Saturday, August 3, 2019

Midair Collision: Piper PA-34-200 Seneca, N16281 and Cessna 172N Skyhawk, N6428D, fatal accident occurred July 17, 2018 near Miami Executive Airport (KTMB), Kendall, Miami-Dade County, Florida

Ralph Knight, 72
Designated Pilot Examiner (DPE)
  Piper PA-34-200 Seneca, N16281

Nisha Sejwal, 19
Private Pilot
Piper PA-34-200 Seneca, N16281

Jorge Sanchez, 22
Flight Instructor
 Cessna 172N Skyhawk, N6428D

The fourth victim was identified as Carlos Alfredo Zanetti Scarpati, 22, "a fairly new student pilot" at Dean International Flight School based out of Miami Executive Airport. He was in the Cessna 172N Skyhawk, N6428D with pilot Jorge Sanchez, 22, at the time of the fatal crash.



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

Additional Participating Entities:

Federal Aviation Administration / Flight Standards District Office; Miramar, Florida
Piper Aircraft; Vero Beach, Florida
Textron; Wichita, Kansas 

N16281 Aviation Accident Factual Report - National Transportation Safety Board: https://app.ntsb.gov/pdf


N16281 Investigation Docket - National Transportation Safety Board: https://dms.ntsb.gov/pubdms

http://registry.faa.gov/N16281



Location: Miami, FL
Accident Number: ERA18FA194A
Date & Time: 07/17/2018, 1259 EDT
Registration: N16281
Aircraft: Piper PA34
Aircraft Damage: Destroyed
Defining Event: Midair collision
Injuries: 2 Fatal
Flight Conducted Under: Part 91: General Aviation - Instructional 

On July 17, 2018, at 1259 eastern daylight time, a Piper PA-34-200, N16281, and a Cessna 172N, N6428D, collided in midair about 9 miles northwest of Miami Executive Airport (TMB), Miami, Florida. The private pilot and designated pilot examiner (DPE) onboard the Piper and the flight instructor and student pilot onboard the Cessna were fatally injured; both airplanes were destroyed. Both airplanes were registered to and were being operated by Dean International, Inc., as Title 14 Code of Federal Regulations Part 91 flights. The Piper pilots were conducting an evaluation flight for a commercial pilot certificate and the Cessna pilots were conducting a cross-country instructional flight. Visual meteorological conditions prevailed and no flight plan was filed for either flight. The Piper departed TMB on a local flight at 1253, and the Cessna departed Immokalee Regional Airport (IMM), Immokalee, Florida, at 1217, destined for TMB.

According air traffic control data provided by the Federal Aviation Administration (FAA), the Piper was en route to a nearby training area at an altitude of about 1,500 ft mean sea level (msl) and was no longer communicating with the TMB tower controller as the airplane was outside the Class D airspace. The Cessna was returning to TMB at an altitude of about 1,500 ft msl and had contacted the TMB tower controller just before the collision. The controller acknowledged the transmission and issued a traffic advisory, but no further communications were received from the Cessna. Review of radar data revealed the two targets converged nearly straight-on. At the time of the collision, the Piper was flying northwest and the Cessna was flying southeast.

Pilot Information

Certificate: Private
Age: 19, Female
Airplane Rating(s): Single-engine Land
Seat Occupied: Left
Other Aircraft Rating(s): None
Restraint Used:
Instrument Rating(s): Airplane
Second Pilot Present: Yes
Instructor Rating(s):None 
Toxicology Performed: Yes
Medical Certification: Class 1 Without Waivers/Limitations
Last FAA Medical Exam: 09/29/2017
Occupational Pilot: No
Last Flight Review or Equivalent:
Flight Time: 253 hours (Total, all aircraft)

Check Pilot Information

Certificate: Airline Transport; Commercial
Age: 72, Male
Airplane Rating(s): Multi-engine Land; Multi-engine Sea; Single-engine Land; Single-engine Sea
Seat Occupied: Right
Other Aircraft Rating(s): Glider
Restraint Used:
Instrument Rating(s): Airplane
Second Pilot Present: Yes
Instructor Rating(s): Airplane Multi-engine; Airplane Single-engine; Instrument Airplane
Toxicology Performed: Yes
Medical Certification: Class 2 With Waivers/Limitations
Last FAA Medical Exam: 08/16/2017
Occupational Pilot: Yes
Last Flight Review or Equivalent:
Flight Time: 26000 hours (Total, all aircraft)




Piper

The pilot held a private pilot certificate with ratings for airplane single-engine land and instrument airplane. Her most recent first-class FAA medical certificate was issued on September 29, 2017. According to her application for a commercial pilot certificate, dated July 17, 2018, she reported a total flight experience of 253 hours. The pilot's logbook was not recovered.

