powered by a 4-cylinder, air-cooled, 180-horsepower Lycoming O-360-A4K engine that drove a 2-bladed Sensenich fixed-pitch propeller.

According to FAA and maintenance records, the Grumman was manufactured in 1977. Its most recent annual inspection was completed on September 1, 2016. At the time of the inspection, the airplane had accrued a total of 1,673.4 hours of operation.



Meteorological Information and Flight Plan

Conditions at Accident Site: Visual Conditions
Condition of Light: Day
Observation Facility, Elevation: KEVB, 10 ft msl
Distance from Accident Site: 6 Nautical Miles
Observation Time: 0847 EDT
Direction from Accident Site: 5°
Lowest Cloud Condition: Scattered / 5000 ft agl
Visibility:  10 Miles
Lowest Ceiling: None
Visibility (RVR):
Wind Speed/Gusts: 6 knots /
Turbulence Type Forecast/Actual: / None
Wind Direction: 260°
Turbulence Severity Forecast/Actual: / N/A
Altimeter Setting: 30.02 inches Hg
Temperature/Dew Point: 20°C / 17°C
Precipitation and Obscuration: No Obscuration; No Precipitation
Departure Point: DAYTONA BEACH, FL (7FL6)
Type of Flight Plan Filed: None
Destination: TITUSVILLE, FL (X21)
Type of Clearance: None
Departure Time: 0839 EDT
Type of Airspace: Class G 

At 0847 (1 minute after the accident), the recorded weather at EVB, which was located 6 nautical miles north of the accident site, included wind from 260° at 6 knots, visibility 10 miles, scattered clouds at 5,000 ft, temperature 20°C, dew point 17°C, and an altimeter setting of 30.02 inches of mercury.

According to the US Naval Observatory, at 0840 (6 minutes before the accident) in the area of the accident location, the altitude of the sun was 18.2° above the horizon, and the azimuth of the sun was 94.7° east of north.

Wreckage and Impact Information

Crew Injuries: 1 Fatal
Aircraft Damage: Destroyed
Passenger Injuries: N/A
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 1 Fatal
Latitude, Longitude: 28.959444, -80.957222

Examination of the accident site revealed a 1/4-mile-long debris field with most of the debris contained in a section that was 1,036 ft long and 290 ft wide. The Cessna and the Grumman came to rest about 220 ft apart.

Cessna 170B

Examination of the Cessna wreckage revealed that the aft fuselage had completely separated, just forward of the empennage, from the rest of the airplanes structure. The empennage was attached to the rest of the airplane by the control cables for the elevator, rudder, and pitch trim, which were twisted around each other multiple times. Further examination of the aft fuselage and empennage also revealed paint transfer marks that matched the trim color of the Grumman. These marks appeared on the leading edge of the vertical stabilizer, which had been crushed back; the right horizontal stabilizer; and the right side of the aft fuselage.

The Cessna's right wing flap came to rest about 397 ft northeast of the Cessna main wreckage. The inboard section of the right aileron was missing. The right aileron control cables and both right wing flap tracks had been severed, and the area just forward of the right wing flap mounting location displayed evidence of propeller strikes and was missing large sections of its structure.

Grumman American AA-5B

Examination of the wreckage of the Grumman revealed that no major portions of the airplane were missing. Both wings displayed heavy crush and compression damage. The fuselage was accordioned downward and forward, and the empennage was scorpioned forward. The top of the vertical stabilizer came to rest on the ground forward of the engine mounting location. The leading edges of the propeller blades were damaged and displayed semicircular gouges that matched the diameter of the aileron cables in the Cessna's right wing. 

Medical And Pathological Information

The Office of the Medical Examiner, Daytona Beach, Florida, performed autopsies on the pilots of the Cessna and the Grumman and determined that their cause of death was multiple blunt force injuries.

Toxicology testing for both pilots was performed at the FAA Forensic Science Laboratory. The results for the Cessna pilot were negative for carbon monoxide and ethanol. The drug atorvastatin, which is a statin used for lowering blood cholesterol, was detected in liver and blood samples. This drug is generally considered not to be impairing. The results for the Grumman pilot were negative for ethanol and tested-for drugs.

