Thursday, March 26, 2020

Loss of Lift: Beech G33 Bonanza, N9345Q; fatal accident occurred April 16, 2018 in Warsaw, Coshocton County, Ohio

Edward Zezlina Sr.

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

Additional Participating Entities:
Federal Aviation Administration / Flight Standards District Office; Columbus, Ohio
Continental Motors; Mobile, Alabama
Textron Aviation; Wichita, Kansas

Aviation Accident Factual Report - National Transportation Safety Board:

Location: Warsaw, OH
Accident Number: CEN18FA143
Date & Time: 04/16/2018, 0630 EDT
Registration: N9345Q
Aircraft: BEECH G33
Aircraft Damage: Substantial
Defining Event: Loss of lift
Injuries: 2 Fatal
Flight Conducted Under: Part 91: General Aviation - Personal 

Edward Zezlina Sr. and Linda J. O’Brien

On April 16, 2018, about 0632 eastern daylight time, a Beech G33 airplane, N9345Q, impacted terrain near Warsaw, Ohio. The commercial pilot and the passenger were fatally injured. The airplane was substantially damaged. The airplane was privately owned and operated as a Title 14 Code of Federal Regulations Part 91 personal flight. Instrument meteorological conditions prevailed, and an instrument flight rules flight plan was filed for the flight, which departed from Elyria Airport (1G1), Elyria, Ohio, and was en route to Deland Municipal Airport, Deland, Florida.

According to Federal Aviation Administration air traffic control information, at 0627, the pilot reported to the controller that he needed to descend from 4,000 ft mean sea level (msl) to 3,000 ft msl due to icing. Passing through 3,700 ft, the pilot reported, "looks like we are out of the clouds here." When the airplane reached 3,000 ft, the controller asked the pilot for an update; the pilot replied that they were underneath the clouds and that the temperature was 34°F above freezing. As the airplane descended to 2,700 ft, the controller issued a low altitude alert and told the pilot that the minimum vectoring altitude in the area was 2,900 ft. The pilot acknowledged and stated, "we have some rime ice, but we are losing it." The controller asked if the pilot needed to land and the pilot responded "negative," indicating again that the icing was "clearing up" and that the temperature was 39°F; however, the airplane continued to descend through 2,200 ft. When the controller queried the pilot, the pilot responded, "ah, we're doing okay right now" and "waiting for this ice to dissipate." The airplane continued to descend until radar contact was lost at 0632 at an altitude of 1,500 ft.

A passing pilot spotted the wreckage of the airplane and relayed the information to the controller, who notified local law enforcement.

Pilot Information

Certificate: Flight Instructor; Commercial
Age: 67, Male
Airplane Rating(s): Multi-engine Land; Single-engine Land
Seat Occupied: Left
Other Aircraft Rating(s): Glider
Restraint Used:
Instrument Rating(s): Airplane
Second Pilot Present: No
Instructor Rating(s): Airplane Single-engine
Toxicology Performed: Yes
Medical Certification: Class 1 With Waivers/Limitations
Last FAA Medical Exam: 02/24/2017
Occupational Pilot: No
Last Flight Review or Equivalent:
Flight Time:  (Estimated) 2300 hours (Total, all aircraft), 500 hours (Total, this make and model)

Aircraft and Owner/Operator Information

Aircraft Make: BEECH
Registration: N9345Q
Model/Series: G33 G33
Aircraft Category: Airplane
Year of Manufacture: 1971
Amateur Built: No
Airworthiness Certificate: Normal
Serial Number: CD-1269
Landing Gear Type:
Date/Type of Last Inspection:
Certified Max Gross Wt.:
Time Since Last Inspection:
Airframe Total Time: 
Engine Manufacturer:
Engine Model/Series:
Registered Owner: ZEZLINA EDWARD M
Rated Power:
Operator: On file
Operating Certificate(s) Held: None

The accident airplane was not equipped or certificated for flight in any icing conditions. 

Meteorological Information and Flight Plan

Conditions at Accident Site: Visual Conditions
Condition of Light: Day
Observation Facility, Elevation: K4I3, 1191 ft msl
Distance from Accident Site: 20 Nautical Miles
Observation Time: 0636 EDT
Direction from Accident Site: 258°
Lowest Cloud Condition: Scattered / 2200 ft agl
Visibility:  10 Miles
Lowest Ceiling: Broken / 4300 ft agl
Visibility (RVR): 
Wind Speed/Gusts: 9 knots /
Turbulence Type Forecast/Actual: Clear Air / Unknown
Wind Direction: 270°
Turbulence Severity Forecast/Actual: Light / Unknown
Altimeter Setting: 29.67 inches Hg
Temperature/Dew Point: 3°C / 1°C
Precipitation and Obscuration: Unknown Obscuration; Unknown Precipitation
Departure Point: ELYRIA, OH (1G1)
Type of Flight Plan Filed: IFR
Destination: DELAND, FL (DED)
Type of Clearance: IFR
Departure Time:
Type of Airspace: Class G 

A review of the National Weather Analysis (NWA) Chart issued at 0500 on the day of the accident indicated that the accident site was west of the surface low pressure center in western Pennsylvania and a surface trough that connected that surface low pressure center and a surface low pressure center in eastern Lake Erie. Modeling depicted air temperatures in the upper 30s to mid-40s °F, dew point temperatures in the mid-30s °F with temperature-dew point spreads of 5° F or less, a west wind of 10 to 15 knots, overcast sky cover, and light rain.