The DPE held an airline transport pilot certificate with ratings for airplane single-engine land, airplane single-engine sea, airplane multiengine land, and airplane multiengine sea. He also held a commercial pilot certificate with a rating for glider. Additionally, he held a flight instructor certificate with ratings for airplane single-engine, airplane multiengine, and instrument airplane. His most recent second-class FAA medical certificate was issued on August 16, 2017. At that time, he reported a total flight experience of 26,000 hours. The DPE's logbook was not recovered.

Cessna

The flight instructor held a commercial pilot certificate with ratings for airplane single-engine land and instrument airplane. He also held a flight instructor certificate with a rating for airplane single-engine. His most recent first-class FAA medical certificate was issued on December 15, 2014. According to his application for a flight instructor certificate, dated March 18, 2018, he reported a total flight experience of 311 hours. The flight instructor's logbook was not recovered.

The student pilot's most recent first-class FAA medical certificate was issued on March 20, 2018. According to the student pilot's logbook, he had a total flight experience of 52 hours.

Aircraft and Owner/Operator Information

Aircraft Make: Piper
Registration: N16281
Model/Series: PA34 200
Aircraft Category: Airplane
Year of Manufacture:1973 
Amateur Built: No
Airworthiness Certificate: Normal
Serial Number: 34-7350122
Landing Gear Type: Retractable - Tricycle
Seats: 6
Date/Type of Last Inspection: 06/19/2018, Annual
Certified Max Gross Wt.: 4200 lbs
Time Since Last Inspection:
Engines: 2 Reciprocating
Airframe Total Time: 10153 Hours as of last inspection
Engine Manufacturer: Lycoming
ELT: C91  installed, not activated
Engine Model/Series: IO-360-C1E6
Registered Owner: Dean International Inc
Rated Power: 200 hp
Operator: Dean International Inc
Operating Certificate(s) Held: Pilot School (141) 

The Piper was a six-seat, low-wing, retractable tricycle gear airplane manufactured in 1973. It was powered by two counter-rotating Lycoming IO-360 200-horsepower engines, both equipped with two-blade Hartzell constant-speed propellers. Review of maintenance records revealed that the most recent annual inspection was completed on June 19, 2018. At that time, the airframe had accumulated about 10,153 total hours of operation. The left engine had accumulated about 10,207 total hours of operation, of which 1,147 hours were since major overhaul. The right engine had accumulated about 11,401 total hours of operation, of which 1,147 hours were since major overhaul.

The Cessna was a four-seat, high-wing, fixed tricycle gear airplane, manufactured in 1979. It was powered by a Lycoming O-320, 160-horsepower engine equipped with a two-blade McCauley fixed-pitch propeller. Review of maintenance records revealed that the most 100-hour inspection was completed on June 13, 2018. At that time, the airframe had accumulated about 18,447 total hours of operation. The engine had accumulated about 13,256 total hours of operation, of which 2,541 hours were since major overhaul. 



Meteorological Information and Flight Plan

Conditions at Accident Site: Visual Conditions
Condition of Light: Day
Observation Facility, Elevation: TMB, 10 ft msl
Distance from Accident Site: 9 Nautical Miles
Observation Time: 1253 EDT
Direction from Accident Site: 135°
Lowest Cloud Condition: Scattered / 3500 ft agl
Visibility:  10 Miles
Lowest Ceiling: None
Visibility (RVR):
Wind Speed/Gusts: 5 knots /
Turbulence Type Forecast/Actual: None / None
Wind Direction: 120°
Turbulence Severity Forecast/Actual: N/A / N/A
Altimeter Setting: 30.1 inches Hg
Temperature/Dew Point: 32°C / 24°C
Precipitation and Obscuration: No Obscuration; No Precipitation
Departure Point: Miami, FL (TMB)
Type of Flight Plan Filed: None
Destination: Miami, FL (TMB)
Type of Clearance: None
Departure Time: 1253 EDT
Type of Airspace: 

The recorded weather at TMB at 1253 included wind from 120° at 5 knots, 10 statute miles visibility, scattered clouds at 3,500 ft and 4,200 ft, temperature 32°C, dew point 24°C, altimeter setting of 30.10 inches of mercury.