Additional Information

Formation Flights From 7FL6

According to a pilot based at 7FL6 who was familiar with the formation flying activities that occurred there, in 1985, three individuals began to operate formation flights from 7FL6. Formation flying grew over the years, and, at the time of the accident, more than 100 pilots were conducting extensive formation flights from 7FL6. Practice formation flights usually occurred on Wednesdays and Thursdays. On Saturday mornings, pilots would meet, brief, and set up multiple formation flights, which usually consisted of about 40 airplanes that operated in groups of 4 airplanes per flight, to fly to other airports for breakfast. These flights would sometimes have passengers on board. Formation flights would also operate with numerous airplanes in the formation during other events at 7FL6. Additionally, formation flights would be operated at 30 to 40 public fly-by events per year. He also stated that no one was in charge of organizing and overseeing the formation flights, and that the "Gaggle Flight Formation Group" was not an organization, no member paid any dues, and "we are a non-entity."



Formation Flying Standards Organizations

In response to a perceived need within the warbird community to standardize formation flying and increase its safety, the "Formation and Safety Training" National Standard Program was developed. Prior to this, various warbird organizations had created and were using procedures and signals unique to their membership background.

In 1993, the Warbird Operators Conference agreed to adopt a common national program for formation flying. Committee action resulted in acceptance of the T-34 Association "Formation Flight Manual" and the Darton Video "Formation Flying, The Art" as common standards by five organizations within the warbird community: the Canadian Harvard Aircraft Association, Confederate Air Force, EAA (Experimental Aircraft Association) Warbirds of America, North American Trainer Association, and the T-34 Association. A Formation and Safety Team (FAST) was charged to develop formation standardization materials, appoint check pilots, determine evaluation and flight check administration methods, and create manuals.

In 1995, the Valiant Air Command and the YAK Pilots Club (now know as the Red Star Pilots Association) joined FAST, and the Joint Liaison Formation Committee which was developed to encourage and enforce safety, standardization, and proficiency in liaison and light trainer formation flying was approved to use FAST documents and manuals.

In 1997, the FAA began requiring local Flight Standards District Offices (FSDOs) to include in airshow waiver approvals a stipulation that anyone participating in non-aerobatic formation flight during an airshow must possess valid industry formation training and an evaluation credential acceptable to FAA. Cards (similar to a wallet sized pilot certificate) had been developed by FAST to show as appropriate credentials and the International Council of Airshows (ICAS) also had a non-aerobatic formation card. However, since the FAST was recognized by FAA as a warbird only organization, the many and diverse groups of formation flyers outside the warbird community were now excluded from participating in formation within waivered airspace during an airshow unless they had an ICAS non-aerobatic formation card. Then, in late 1998, ICAS terminated issuance of non-aerobatic formation cards.

Discussions between Experimental Aircraft Association (EAA), FAST, and FAA in late 1997 resulted in FAST authorization for EAA to also use copyrighted FAST materials to create its own formation flying program dedicated to the EAA aircraft community. Subsequent discussions resulted in the forming of an independent corporation, Formation Flying, Inc. (FFI), to which EAA would become a signatory.

Since that time, about 20 signatory programs have been providing standards for formation training and flying, a system for proficiency evaluation, and a method for monitoring currency. They also use formation standards evaluation guides, forms, and manuals, along with a program to approve the issuance of formation pilot credentials based on demonstrated competency and maintained currency.

According to the leader of the Gaggle Flight Formation Group, some of the pilots that operated formation flights from 7FL6 had a FAST formation qualification card, and the group "backed away" from using FAST because "it got into a clique thing." He stated that the group was "careful" about new pilots who wanted to operate formation flights with them. He further stated that the group would ask the new pilots if they had any formation flying experience and would offer training. If any of the new pilots did not want training, they could still operate flights, but group members "would keep them at a distance, until they [the group members] could determine if they [the new pilots] could fly formation."

Review of the "Gaggle Flight" Formation Manual did not reveal any evidence of a structured program that provided standards for formation training and flying, a system for proficiency evaluation, a method for monitoring currency, or any formation standards evaluation guides or forms. No integrated program existed at 7FL6 to approve the issuance of formation pilot credentials based on demonstrated competency and maintained currency for the multiple formation groups that were operating at the airport.

Flight Leader Responsibilities

According to FAST's Foundation and Principles document, assuming the role of flight leader is a huge undertaking. In addition to being able to fly smoothly, providing a stable platform for the wingmen, Lead must monitor the wingmen, monitor the flight environment, and plan well ahead of the formation. The flight leader's responsibilities also include, but are not limited to:

• Safe conduct of flight
• Selection of wingmen
• Verification of pilots' credentials, currency and competency in type
• Mission planning
• Briefing the mission
• Debriefing the mission
• Training new formation pilots
• Endorsing Formation Proficiency Reports (FPR)
• Recommending pilots for Wing and Lead check rides

According to Formation Flying Inc., the flight leader is also responsible for the safe conduct of all formation flight under his/her control. He/she is responsible for approving all members in the flight. This implies the flight leader is familiar with the experience level, currencies, and credentials of each member with respect to the mission to be accomplished.

