Saturday, April 18, 2020

Loss of Visual Reference: Cessna 172S Skyhawk, N615JA; fatal accident occurred February 28, 2018 near Ocean City Municipal Airport (KOXB), Worcester County, Maryland

Marcson Ngwa 

Photo of fuel and oil slick

 Photo of various floating debris and fuel oil slick 

View of recovered outer side of crush damage pilot’s side door 

View of inner side of recovered crush damaged pilot’s door 

View of recovered outer side of crush damaged passenger door 

View of inside of crush damage passenger door 

View of recovered seatback cushion 

View of recovered small part of leading edge of wing showing crush damage 

View of recovered various fuselage skin pieces all showing crush damage 

View of recovered nose gear wheel attached to broken strut 

View of recovered main landing gear wheel 

Radar Data Flight Track N615JA

Marcson Ngwa 

The National Transportation Safety Board did not travel to the scene of this accident. 

Additional Participating Entities:

Federal Aviation Administration / Flight Standards District Office; Baltimore, Maryland
Cessna/Textron Aviation; Wichita, Kansas
Lycoming Engines; Wichita, Kansas

Aviation Accident Factual Report - National Transportation Safety Board:

Investigation Docket - National Transportation Safety Board:

Location: Ocean City, MD
Accident Number: ERA18LA094
Date & Time: 02/28/2018, 1930 EST
Registration: N615JA
Aircraft: CESSNA 172
Aircraft Damage: Destroyed
Defining Event: Loss of visual reference
Injuries: 2 Fatal
Flight Conducted Under: Part 91: General Aviation - Personal

On February 28, 2018, about 1930 eastern standard time, a Cessna 172S, N615JA, was destroyed when it impacted the Atlantic Ocean about 2 miles east of Ocean City Municipal Airport (OXB), Ocean City, Maryland. The private pilot was fatally injured. The passenger was not located and was presumed fatally injured. The airplane was registered to Middle River Aviation and operated as a Title 14 Code of Federal Regulations Part 91 personal flight. Night visual meteorological conditions prevailed, and no flight plan was filed for the flight, which departed Martin State Airport (MTN), Baltimore, Maryland, about 1753.

According to information from MTN ground control, the pilot requested visual flight rules (VFR) flight following to OXB and departed from runway 15 at MTN. The pilot contacted the departure controller after takeoff and reported climbing past 1,600 ft mean sea level (msl). The controller identified the airplane 3 miles southeast of MTN and instructed the pilot to proceed on course below the Class B airspace and to maintain VFR. At 1805, the pilot reported reaching his cruise altitude of 3,500 ft and was issued the current altimeter setting.

A review of radar track data showed the airplane approaching OXB from the northwest at an altitude around 3,500 ft msl before beginning a slow descent about 15 nautical miles (nm) northwest of OXB. The airplane continued its descent, and radar service was terminated about 3 nm northwest of OXB at an altitude of 1,350 ft msl.

The airplane was reported missing the following morning, and a search was initiated. About 1030, a search flight conducted by the flight school discovered an oil slick about 2 miles from the approach end of runway 14 at OXB.

According to the Maryland Natural Resources Police, on March 1, 2019, they were notified of an airplane that had gone missing en route to OXB. A search of the shoreline identified debris from the airplane. During the search, a fuel and oil slick was discovered that was still bubbling to the surface. They positioned their vessel around the highest concentration of fuel and oil and anchored. Divers subsequently discovered a wing and the fuselage of the airplane. Shortly thereafter, the pilot was found within the wreckage. Divers continued to search for the other victim, but the search was unsuccessful due to the deteriorating visibility and sea conditions. 

Pilot Information

Certificate: Private
Age: 28, Male
Airplane Rating(s): Single-engine Land
Seat Occupied: Unknown
Other Aircraft Rating(s): None
Restraint Used:
Instrument Rating(s): None
Second Pilot Present: No
Instructor Rating(s): None
Toxicology Performed:Yes 
Medical Certification: Class 1 Without Waivers/Limitations
Last FAA Medical Exam: 02/27/2017
Occupational Pilot: No
Last Flight Review or Equivalent: 08/24/2017
Flight Time:  (Estimated) 81 hours (Total, all aircraft), 81 hours (Total, this make and model), 3 hours (Last 90 days, all aircraft), 2 hours (Last 30 days, all aircraft) 

The pilot held a private pilot certificate with an airplane single-engine land rating that was issued on August 24, 2017. He held a Federal Aviation Administration (FAA) first-class airman medical certificate that was issued on February 2, 2017. According to the operator, the pilot had accumulated about 81 hours of total flight experience. The pilot's logbooks were not available for review, and his night flying experience could not be determined. A review of the operator's rental minimums revealed that the pilot did meet the qualifications to rent the Cessna Skyhawk 172S. In addition, the rental agreement did not specify night flying minimums. A review of the dispatch record revealed that the estimated time of departure was 1351 and the return time was estimated at 1730. 