Wreckage and Impact Information

Crew Injuries: 2 Fatal
Aircraft Damage: Destroyed
Passenger Injuries: N/A
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 2 Fatal
Latitude, Longitude: 25.757778, -80.556944 (est) 

The Piper main wreckage was located about 620 ft west of the collision point as indicated by radar data. The wreckage was mostly intact and upright, with the vertical stabilizer and outboard section of right wing separated. The vertical stabilizer was located about 50 ft west of the main wreckage and the outboard section of right wing was located by aerial drone about 220 ft north-northeast of the main wreckage. Both engines remained attached to the airframe and the propellers remained attached to their respective engine. The right engine propeller was in a feathered position and the corresponding cockpit controls for both engines were in the aft position, consistent with impact damage. One right propeller blade exhibited little damage and the other right propeller blade was bent forward. One left engine propeller blade exhibited little damage and the other was bent aft. The landing gear selector handle was in the down position and the landing gear was found mid-extension. The flaps were in the retracted position. Flight control continuity was confirmed and measurement of the stabilator trim jackscrew corresponded to a nose-up trim setting midrange between neutral and full nose-up. Measurement of the rudder trim shaft corresponded to an approximate neutral rudder trim. The two front seats were equipped with lapbelts and shoulder harnesses. The right seat restraint was unlatched by rescue personnel and the left seat restraint was cut by rescue personnel.

The Cessna main wreckage was located about 1,340 ft southeast of the collision point, as indicated by radar data. The airplane came to rest upright and its left wing had separated. The left wing was located by aerial drone about 1,320 ft northwest of the main wreckage. The engine remained attached to the airframe and the propeller remained attached to the engine. One propeller blade exhibited little damage and the other blade was bent aft and exhibited chordwise scratches. The flaps were found in the retracted position and flight control continuity was confirmed. Measurement of the elevator trim jackscrew corresponded to an approximate 5° trim tab up (nose-down) position. The two front seats were equipped with lapbelts and shoulder harnesses. The right seat restraint was not recovered and the left seat restraint was separated consistent with overload.

During the wreckage examinations, red and blue paint transfer was found on a top inboard section of Cessna's right wing. Tire marks were found on the Piper's right wingtip and the left main landing gear tire of the Cessna was not recovered. Additionally, the right upper strut attachment fitting from the Cessna was found in the Piper tailcone. The Cessna's left front wing spar carry-through fitting (near the left wing root) was found in the outboard right wing of the Piper. In addition, a section of the Cessna's right wing spar was found in the Piper's vertical stabilizer. The findings were consistent with a nearly head-on, off-center collision with the Cessna in a slight left bank to the Piper's right. 

Medical And Pathological Information

The Miami-Dade County Medical Examiner Department, Miami, Florida, performed autopsies on all four pilots.

Toxicology testing was performed on all four pilots by the FAA Forensic Sciences Laboratory. The results were negative for the pilot of the Piper. The testing identified ibuprofen in the blood of the DPE in the Piper, which is not considered impairing.

The testing identified ethanol at 0.049 gm/dl in the Cessna student pilot's cavity blood, 0.020 gm/dl in liver, and 0.047 gm/dl in muscle. In addition, N-propanol and N-butanol were found in cavity blood and muscle. Ethanol may be produced in body tissues by microbial activity after death. N-butanol and N-propanol are other alcohols commonly produced in tissues after death.