Flight leaders should identify members needing additional training and recommend or give it where necessary, even to the point of recommending recertification under their program. Flight leaders should assess the state of proficiency of wingman and flight leaders and forward recommendations when appropriate for certification to regional Program check pilots.

Leadership ability is the most important quality to be evaluated as a Flight Leader applicant. The applicant must demonstrate not only that he/she has the pilot skills and is in charge, but also that flight members can be confident and comfortable in following maneuvers and instructions. Flight leadership implies above average knowledge of aircraft and performance limitations, airspace and air traffic control environment, wingmen and their limitations, formation procedures, operational techniques, and signals, as well as excellent situational awareness.

The "Gaggle Flight" Formation Manual gave only minimal guidance about the flight leader's responsibilities, stating that, in any formation, the leader is responsible for "maintaining visual lookout for his flight, flying his aircraft as smoothly as possible, and keeping power changes and control inputs to a minimum." The manual also indicated that the flight leader "should brief the flight and then execute the profile as closely as possible. If changes are required, he should inform his wingmen accordingly."

Wingman Responsibilities

According to FAST, being a good wingman means more than just hanging on Lead's wing. The wingman is part of a disciplined team, and with that comes additional responsibilities:

• Provide mutual support
• Maintain formation integrity
• Assist in mission planning, if requested
• Keep Lead in sight at all times
• Be aware of departure, enroute and arrival routing so he can assume the lead, if required
• Monitor Lead for proper configuration and abnormal conditions
• Assist during abnormals or emergencies, as directed
• Monitor radio communication
• Trust and follow Lead's direction

According to FFI, a wingman, should use familiar phrases, should aim high, be the best they can be, and trust in the leader, maintain currency, and learn the traits of a good leader.

According to the "Gaggle Flight" Formation Manual, the wingman "is always flying off the leader. As a wingman you should position yourself so that you are in a comfortable position keeping in mind what has been briefed as the ideal wing position." The manual also stated that "normally Gaggle Flight will fly with the wingman stacked slightly low with nose tail separation and wing tip separation. This is a reasonably comfortable position for most flights that have four aircraft." In addition, the manual stated, "remember when flying in the number 2 position you set the spacing for the rest of the formation."

Dissimilar Aircraft in Same Formation

The Cessna 170B and the Grumman American AA-5B were dissimilar aircraft because the Cessna was a high-wing airplane and the Grumman was a low-wing airplane. The pilot of the Cessna would have had limited visibility outside of the cockpit to any area that was directly above, or above and to the left or right of the cockpit due to the cabin roof and wings. The converse would generally be true for the low wing aircraft, like the Grumman, operating in the formation.

FAA Formation Flight Regulation and Guidance

According to 14 CFR Part 91.111, Operating Near Other Aircraft,

(a) No person may operate an aircraft so close to another aircraft as to create a collision hazard.
(b) No person may operate an aircraft in formation flight except by arrangement with the pilot in command of each aircraft in the formation.
(c) No person may operate an aircraft, carrying passengers for hire, in formation flight.

According to the section in FAA Advisory Circular AC-90-48D, Pilots' Role in Collision Avoidance, discussing flying in formation,

Several midair collisions have occurred which involved aircraft on the same mission, with each pilot aware of the other's presence. Pilots who are required, by the nature of their operations, to fly in pairs or in formation are cautioned to:

1. Recognize the high statistical probability of their involvement in midair collisions.
2. Make sure that adequate preflight preparations are made and the procedures to be followed are understood by all pilots intending to participate in the mission.
3. Always keep the other aircraft in sight despite possible distraction and preoccupation with other mission requirements.
4. Avoid attempting formation flight without having obtained instruction and attained the skill necessary for conducting such operations.



N425AE Aviation Accident Factual Report - National Transportation Safety Board: https://app.ntsb.gov/pdf


N425AE Investigation Document - National Transportation Safety Board: https://dms.ntsb.gov/pubdms

http://registry.faa.gov/N425AE


Location: Edgewater, FL
Accident Number: ERA17FA143B
Date & Time: 04/01/2017, 0846 EDT
Registration: N425AE
Aircraft: GRUMMAN AMERICAN AVN. CORP. AA-5B
Aircraft Damage: Destroyed
Defining Event: Midair collision
Injuries: 1 Fatal
Flight Conducted Under: Part 91: General Aviation - Personal 

On April 1, 2017, about 0846 eastern daylight time, a Cessna 170B, N8082D, and a Grumman American AA-5B, N425AE, were destroyed during an in-flight collision over Edgewater, Florida. The airline transport pilot flying the Cessna and the airline transport pilot flying the Grumman were fatally injured. Both airplanes were owned and operated by their respective pilots as Title 14 Code of Federal Regulations (CFR) Part 91 personal flights. No flight plans were filed, and visual meteorological conditions prevailed at the time of the accident. The airplanes were part of a recreational formation flight that departed from Spruce Creek Airport (7FL6), Daytona Beach, Florida, about 0839 and were destined for Arthur Dunn Airpark (X21), Titusville, Florida.