The 0800 upper air sounding from a station 98 miles west-southwest of the accident site depicted a greater than 90% relative humidity from the surface to 8,000 ft mean sea level (msl ). The freezing level was located at 1,512 ft msl (505 ft agl).

An interactive sounding analysis program reported the possibility of clouds from 2,000 ft through 14,000 ft msl. Moderate or greater rime icing was indicated between 2,000 and 9,500 ft msl (around 1,000 to 8,500 ft agl). In addition, there was a high probability of light to moderate clear-air turbulence in several layers between the surface and 13,000 ft msl.

Satellite infrared imagery indicated cloud cover over the accident site with approximate tops at 15,000 ft msl. Additional data indicated mid-level water clouds and thick mid-level water or ice clouds.

There are no SIGMET advisories or Center Weather Service Unit (CWSU) Center Weather Advisories (CWA) valid for the accident site at the accident time. An AIRMET Zulu was valid for the accident site at the accident time for altitudes below 18,000 ft msl. AIRMET Zulu warned of moderate icing conditions below 15,000 ft. The AIRMET was issued at 0445 and valid until 1100.

The Graphical Forecasts for Aviation (GFA) products made available before the accident time and before the accident flight departed 1G1 indicated cloud cover between 3,500 ft and 10,000 ft msl with a 30 to 60% chance of light rain showers or moderate rain and a surface wind from the west between 10 to 15 knots.

Current Icing Potential (CIP) and Forecast Icing Potential (FIP) products are created by the NWS Aviation Weather Center (AWC) and are intended to be supplemental to other icing advisories (e.g. AIRMETs and SIGMETs). The FIP images indicated a 60 to 85% probability of light to moderate icing at 4,000 to 6,000 ft at 0600 at the accident site. The FIP indicated no potential for any Supercooled Large Droplets. This FIP information would have been available on the NWS AWC website before the accident flight departed 1G1.

The CIP product indicated a 40 to 85% probability of light icing at 4,000 to 6,000 ft at 0600 at the accident site. The CIP also indicated a 40 to 70% chance of SLD near the accident site around the accident time, with the bottom of the SLD layer between 2,500 and 5,000 ft msl and the top of the SLD layer between 12,500 and 15,000 ft msl.

A search of official weather briefing sources, such as Leidos Flight Service and Direct User Access Terminal Service (DUATS), revealed that the accident pilot did not request a weather briefing from Leidos or DUATS. ForeFlight did not have any record of the accident pilot accessing weather information. With no internet access while in flight, ForeFlight is still able to access weather information directly from the FAA, but leaves no remote record of such access. There was no record of the accident pilot receiving or retrieving any other weather information before or during the accident flight.

Wreckage and Impact Information

Crew Injuries: 1 Fatal
Aircraft Damage: Substantial
Passenger Injuries: 1 Fatal
Aircraft Fire: On-Ground
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 2 Fatal
Latitude, Longitude: 40.406389, -82.081944

The airplane impacted a wooded area; several large trees displayed damage consistent with impact. The outboard section of the right wing was found near the base of one of the trees. Portions of the wing and pieces of plexiglass where found in the debris path, which was about 100 ft long and oriented heading of about 220°.

The wreckage came to rest in the upright position. A postcrash fire consumed a majority of the fuselage and cockpit area. Flight control continuity was confirmed from the cockpit controls to the flight control surfaces. The landing gear and flaps were both in the retracted position. The propeller was fractured at the propeller hub; all three blades displayed nicks, gouges, curling, and rotational scoring. There were numerous branches with 45° cuts found in the debris field. No preimpact anomalies were detected with the airframe engine.

A member of the Ohio State Highway Patrol – Crash Reconstruction and Analysis Unit documented the accident scene and discovered two pieces of ice located about 25 ft east of the main wreckage with a curvature similar to the leading edge of a wing or horizontal stabilizer.

Medical And Pathological Information

An autopsy was conducted on the pilot by the Office of the Licking County Coroner, Newark, Ohio. The autopsy cited cause of death due to multiple blunt force injuries. The autopsy also noted the presence of mild atherosclerosis of the aorta.

The FAA Forensic Sciences Laboratory performed toxicology testing on specimens from the pilot. Testing was positive for losartan, which is used to treat high blood pressure and to lower the risk of stroke in certain people with heart disease. The pilot had reported his use of this medication to the FAA, and it is not impairing. 

Additional Information

FAA Advisory Circular 91-74B, Pilot Guide: Flight in Icing Conditions, stated:

An aircraft with a completely unprotected wing is unlikely to be certificated for flight in icing conditions, but may inadvertently encounter icing conditions…The ice causes an increase in drag, which the pilot detects as a loss in airspeed or an increase in the power required to maintain the same airspeed. (The drag increase is also due to ice on other parts of the aircraft). The longer the encounter, the greater the drag increase; even with increased power, it may not be possible to maintain airspeed. If the aircraft has relatively limited power (as is the case with many aircraft with no ice protection), it may soon approach stall speed and a dangerous situation.

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