The testing also identified 0.0015 µg/mL of delta-9-tetrahydrocannabinol (THC), the main psychoactive component of marijuana, in the Cessna flight instructor's cavity blood and urine. In addition, two inactive metabolites, 11-hydroxy-delta-9-tetrahydrocannabinol and 11-nor-9-carboxy-delta-9-tetrahydrocannabinol (THC-COOH), were found in urine and 0.0044 µg/mL 11-nor-9-carboxy-delta-9-tetrahydrocannabinol (THC-COOH) was found in cavity blood. Marijuana is a psychoactive drug with therapeutic levels as low as 0.001 µg/ml. According to National Highway Traffic Safety Administration's Drugs and Human Performance Fact Sheets, "It is difficult to establish a relationship between a person's marijuana blood or plasma concentration and performance impairing effects. Concentrations of parent drug and metabolite are very dependent on pattern of use as well as dose. THC concentrations typically peak during the act of smoking, while peak 11-OH THC concentrations occur approximately 9-23 minutes after the start of smoking. Concentrations of both analytes decline rapidly and are often < 0.005 ug/mL at 3 hours."

Additional Information

Aircraft Performance and Cockpit Visibility Study

Automatic Dependent Surveillance—Broadcast (ADS-B) and Traffic Information Services—Broadcast (TIS-B) data were reviewed to calculate the position and orientation of each airplane during the minutes preceding the collision. The information was then used to estimate the approximate location of each airplane in the other airplane's windows and to simulate the traffic information that could have been presented to the pilots had the airplanes been equipped with a cockpit display of traffic information (CDTI) (neither was so equipped).

The study revealed that the Piper and the Cessna would have remained relatively small, slow-moving objects in each other's windows until about 12 seconds before the collision, and subsequently grown in size suddenly. About 18.5 seconds before the collision, the Cessna would have been obscured from the Piper pilot's (nominal) field of view by the Piper's instrument panel, though the Cessna would have remained unobscured in the Piper DPE's (nominal) field of view.

Simulation of CDTI displays for both airplanes indicated that both pilots could
have been made aware of the presence of the other airplane at least as soon as the Piper became airborne, that is, about 6 minutes and 10 seconds before the collision. However, given the numerous traffic targets near TMB at the time of the accident, there would have been little reason for the pilots of each airplane to pay particular attention to the target representing the other until the airplanes drew much closer to each other. About 39.5 seconds before the collision, each airplane would have received an aural and visual ADS-B Traffic Advisory System (ATAS) alert of the other as they penetrated each other's protected airspace zone. The Cessna would also have received a second ATAS alert 30.5 seconds before the collision, as the ATAS algorithm predicted it would penetrate the Piper's collision airspace zone. The CDTI displays on both aircraft would have depicted the airplanes in alert status (solid yellow arrowheads enclosed in a yellow circle), converging on each other up until the collision occurred.

For more information, see Aircraft Performance & Cockpit Visibility Study in the NTSB public docket for this accident.



N6428D  Aviation Accident Factual Report - National Transportation Safety Board:  https://app.ntsb.gov/pdf


N6428D  Investigation Docket - National Transportation Safety Board:  https://dms.ntsb.gov/pubdms

http://registry.faa.gov/N6428D

Location: Miami, FL
Accident Number: ERA18FA194B
Date & Time: 07/17/2018, 1259 EDT
Registration: N6428D
Aircraft: Cessna 172
Aircraft Damage: Destroyed
Defining Event: Midair collision
Injuries: 2 Fatal
Flight Conducted Under: Part 91: General Aviation - Instructional 

On July 17, 2018, at 1259 eastern daylight time, a Piper PA-34-200, N16281, and a Cessna 172N, N6428D, collided in midair about 9 miles northwest of Miami Executive Airport (TMB), Miami, Florida. The private pilot and designated pilot examiner (DPE) onboard the Piper and the flight instructor and student pilot onboard the Cessna were fatally injured; both airplanes were destroyed. Both airplanes were registered to and were being operated by Dean International, Inc., as Title 14 Code of Federal Regulations Part 91 flights. The Piper pilots were conducting an evaluation flight for a commercial pilot certificate and the Cessna pilots were conducting a cross-country instructional flight. Visual meteorological conditions prevailed and no flight plan was filed for either flight. The Piper departed TMB on a local flight at 1253, and the Cessna departed Immokalee Regional Airport (IMM), Immokalee, Florida, at 1217, destined for TMB.