Three other airplanes were part of the formation flight: a Great Lakes biplane, a Grumman AA-1C (referred to in this report as the Lynx), and an American Champion 8KCAB (referred to in this report as the Super Decathlon). All five pilots participating in the formation flight were members of a pilot group based at 7FL6. On the morning of the accident, the group members were flying to X21 to attend a monthly breakfast event.

The five-airplane formation flight took off from 7FL6. The flight leader was flying the biplane, which took off with the accident Grumman in formation first; the accident Cessna and the Lynx took off in formation next followed by the Super Decathlon. The flight initially formed into a five-airplane "V" formation (see figure 1), with the biplane at the apex, the Grumman in the No. 2 position (to the left and aft of the biplane), the Cessna in the No. 3 position (to the right and aft of the biplane), the Lynx in the No. 4 position (to the right and aft of the Cessna), and the Super Decathlon in the No. 5 position (to the left and aft of the Grumman).


Figure 1 – Example of a 5-airplane "V" formation (aircraft pictured not representative of those involved in this accident).

The formation flight then turned south toward X21. Due to the position of the sun, the flight leader decided to change to a left echelon formation (see figure 2), which would have allowed the pilots to avoid the sun glare. In the left echelon formation, the airplanes would be arranged diagonally to the left of the biplane, with each airplane positioned slightly lower than (stepped down), behind, and to the left of the airplane ahead. This formation would require the Cessna and the Lynx to transition across the formation from right to left behind the leader. The Grumman would remain in the No. 2 position to the left and aft of the leader; the Cessna, in the No. 3 position, would be to the left and aft of the Grumman; the Lynx, in the No. 4 position, would be to the left and aft of the Cessna; and the Super Decathlon, in the No. 5 position, would be to the left and aft of the Lynx.


Figure 2 – Example of a 5-airplane echelon left formation (aircraft pictured not representative of those involved in this accident).

According to the flight leader, moments after he commanded the Cessna and the Lynx to transition across the formation to the left, he saw at his 7:00 position a "flash" of something white that looked like the bottom of an airplane.

According to the pilot of the Lynx, when the flight leader commanded his airplane and the Cessna to transition to the left, he heard the flight leader state "cleared to cross," and he observed the Cessna start to move to the left "slow and normal." The Lynx pilot stayed with the Cessna, and, when the Cessna was almost on the left echelon bearing line, he saw the airplane move into position behind the Grumman. The Lynx pilot then suddenly saw "parts" coming toward him on his airplane's right side along with what appeared to be "vapor." The Lynx pilot also saw the Grumman abruptly pitch up and go past him above and to the right of his airplane. The Lynx pilot stated that the Grumman looked as if it was entering a loop because the airplane's nose was already past vertical and he could see the top of the airplane. He observed something on the right side of the Cessna move upward before the Cessna's tail began to "slew left," and then the Cessna disappeared from his view.

The biplane and the Lynx then broke formation, with the biplane immediately pulling up and turning hard left and the Lynx entering a 60° left bank. The flight leader could see airplane parts falling to the ground and the Cessna descending "like a falling leaf maneuver" with what appeared to be the airplane's right wing folded over. The flight leader then began to circle the accident site and reported the accident to an air traffic controller at New Smyrna Beach Municipal Airport, (EVB), New Smyrna Beach, Florida. Afterward, the flight leader continued to circle the accident site until emergency responders arrived.

Witnesses who were driving on Interstate 95 (I-95) saw the formation flight traveling southbound. They observed that the formation flight was about 1/4 mile west of I-95 when the collision occurred, and they observed part of the wing on one airplane come off and the airplane tumble and rapidly descend tail low until it descended behind a tree line. They also saw the other airplane descend rapidly, almost straight down, until losing sight of it. Further, the witnesses saw parts from both airplanes descend to the ground, with one piece landing in the median between the northbound and southbound lanes of I-95.

