Comet Henry John Haraldson
February 11, 1949 - January 13, 2019
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Aviation Accident Final Report - National Transportation Safety Board
The National Transportation Safety Board did not travel to the scene of this accident.
Additional Participating Entities:
Federal Aviation Administration / Flight Standards District Office; Rapid City, South Dakota
Piper Aircraft; Vero Beach, Florida
Lycoming Engines; Williamsport, Pennsylvania
Investigation Docket - National Transportation Safety Board:
Location: Salem, South Dakota
Accident Number: CEN19LA053
Date and Time: January 13, 2019, 14:25 Local
Registration: N75191
Aircraft: Piper PA28
Aircraft Damage: Substantial
Defining Event: Medical event
Injuries: 1 Fatal
Flight Conducted Under: Part 91: General aviation - Personal
Analysis
About 15 minutes after departing on a cross-country flight in day visual meteorological conditions, the pilot contacted air traffic control to report that he was having chest pain and blacking out, and was having difficulty controlling the airplane. The controller continued to communicate with the pilot for about 20 minutes before radio contact was lost. The wreckage was subsequently located in a field. Examination did not reveal any preimpact anomalies that would have precluded normal operation of the airplane.
The pilot's Federal Aviation Administration medical certificate expired about 10 weeks before the accident. He had begun but not completed the requirements for operation under BasicMed. Autopsy of the pilot identified coronary artery disease including 80% stenosis of the left anterior descending coronary artery and 50% stenosis of the right coronary artery and diagnosed an acute myocardial infarction (heart attack). It is likely that the sudden, impairing effects of the heart attack and associated severe chest pain resulted in the pilot's loss of airplane control while attempting to land in a field, and its subsequent impact with terrain.
Probable Cause and Findings
The National Transportation Safety Board determines the probable cause(s) of this accident to be:
The incapacitating effects of an acute myocardial infarction (heart attack), which resulted in the pilot's loss of airplane control and impact with terrain.
Findings
Personnel issues Cardiovascular - Pilot
Personnel issues Aircraft control - Pilot
Factual Information
History of Flight
Maneuvering Medical event (Defining event)
Emergency descent Off-field or emergency landing
Landing Collision with terr/obj (non-CFIT)
On January 13, 2019, about 1425 central standard time, a Piper PA-28-181 airplane, N75191, was substantially damaged when it impacted terrain about 6 miles south of Salem, South Dakota. The private pilot was fatally injured. The airplane was owned and operated by the pilot as a Title 14 Code of Federal Regulations Part 91 personal flight. Day visual meteorological conditions prevailed in the area and no flight plan was filed for the cross-country flight, which originated from Mitchell Municipal Airport (MHE), Mitchell, South Dakota, and was destined for Mary Skie-Lincoln County Airport (Y14), Tea, South Dakota.
About 15 minutes after departing, the pilot contacted Sioux Falls Approach Control and stated that he was having chest pains, was blacking out, and was having difficulty maintaining control of the airplane. About 1411, radar track data indicated the airplane was traveling southeast. The airplane then maneuvered/circled for about 6 minutes, briefly headed northwest briefly and began maneuvering/circling again. The controller continued to communicate with the pilot for about 20 minutes before radio contact was lost about 1425; the track data ended about the same time, about 2 miles southwest of the accident site. The wreckage was subsequently located in a field about 30 nautical miles east-southeast of the departure airport.
Pilot Information
Certificate: Private
Age: 69, Male
Airplane Rating(s): Single-engine land
Seat Occupied:
Other Aircraft Rating(s): None
Restraint Used:
Instrument Rating(s): Airplane
Second Pilot Present: No
Instructor Rating(s): None
Toxicology Performed: Yes
Medical Certification: Class 3 With waivers/limitations
Last FAA Medical Exam: October 5, 2016
Occupational Pilot: No
Last Flight Review or Equivalent:
Flight Time: 2515.6 hours (Total, all aircraft), 11 hours (Last 90 days, all aircraft), 2.9 hours (Last 30 days, all aircraft), 1 hours (Last 24 hours, all aircraft)
According to Federal Aviation Administration (FAA) records, the 69-year-old pilot held a private pilot certificate with airplane single-engine land and instrument ratings. The pilot's most recent third-class FAA medical certificate was issued on October 5, 2016, with a limitation for corrective lenses, and expired on October 31, 2018. On the application for that medical certificate, he reported 2,250 total hours of flight experience, with 50 hours in the previous 6 months.