According air traffic control data provided by the Federal Aviation Administration (FAA), the Piper was en route to a nearby training area at an altitude of about 1,500 ft mean sea level (msl) and was no longer communicating with the TMB tower controller as the airplane was outside the Class D airspace. The Cessna was returning to TMB at an altitude of about 1,500 ft msl and had contacted the TMB tower controller just before the collision. The controller acknowledged the transmission and issued a traffic advisory, but no further communications were received from the Cessna. Review of radar data revealed the two targets converged nearly straight-on. At the time of the collision, the Piper was flying northwest and the Cessna was flying southeast.



Flight Instructor Information

Certificate: Commercial
Age: 22, Male
Airplane Rating(s): Single-engine Land
Seat Occupied: Right
Other Aircraft Rating(s): None
Restraint Used:
Instrument Rating(s): Airplane
Second Pilot Present: Yes
Instructor Rating(s): Airplane Single-engine
Toxicology Performed: Yes
Medical Certification: Class 1 Without Waivers/Limitations
Last FAA Medical Exam: 12/15/2014
Occupational Pilot: Yes
Last Flight Review or Equivalent:
Flight Time: 311 hours (Total, all aircraft)

Student Pilot Information

Certificate: Student
Age: 22, Male
Airplane Rating(s): None
Seat Occupied: Left
Other Aircraft Rating(s): None
Restraint Used:
Instrument Rating(s): None
Second Pilot Present: Yes
Instructor Rating(s): None
Toxicology Performed: Yes
Medical Certification: Class 1 With Waivers/Limitations
Last FAA Medical Exam: 03/20/2018
Occupational Pilot: No
Last Flight Review or Equivalent: 
Flight Time: 52 hours (Total, all aircraft)

Piper

The pilot held a private pilot certificate with ratings for airplane single-engine land and instrument airplane. Her most recent first-class FAA medical certificate was issued on September 29, 2017. According to her application for a commercial pilot certificate, dated July 17, 2018, she reported a total flight experience of 253 hours. The pilot's logbook was not recovered.

The DPE held an airline transport pilot certificate with ratings for airplane single-engine land, airplane single-engine sea, airplane multiengine land, and airplane multiengine sea. He also held a commercial pilot certificate with a rating for glider. Additionally, he held a flight instructor certificate with ratings for airplane single-engine, airplane multiengine, and instrument airplane. His most recent second-class FAA medical certificate was issued on August 16, 2017. At that time, he reported a total flight experience of 26,000 hours. The DPE's logbook was not recovered.

Cessna

The flight instructor held a commercial pilot certificate with ratings for airplane single-engine land and instrument airplane. He also held a flight instructor certificate with a rating for airplane single-engine. His most recent first-class FAA medical certificate was issued on December 15, 2014. According to his application for a flight instructor certificate, dated March 18, 2018, he reported a total flight experience of 311 hours. The flight instructor's logbook was not recovered.

The student pilot's most recent first-class FAA medical certificate was issued on March 20, 2018. According to the student pilot's logbook, he had a total flight experience of 52 hours.

Aircraft and Owner/Operator Information

Aircraft Make: Cessna
Registration: N6428D
Model/Series: 172 N
Aircraft Category: Airplane
Year of Manufacture: 1979
Amateur Built: No
Airworthiness Certificate: Normal
Serial Number: 17272794
Landing Gear Type: Tricycle
Seats: 4
Date/Type of Last Inspection: 06/13/2018, 100 Hour
Certified Max Gross Wt.: 2300 lbs
Time Since Last Inspection:
Engines: 1 Reciprocating
Airframe Total Time: 18447 Hours as of last inspection
Engine Manufacturer: Lycoming
ELT: Installed, not activated
Engine Model/Series: O-320-D2G
Registered Owner: Dean International Inc
Rated Power: 160 hp
Operator: Dean International Inc
Operating Certificate(s) Held: Pilot School (141) 

The Piper was a six-seat, low-wing, retractable tricycle gear airplane manufactured in 1973. It was powered by two counter-rotating Lycoming IO-360 200-horsepower engines, both equipped with two-blade Hartzell constant-speed propellers. Review of maintenance records revealed that the most recent annual inspection was completed on June 19, 2018. At that time, the airframe had accumulated about 10,153 total hours of operation. The left engine had accumulated about 10,207 total hours of operation, of which 1,147 hours were since major overhaul. The right engine had accumulated about 11,401 total hours of operation, of which 1,147 hours were since major overhaul.