The Cessna and the Grumman were equipped with handheld GPS units. The GPS device in the Grumman was impact damaged, and data were unable to be extracted using normal means. The data extracted from the GPS device in the Cessna, a Garmin Aera 510, included data from the day of the accident starting at 0743:55.

According to the GPS data, on the day of the accident, the Cessna took off from runway 23 about 0839:38 and began a turn to the left. Upon reaching the end of the runway, the Cessna was at a GPS altitude of 202 ft. The Cessna flew over residences at a GPS altitude of 220 ft and continued turning until it was on a ground track of about 142°. For about the next 2 miles, the airplane climbed slowly, reaching a GPS altitude of 634 ft at 0841:15. The Cessna continued to climb and, about 7.8 miles later, at 0846:13, the GPS data indicated that the airplane had begun to descend rapidly to the ground near the location of the accident site.

The pilot of the Lynx provided a screenshot from his GPS unit to assist the National Transportation Safety Board (NTSB) in determining the route of flight for the formation flight. A comparison of the GPS data from the Lynx and the Cessna indicated that both airplanes had flown the same route of flight.



PERSONNEL INFORMATION

According to Federal Aviation Administration (FAA) records, the pilot of the Cessna held an airline transport pilot certificate with a rating for airplane multiengine land and commercial privileges for airplane single-engine land. He also held a flight instructor certificate with ratings for airplane single-engine, airplane multiengine, and instrument airplane; a flight engineer certificate with a rating for flight engineer turbojet powered; and a mechanic certificate with airframe and powerplant ratings. He also held type ratings for the Boeing 737, 757, 767, and 777 and the Beechcraft 1900 and 300. His most recent FAA first-class medical certificate was issued on February 10, 2017, with no limitations. He had accrued about 24,237 hours total flight experience as of March 2017.

According to FAA records, the pilot of the Grumman held an airline transport pilot certificate with a rating for airplane multiengine land and commercial privileges for airplane single-engine land and airplane single-engine sea. She also held a flight instructor certificate with ratings for airplane single-engine, airplane multiengine, and instrument airplane; a flight engineer certificate with a rating for flight engineer turbojet powered; and a ground instructor certificate with ratings for advanced and instrument. In addition, she held type ratings for the Airbus A-330; Boeing 747, 757, and 767; Beechcraft 1900; and Cessna 510S. Her most recent FAA first-class medical certificate was issued on October 19, 2016, with no limitations. She had accrued about 11,368 hours total flight experience as of March 2016. 

Pilot Information

Certificate: Airline Transport
Age: 66, Female
Airplane Rating(s): Multi-engine Land; Single-engine Land; Single-engine Sea
Seat Occupied: Left
Other Aircraft Rating(s): None
Restraint Used: 3-point
Instrument Rating(s): Airplane
Second Pilot Present: No
Instructor Rating(s):  Airplane Multi-engine; Airplane Single-engine; Instrument Airplane
Toxicology Performed: Yes
Medical Certification: Class 1 Without Waivers/Limitations
Last FAA Medical Exam: 10/19/2016
Occupational Pilot: No
Last Flight Review or Equivalent: 10/18/2015
Flight Time:  (Estimated) 11368 hours (Total, all aircraft), 2032 hours (Pilot In Command, all aircraft) 

Aircraft and Owner/Operator Information

Aircraft Make: GRUMMAN AMERICAN AVN. CORP.
Registration: N425AE
Model/Series: AA-5B
Aircraft Category: Airplane
Year of Manufacture:
Amateur Built: No
Airworthiness Certificate: Normal; Utility
Serial Number: AA5B0487
Landing Gear Type: Tricycle
Seats: 4
Date/Type of Last Inspection: 09/01/2016, Annual
Certified Max Gross Wt.: 2401 lbs
Time Since Last Inspection:
Engines: 1 Reciprocating
Airframe Total Time: 1673.44 Hours as of last inspection
Engine Manufacturer: LYCOMING
ELT:  C91A installed, not activated
Engine Model/Series: O-360-A4K
Registered Owner: ANNIES THINGS LLC
Rated Power: 180 hp
Operator: On file
Operating Certificate(s) Held: None

Cessna 170B

The Cessna 170B was a four-seat, tailwheel-equipped, strut-braced, high-wing airplane. It was powered by a 6-cylinder, air-cooled, 145-horsepower Continental O-300-A engine that drove a 2-bladed McCauley fixed-pitch propeller.

According to FAA and maintenance records, the airplane was manufactured in 1952. Its most recent annual inspection was completed on October 1, 2016. At the time of the inspection, the airplane had accrued a total of 4,596.8 hours of operation.