Aircraft and Owner/Operator Information

Aircraft Make: CESSNA
Model/Series: 172 S
Aircraft Category: Airplane
Year of Manufacture: 2007
Amateur Built:No 
Airworthiness Certificate: Normal
Serial Number: 172S10554
Landing Gear Type: Tricycle
Seats: 4
Date/Type of Last Inspection: 01/16/2018, Annual
Certified Max Gross Wt.: 2550 lbs
Time Since Last Inspection: 68 Hours
Engines: 1 Reciprocating
Airframe Total Time: 6206.9 Hours
Engine Manufacturer: LYCOMING
ELT: C126 installed, not activated
Engine Model/Series: IO-360-L2A
Rated Power: 180 hp
Operating Certificate(s) Held: Pilot School (141) 

The single-engine airplane was manufactured in 2007 and was powered by a Lycoming IO-360-L2A engine rated at 180 horsepower, equipped with a McCauley 2-bladed propeller. The most recent annual inspection was completed on January 16, 2018 at a tachometer time of 6,206.9 hours. A review of the maintenance logbooks revealed that the last altimeter pitot-static system and transponder test was performed on April 13, 2017; the records also indicated that all applicable Airworthiness Directives for the airframe, engine, propeller, and accessories had been completed. Fueling records revealed that the airplane was last fueled on the day of the accident with 11.08 gallons of 100LL aviation fuel. A review of the airplane's dispatch record for the accident flight revealed that there were no open discrepancies noted on the log.

Meteorological Information and Flight Plan

Conditions at Accident Site: Visual Conditions
Condition of Light: Night
Observation Facility, Elevation: OXB, 11 ft msl
Distance from Accident Site: 2 Nautical Miles
Observation Time: 1953 EST
Direction from Accident Site:90° 
Lowest Cloud Condition:  
Visibility:  10 Miles
Lowest Ceiling: Overcast / 10000 ft agl
Visibility (RVR):
Wind Speed/Gusts: 10 knots /
Turbulence Type Forecast/Actual:
Wind Direction: 230°
Turbulence Severity Forecast/Actual:
Altimeter Setting: 29.98 inches Hg
Temperature/Dew Point: 12°C / 4°C
Precipitation and Obscuration: No Obscuration; No Precipitation
Departure Point: BALTIMORE, MD (MTN)
Type of Flight Plan Filed: None
Destination: OCEAN CITY, MD (OXB)
Type of Clearance: VFR Flight Following
Departure Time: 1753 EST
Type of Airspace: Class G 

The 1953 recorded weather at OXB, about 2 miles west of the accident site, included wind from 230° at 10 knots, 10 statute miles visibility, and overcast clouds at 10,000 ft above ground level. The temperature was 12°C, dew point 4°C, and the altimeter setting was 29.98 inches of mercury.

According to the Astronomical Applications Department at the United States Naval Observatory, the sunset was at 1752, the end of civil twilight was at 1819, and moonrise was at 1631. The phase of the moon on the day of the accident was waxing gibbous, with 98% of the moon's visible disk illuminated. 

Airport Information

Runway Surface Type: N/A
Airport Elevation: 11 ft
Runway Surface Condition: Water--calm
Runway Used: N/A
IFR Approach: None
Runway Length/Width:
VFR Approach/Landing: None 

Wreckage and Impact Information

Crew Injuries: 1 Fatal
Aircraft Damage: Destroyed
Passenger Injuries: 1 Fatal
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 2 Fatal
Latitude, Longitude: 38.288056, -75.091944 

The wreckage was located in the Atlantic Ocean about 2 miles off the shoreline at a depth of 50 ft. The main wreckage was not recovered. Loose debris that was found in the area of the wreckage was collected and comprised the nose gear strut and wheel, main landing gear tire, flight manuals, fire extinguisher, back seat cover, wheel chock, pilot and passenger doors, and a red tag with the airplane's registration number that read, "remove before flight." Small pieces of the fuselage were also located along the shoreline. 

Medical And Pathological Information

The Office of the Chief Medical Examiner, State of Maryland, performed an autopsy on the pilot. The cause of death was noted as drowning.

Toxicology testing performed by the FAA's Forensic Sciences Laboratory was negative for carbon monoxide, cyanide, and tested-for drugs.

Additional Information

According to the FAA Airplane Flying Handbook, FAA-H-8083-3, Chapter 10:

Night flying requires that pilots be aware of, and operate within, their abilities and limitations. Although careful planning of any flight is essential, night flying demands more attention to the details of preflight preparation and planning. Night flying is very different from day flying and demands more attention of the pilot. The most noticeable difference is the limited availability of outside visual references. Therefore, flight instruments should be used to a greater degree in controlling the airplane. Crossing large bodies of water at night in single-engine airplanes could be potentially hazardous, not only from the standpoint of landing (ditching) in the water, but also because with little or no lighting the horizon blends with the water, in which case, depth perception and orientation become difficult. During poor visibility conditions over water, the horizon will become obscure, and may result in a loss of orientation. Even on clear nights, the stars may be reflected on the water surface, which could appear as a continuous array of lights, thus making the horizon difficult to identify.

According to Advisory Circular 60-4A, "Pilot's Spatial Disorientation," tests conducted with qualified instrument pilots indicated that it can take as long as 35 seconds to establish full control by instruments after a loss of visual reference of the earth's surface. AC 60-4A further stated that surface references and the natural horizon may become obscured even though visibility may be above VFR minimums and that an inability to perceive the natural horizon or surface references is common during flights over water, at night, in sparsely populated areas, and in low-visibility conditions.

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