The Cessna was a four-seat, high-wing, fixed tricycle gear airplane, manufactured in 1979. It was powered by a Lycoming O-320, 160-horsepower engine equipped with a two-blade McCauley fixed-pitch propeller. Review of maintenance records revealed that the most 100-hour inspection was completed on June 13, 2018. At that time, the airframe had accumulated about 18,447 total hours of operation. The engine had accumulated about 13,256 total hours of operation, of which 2,541 hours were since major overhaul. 

Meteorological Information and Flight Plan

Conditions at Accident Site: Visual Conditions
Condition of Light: Day
Observation Facility, Elevation: TMB, 10 ft msl
Distance from Accident Site: 9 Nautical Miles
Observation Time: 1253 EDT
Direction from Accident Site: 135°
Lowest Cloud Condition: Scattered / 3500 ft agl
Visibility: 10 Miles
Lowest Ceiling: None
Visibility (RVR):
Wind Speed/Gusts: 5 knots /
Turbulence Type Forecast/Actual: None / None
Wind Direction: 120°
Turbulence Severity Forecast/Actual: N/A / N/A
Altimeter Setting: 30.1 inches Hg
Temperature/Dew Point: 32°C / 24°C
Precipitation and Obscuration: No Obscuration; No Precipitation
Departure Point: Immokalee, FL (IMM)
Type of Flight Plan Filed: None
Destination: Miami, FL (TMB)
Type of Clearance: None
Departure Time: 1217 EDT
Type of Airspace: 

The recorded weather at TMB at 1253 included wind from 120° at 5 knots, 10 statute miles visibility, scattered clouds at 3,500 ft and 4,200 ft, temperature 32°C, dew point 24°C, altimeter setting of 30.10 inches of mercury. 

Wreckage and Impact Information

Crew Injuries: 2 Fatal
Aircraft Damage: Destroyed
Passenger Injuries: N/A
Aircraft Fire: On-Ground
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 2 Fatal
Latitude, Longitude: 25.757778, -80.556944 (est) 

The Piper main wreckage was located about 620 ft west of the collision point as indicated by radar data. The wreckage was mostly intact and upright, with the vertical stabilizer and outboard section of right wing separated. The vertical stabilizer was located about 50 ft west of the main wreckage and the outboard section of right wing was located by aerial drone about 220 ft north-northeast of the main wreckage. Both engines remained attached to the airframe and the propellers remained attached to their respective engine. The right engine propeller was in a feathered position and the corresponding cockpit controls for both engines were in the aft position, consistent with impact damage. One right propeller blade exhibited little damage and the other right propeller blade was bent forward. One left engine propeller blade exhibited little damage and the other was bent aft. The landing gear selector handle was in the down position and the landing gear was found mid-extension. The flaps were in the retracted position. Flight control continuity was confirmed and measurement of the stabilator trim jackscrew corresponded to a nose-up trim setting midrange between neutral and full nose-up. Measurement of the rudder trim shaft corresponded to an approximate neutral rudder trim. The two front seats were equipped with lapbelts and shoulder harnesses. The right seat restraint was unlatched by rescue personnel and the left seat restraint was cut by rescue personnel.

The Cessna main wreckage was located about 1,340 ft southeast of the collision point, as indicated by radar data. The airplane came to rest upright and its left wing had separated. The left wing was located by aerial drone about 1,320 ft northwest of the main wreckage. The engine remained attached to the airframe and the propeller remained attached to the engine. One propeller blade exhibited little damage and the other blade was bent aft and exhibited chordwise scratches. The flaps were found in the retracted position and flight control continuity was confirmed. Measurement of the elevator trim jackscrew corresponded to an approximate 5° trim tab up (nose-down) position. The two front seats were equipped with lapbelts and shoulder harnesses. The right seat restraint was not recovered and the left seat restraint was separated consistent with overload.