Grumman American AA-5B

The Grumman American AA-5B was a four-seat, nosewheel-equipped, fully cantilevered, low-wing airplane. It was powered by a 4-cylinder, air-cooled, 180-horsepower Lycoming O-360-A4K engine that drove a 2-bladed Sensenich fixed-pitch propeller.

According to FAA and maintenance records, the Grumman was manufactured in 1977. Its most recent annual inspection was completed on September 1, 2016. At the time of the inspection, the airplane had accrued a total of 1,673.4 hours of operation.

Meteorological Information and Flight Plan

Conditions at Accident Site: Visual Conditions
Condition of Light: Day
Observation Facility, Elevation: KEVB, 10 ft msl
Distance from Accident Site: 6 Nautical Miles
Observation Time: 0847 EDT
Direction from Accident Site: 5°
Lowest Cloud Condition: Scattered / 5000 ft agl
Visibility:  10 Miles
Lowest Ceiling: None
Visibility (RVR):
Wind Speed/Gusts: 6 knots /
Turbulence Type Forecast/Actual: / None
Wind Direction: 260°
Turbulence Severity Forecast/Actual: / N/A
Altimeter Setting: 30.02 inches Hg
Temperature/Dew Point: 20°C / 17°C
Precipitation and Obscuration: No Obscuration; No Precipitation
Departure Point: DAYTONA BEACH, FL (7FL6)
Type of Flight Plan Filed: None
Destination: TITUSVILLE, FL (X21)
Type of Clearance: None
Departure Time: 0839 EDT
Type of Airspace: Class G 

At 0847 (1 minute after the accident), the recorded weather at EVB, which was located 6 nautical miles north of the accident site, included wind from 260° at 6 knots, visibility 10 miles, scattered clouds at 5,000 ft, temperature 20°C, dew point 17°C, and an altimeter setting of 30.02 inches of mercury.

According to the US Naval Observatory, at 0840 (6 minutes before the accident) in the area of the accident location, the altitude of the sun was 18.2° above the horizon, and the azimuth of the sun was 94.7° east of north. 

Wreckage and Impact Information

Crew Injuries: 1 Fatal
Aircraft Damage: Destroyed
Passenger Injuries: N/A
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 1 Fatal
Latitude, Longitude: 28.959444, -80.957222 

Examination of the accident site revealed a 1/4-mile-long debris field with most of the debris contained in a section that was 1,036 ft long and 290 ft wide. The Cessna and the Grumman came to rest about 220 ft apart.

Cessna 170B

Examination of the Cessna wreckage revealed that the aft fuselage had completely separated, just forward of the empennage, from the rest of the airplanes structure. The empennage was attached to the rest of the airplane by the control cables for the elevator, rudder, and pitch trim, which were twisted around each other multiple times. Further examination of the aft fuselage and empennage also revealed paint transfer marks that matched the trim color of the Grumman. These marks appeared on the leading edge of the vertical stabilizer, which had been crushed back; the right horizontal stabilizer; and the right side of the aft fuselage.

The Cessna's right wing flap came to rest about 397 ft northeast of the Cessna main wreckage. The inboard section of the right aileron was missing. The right aileron control cables and both right wing flap tracks had been severed, and the area just forward of the right wing flap mounting location displayed evidence of propeller strikes and was missing large sections of its structure.

Grumman American AA-5B

Examination of the wreckage of the Grumman revealed that no major portions of the airplane were missing. Both wings displayed heavy crush and compression damage. The fuselage was accordioned downward and forward, and the empennage was scorpioned forward. The top of the vertical stabilizer came to rest on the ground forward of the engine mounting location. The leading edges of the propeller blades were damaged and displayed semicircular gouges that matched the diameter of the aileron cables in the Cessna's right wing. 



Medical And Pathological Information

The Office of the Medical Examiner, Daytona Beach, Florida, performed autopsies on the pilots of the Cessna and the Grumman and determined that their cause of death was multiple blunt force injuries.

Toxicology testing for both pilots was performed at the FAA Forensic Science Laboratory. The results for the Cessna pilot were negative for carbon monoxide and ethanol. The drug atorvastatin, which is a statin used for lowering blood cholesterol, was detected in liver and blood samples. This drug is generally considered not to be impairing. The results for the Grumman pilot were negative for ethanol and tested-for drugs.