During the wreckage examinations, red and blue paint transfer was found on a top inboard section of Cessna's right wing. Tire marks were found on the Piper's right wingtip and the left main landing gear tire of the Cessna was not recovered. Additionally, the right upper strut attachment fitting from the Cessna was found in the Piper tailcone. The Cessna's left front wing spar carry-through fitting (near the left wing root) was found in the outboard right wing of the Piper. In addition, a section of the Cessna's right wing spar was found in the Piper's vertical stabilizer. The findings were consistent with a nearly head-on, off-center collision with the Cessna in a slight left bank to the Piper's right. 

Medical And Pathological Information

The Miami-Dade County Medical Examiner Department, Miami, Florida, performed autopsies on all four pilots.

Toxicology testing was performed on all four pilots by the FAA Forensic Sciences Laboratory. The results were negative for the pilot of the Piper. The testing identified ibuprofen in the blood of the DPE in the Piper, which is not considered impairing.

The testing identified ethanol at 0.049 gm/dl in the Cessna student pilot's cavity blood, 0.020 gm/dl in liver, and 0.047 gm/dl in muscle. In addition, N-propanol and N-butanol were found in cavity blood and muscle. Ethanol may be produced in body tissues by microbial activity after death. N-butanol and N-propanol are other alcohols commonly produced in tissues after death.

The testing also identified 0.0015 µg/mL of delta-9-tetrahydrocannabinol (THC), the main psychoactive component of marijuana, in the Cessna flight instructor's cavity blood and urine. In addition, two inactive metabolites, 11-hydroxy-delta-9-tetrahydrocannabinol and 11-nor-9-carboxy-delta-9-tetrahydrocannabinol (THC-COOH), were found in urine and 0.0044 µg/mL 11-nor-9-carboxy-delta-9-tetrahydrocannabinol (THC-COOH) was found in cavity blood. Marijuana is a psychoactive drug with therapeutic levels as low as 0.001 µg/ml. According to National Highway Traffic Safety Administration's Drugs and Human Performance Fact Sheets, "It is difficult to establish a relationship between a person's marijuana blood or plasma concentration and performance impairing effects. Concentrations of parent drug and metabolite are very dependent on pattern of use as well as dose. THC concentrations typically peak during the act of smoking, while peak 11-OH THC concentrations occur approximately 9-23 minutes after the start of smoking. Concentrations of both analytes decline rapidly and are often < 0.005 ug/mL at 3 hours." 

Additional Information

Aircraft Performance and Cockpit Visibility Study

Automatic Dependent Surveillance—Broadcast (ADS-B) and Traffic Information Services—Broadcast (TIS-B) data were reviewed to calculate the position and orientation of each airplane during the minutes preceding the collision. The information was then used to estimate the approximate location of each airplane in the other airplane's windows and to simulate the traffic information that could have been presented to the pilots had the airplanes been equipped with a cockpit display of traffic information (CDTI) (neither was so equipped).

The study revealed that the Piper and the Cessna would have remained relatively small, slow-moving objects in each other's windows until about 12 seconds before the collision, and subsequently grown in size suddenly. About 18.5 seconds before the collision, the Cessna would have been obscured from the Piper pilot's (nominal) field of view by the Piper's instrument panel, though the Cessna would have remained unobscured in the Piper DPE's (nominal) field of view.

Simulation of CDTI displays for both airplanes indicated that both pilots could
have been made aware of the presence of the other airplane at least as soon as the Piper became airborne, that is, about 6 minutes and 10 seconds before the collision. However, given the numerous traffic targets near TMB at the time of the accident, there would have been little reason for the pilots of each airplane to pay particular attention to the target representing the other until the airplanes drew much closer to each other. About 39.5 seconds before the collision, each airplane would have received an aural and visual ADS-B Traffic Advisory System (ATAS) alert of the other as they penetrated each other's protected airspace zone. The Cessna would also have received a second ATAS alert 30.5 seconds before the collision, as the ATAS algorithm predicted it would penetrate the Piper's collision airspace zone. The CDTI displays on both aircraft would have depicted the airplanes in alert status (solid yellow arrowheads enclosed in a yellow circle), converging on each other up until the collision occurred.