Additional Information

Formation Flights From 7FL6

According to a pilot based at 7FL6 who was familiar with the formation flying activities that occurred there, in 1985, three individuals began to operate formation flights from 7FL6. Formation flying grew over the years, and, at the time of the accident, more than 100 pilots were conducting extensive formation flights from 7FL6. Practice formation flights usually occurred on Wednesdays and Thursdays. On Saturday mornings, pilots would meet, brief, and set up multiple formation flights, which usually consisted of about 40 airplanes that operated in groups of 4 airplanes per flight, to fly to other airports for breakfast. These flights would sometimes have passengers on board. Formation flights would also operate with numerous airplanes in the formation during other events at 7FL6. Additionally, formation flights would be operated at 30 to 40 public fly-by events per year. He also stated that no one was in charge of organizing and overseeing the formation flights, and that the "Gaggle Flight Formation Group" was not an organization, no member paid any dues, and "we are a non-entity."

Formation Flying Standards Organizations

In response to a perceived need within the warbird community to standardize formation flying and increase its safety, the "Formation and Safety Training" National Standard Program was developed. Prior to this, various warbird organizations had created and were using procedures and signals unique to their membership background.

In 1993, the Warbird Operators Conference agreed to adopt a common national program for formation flying. Committee action resulted in acceptance of the T-34 Association "Formation Flight Manual" and the Darton Video "Formation Flying, The Art" as common standards by five organizations within the warbird community: the Canadian Harvard Aircraft Association, Confederate Air Force, EAA (Experimental Aircraft Association) Warbirds of America, North American Trainer Association, and the T-34 Association. A Formation and Safety Team (FAST) was charged to develop formation standardization materials, appoint check pilots, determine evaluation and flight check administration methods, and create manuals.

In 1995, the Valiant Air Command and the YAK Pilots Club (now know as the Red Star Pilots Association) joined FAST, and the Joint Liaison Formation Committee which was developed to encourage and enforce safety, standardization, and proficiency in liaison and light trainer formation flying was approved to use FAST documents and manuals.

In 1997, the FAA began requiring local Flight Standards District Offices (FSDOs) to include in airshow waiver approvals a stipulation that anyone participating in non-aerobatic formation flight during an airshow must possess valid industry formation training and an evaluation credential acceptable to FAA. Cards (similar to a wallet sized pilot certificate) had been developed by FAST to show as appropriate credentials and the International Council of Airshows (ICAS) also had a non-aerobatic formation card. However, since the FAST was recognized by FAA as a warbird only organization, the many and diverse groups of formation flyers outside the warbird community were now excluded from participating in formation within waivered airspace during an airshow unless they had an ICAS non-aerobatic formation card. Then, in late 1998, ICAS terminated issuance of non-aerobatic formation cards.

Discussions between Experimental Aircraft Association (EAA), FAST, and FAA in late 1997 resulted in FAST authorization for EAA to also use copyrighted FAST materials to create its own formation flying program dedicated to the EAA aircraft community. Subsequent discussions resulted in the forming of an independent corporation, Formation Flying, Inc. (FFI), to which EAA would become a signatory.

Since that time, about 20 signatory programs have been providing standards for formation training and flying, a system for proficiency evaluation, and a method for monitoring currency. They also use formation standards evaluation guides, forms, and manuals, along with a program to approve the issuance of formation pilot credentials based on demonstrated competency and maintained currency.

According to the leader of the Gaggle Flight Formation Group, some of the pilots that operated formation flights from 7FL6 had a FAST formation qualification card, and the group "backed away" from using FAST because "it got into a clique thing." He stated that the group was "careful" about new pilots who wanted to operate formation flights with them. He further stated that the group would ask the new pilots if they had any formation flying experience and would offer training. If any of the new pilots did not want training, they could still operate flights, but group members "would keep them at a distance, until they [the group members] could determine if they [the new pilots] could fly formation."

Review of the "Gaggle Flight" Formation Manual did not reveal any evidence of a structured program that provided standards for formation training and flying, a system for proficiency evaluation, a method for monitoring currency, or any formation standards evaluation guides or forms. No integrated program existed at 7FL6 to approve the issuance of formation pilot credentials based on demonstrated competency and maintained currency for the multiple formation groups that were operating at the airport.

Flight Leader Responsibilities

According to FAST's Foundation and Principles document, assuming the role of flight leader is a huge undertaking. In addition to being able to fly smoothly, providing a stable platform for the wingmen, Lead must monitor the wingmen, monitor the flight environment, and plan well ahead of the formation. The flight leader's responsibilities also include, but are not limited to:

• Safe conduct of flight
• Selection of wingmen
• Verification of pilots' credentials, currency and competency in type
• Mission planning
• Briefing the mission
• Debriefing the mission
• Training new formation pilots
• Endorsing Formation Proficiency Reports (FPR)
• Recommending pilots for Wing and Lead check rides

According to Formation Flying Inc., the flight leader is also responsible for the safe conduct of all formation flight under his/her control. He/she is responsible for approving all members in the flight. This implies the flight leader is familiar with the experience level, currencies, and credentials of each member with respect to the mission to be accomplished.