For more information, see Aircraft Performance & Cockpit Visibility Study in the NTSB public docket for this accident.

10 comments:

Anonymous said...

THC and flying.... never a good combo.
Half life of alcohol is 4 hrs... means I can have a beer and be ready for flight the next day.
Half life of MJ is 11 days... stored in fat of the body too. Means it can be released sporadically for up to a week after smoking it.
Not saying this instructor's drug use contributed to the crash but it will surely invalidate any insurance present.

Anonymous said...

I have a buddy that lost his CDL due to failing a random drug test. It took 2 months for the pot to exit his system and for him to get his license back. The states that are legalizing pot use are only concerned about the revenue that it will generate and don't give a rat's ass about all the problems it's going to create. Just look at the story of the Russian that crossed the centerline and killed a bunch of members of the Jarheads motorcycle club. He had THC in his system also. Even if the THC didn't cause this crash and it was just bad luck, it just reflects poorly on GA as a whole.

Anonymous said...

Wow crashed head on? Wow whatever happened to "Operation Lights On"? I just leave my LED beam and LED nav's on for the entire flight.

Anonymous said...

This was a tragic "failure to see and avoid" accident. No, it wasn't the traces of pot in the blood. Alcohol and prescription medications cause far more accidents every day. We should leave the puritan conjecture for another blog.

Anonymous said...

^^^^^

Maybe. Maybe not.

Anonymous said...

CFII/MEI

IF YOU ARE SMOKING WEED AND ACTING AS A FLIGHT INSTRUCTOR... GTFO

Stupid kids, if you have an obvious judgement problem you should have been 'weeded out' of flight school instead of flying at 19, 22.

Anonymous said...

Apparently, the pilot shortage has done the same for flight school CFI standards as the truck driver shortage has done for driver-trainer standards at the major trucking companies. A big rush to fill the left seat... (CFII/MEI & several-million miles CDL experience allows me to comment on both).

Anonymous said...

Whoever is the intellectually challenged claiming alcohol is far more dangerous than pot, now that the THC content of the "legalized" substance is reaching 90%+ and the psychotic effects are better known not to mention a plethora of unknowns given how little we know about cannabinoid receptors in the body, I suggest he studies the way the synaptic receptors are also hammered by those false messengers for hours whereas they are meant to only be activated for a split second naturally.

And unlike other drugs like cocaine and heroin, MJ also affects other areas of the body besides the brain, namely motor functions and is stored for weeks on end in the body. The same motor functions needed to be a proficient pilot.

The puppy mill issued CFI certificate to the pothead pilot was invalidated the second he took a joint and should have been revoked for weeks if not months on end. But then again ethics ie doing the right thing even if no one is watching, is absent the mind of selfish assholes.

Anonymous said...

"The study revealed that the Piper and the Cessna would have remained relatively small, slow-moving objects in each other's windows until about 12 seconds before the collision, and subsequently grown in size suddenly. About 18.5 seconds before the collision, the Cessna would have been obscured from the Piper pilot's (nominal) field of view by the Piper's instrument panel, though the Cessna would have remained unobscured in the Piper DPE's (nominal) field of view."

Lesson to be learned here is that these two airplanes were closing in on one another at about 300 MPH.

Maening said...

Smoking, drinking, junk food, low blood sugar, impaired circulation, etc., all impair pilot perception, judgment, and reaction times. In this midair, there were 8 eyes that failed to see what was in front of them. From the damage description, possibly the Cessna made a last second maneuver to avoid. Perhaps landing, strobes, and navigation lights on would have helped if they were not being used. I just upgraded my landing and nav lights to LED so I can leave them on all of the time in operation with a white tail strobe. The LEDs are much brighter than the halogen lights and use much less power. I'm going to add a belly strobe. Make it easy to see you!

Most GA do not have BRS. The Cessna could have had a BRS installed and that could have saved those two. Parachutes could have saved all, but most don't use them unless flying aerobatic. In a crash, one is flying uncontrolled aerobatic. I have a BRS on my airplane for just this type of event. RIP all these souls.