Flight leaders should identify members needing additional training and recommend or give it where necessary, even to the point of recommending recertification under their program. Flight leaders should assess the state of proficiency of wingman and flight leaders and forward recommendations when appropriate for certification to regional Program check pilots.

Leadership ability is the most important quality to be evaluated as a Flight Leader applicant. The applicant must demonstrate not only that he/she has the pilot skills and is in charge, but also that flight members can be confident and comfortable in following maneuvers and instructions. Flight leadership implies above average knowledge of aircraft and performance limitations, airspace and air traffic control environment, wingmen and their limitations, formation procedures, operational techniques, and signals, as well as excellent situational awareness.

The "Gaggle Flight" Formation Manual gave only minimal guidance about the flight leader's responsibilities, stating that, in any formation, the leader is responsible for "maintaining visual lookout for his flight, flying his aircraft as smoothly as possible, and keeping power changes and control inputs to a minimum." The manual also indicated that the flight leader "should brief the flight and then execute the profile as closely as possible. If changes are required, he should inform his wingmen accordingly."

Wingman Responsibilities

According to FAST, being a good wingman means more than just hanging on Lead's wing. The wingman is part of a disciplined team, and with that comes additional responsibilities:

• Provide mutual support
• Maintain formation integrity
• Assist in mission planning, if requested
• Keep Lead in sight at all times
• Be aware of departure, enroute and arrival routing so he can assume the lead, if required
• Monitor Lead for proper configuration and abnormal conditions
• Assist during abnormals or emergencies, as directed
• Monitor radio communication
• Trust and follow Lead's direction

According to FFI, a wingman, should use familiar phrases, should aim high, be the best they can be, and trust in the leader, maintain currency, and learn the traits of a good leader.

According to the "Gaggle Flight" Formation Manual, the wingman "is always flying off the leader. As a wingman you should position yourself so that you are in a comfortable position keeping in mind what has been briefed as the ideal wing position." The manual also stated that "normally Gaggle Flight will fly with the wingman stacked slightly low with nose tail separation and wing tip separation. This is a reasonably comfortable position for most flights that have four aircraft." In addition, the manual stated, "remember when flying in the number 2 position you set the spacing for the rest of the formation."

Dissimilar Aircraft in Same Formation

The Cessna 170B and the Grumman American AA-5B were dissimilar aircraft because the Cessna was a high-wing airplane and the Grumman was a low-wing airplane. The pilot of the Cessna would have had limited visibility outside of the cockpit to any area that was directly above, or above and to the left or right of the cockpit due to the cabin roof and wings. The converse would generally be true for the low wing aircraft, like the Grumman, operating in the formation.

FAA Formation Flight Regulation and Guidance

According to 14 CFR Part 91.111, Operating Near Other Aircraft,

(a) No person may operate an aircraft so close to another aircraft as to create a collision hazard.
(b) No person may operate an aircraft in formation flight except by arrangement with the pilot in command of each aircraft in the formation.
(c) No person may operate an aircraft, carrying passengers for hire, in formation flight.

According to the section in FAA Advisory Circular AC-90-48D, Pilots' Role in Collision Avoidance, discussing flying in formation,

Several midair collisions have occurred which involved aircraft on the same mission, with each pilot aware of the other's presence. Pilots who are required, by the nature of their operations, to fly in pairs or in formation are cautioned to:

1. Recognize the high statistical probability of their involvement in midair collisions.
2. Make sure that adequate preflight preparations are made and the procedures to be followed are understood by all pilots intending to participate in the mission.
3. Always keep the other aircraft in sight despite possible distraction and preoccupation with other mission requirements.
4. Avoid attempting formation flight without having obtained instruction and attained the skill necessary for conducting such operations.

2 comments:

Anonymous said...


That's a steep price to pay trying to be cool. Formation flying to a breakfast gathering....really? Probably seemed like a good idea at the the time.

Anonymous said...

Personally, I would never fly form in a gaggle of dissimilar types of airplanes, particularly if you’re combining high wing with low wing airplanes. Not to mention flying with people who never at some point in their aviation career had done it for a living (ie., in the military in tactical airplanes or on the airshow circuit) or thoroughly trained by someone of that background and well proven in the discipline. It is a sure and certain recipe for disaster.