Aircraft and Owner/Operator Information
Aircraft Make: Piper
Registration: N75191
Model/Series: PA28 181
Aircraft Category: Airplane
Year of Manufacture: 1976
Amateur Built:
Airworthiness Certificate: Normal
Serial Number: 28-7690310
Landing Gear Type: Tricycle
Seats: 4
Date/Type of Last Inspection:
Certified Max Gross Wt.:
Time Since Last Inspection:
Engines: 1 Reciprocating
Airframe Total Time:
Engine Manufacturer: Lycoming
ELT:
Engine Model/Series: O-360-A4M
Registered Owner:
Rated Power:
Operator: On file
Operating Certificate(s) Held: None
The four-place, single-engine, low-wing, fixed tricycle landing gear airplane, serial number 28-7690310, was manufactured in 1976. According to maintenance records, the airplane was powered by a 180-horsepower Lycoming O-360 engine, serial number L-1039-36A, which drove a two-blade fixed pitch Sensenich propeller.
Meteorological Information and Flight Plan
Conditions at Accident Site: Visual (VMC)
Condition of Light: Day
Observation Facility, Elevation: KMHE,1299 ft msl
Distance from Accident Site: 30 Nautical Miles
Observation Time: 14:22 Local
Direction from Accident Site: 288°
Lowest Cloud Condition:
Visibility: 10 miles
Lowest Ceiling: Overcast / 1500 ft AGL
Visibility (RVR):
Wind Speed/Gusts: 13 knots /
Turbulence Type Forecast/Actual: /
Wind Direction: 200°
Turbulence Severity Forecast/Actual: /
Altimeter Setting: 30.29 inches Hg
Temperature/Dew Point: 1°C / -3°C
Precipitation and Obscuration: No Obscuration; No Precipitation
Departure Point: Mitchell, SD (MHE)
Type of Flight Plan Filed: None
Destination: Tea, SD (Y14)
Type of Clearance: None
Departure Time:
Type of Airspace: Class G
The 1422 recorded weather at MHE included wind from 200° at 13 knots; 10 statute miles visibility; overcast clouds at 1,500 ft; temperature 1°C; dew point -3°C; altimeter 30.30 inches of mercury.
Wreckage and Impact Information
Crew Injuries: 1 Fatal
Aircraft Damage: Substantial
Passenger Injuries:
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 1 Fatal
Latitude, Longitude: 43.61861,-97.381111(est)
The wreckage was located in a harvested crop field. Review of information and photographs provided by local law enforcement revealed that all major components of the airplane were present at the site. The airplane main wreckage was found resting upright in the field. The cockpit was crushed and the empennage was facing north. A debris field, wheel tracks, and ground scars in the field indicated that the airplane contacted the ground about 600 to 800 ft north of where it came to rest. The wreckage was removed from the scene and was placed in a secure building.
The wreckage was subsequently examined by an FAA inspector and airframe manufacturer's representative. The examination revealed no preimpact anomalies that would have precluded normal operation of the airplane.
Medical and Pathological Information
The McCook County Coroner coordinated the pilot's autopsy at the Sanford Health Pathology Clinic, Sioux Falls, South Dakota. The autopsy indicated that the pilot's cause of death was multiple blunt force injuries due to an airplane crash due to acute myocardial infarction due to atherosclerotic cardiovascular disease. The autopsy identified coronary artery disease, including 80% stenosis of the left anterior descending coronary artery and 50% stenosis of the right coronary artery.
Toxicology testing performed at the FAA Forensic Sciences Laboratory identified valsartan in liver and muscle, ranitidine in muscle, and amlodipine in liver and muscle.
Amlodipine is a calcium channel blocker heart medication used in the treatment of hypertension. Ranitidine is used in the treatment of gastric acid secretion. Valsartan is an angiotensin II receptor antagonist indicated for treatment of high blood pressure, of congestive heart failure, and post-myocardial infarction.
The pilot's personal medical records indicated that he had well-controlled hypertension and occasional visits for respiratory infections. The pilot requested his primary physician fill out the FAA physician attestation form for BasicMed and the physician did so, attesting to the pilot's ability to safely operate an aircraft. The medical records also included the history form filled out by the pilot during this process; however, the FAA had no record of receiving the pilot's BasicMed documents.
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Accident Number: CEN19LA053
Date & Time: 01/13/2019, 1425 CST
Registration: N75191
Aircraft: Piper PA28
Injuries: 1 Fatal
Flight Conducted Under: Part 91: General Aviation - Personal
On January 13, 2019, about 1425 central standard time, a Piper PA28 181 airplane, N75191, impacted terrain about 6 miles south of Salem, South Dakota. The private pilot, the only person on board, was fatally injured and the airplane was substantially damaged. The airplane was owned and operated by the pilot as a Title 14 Code of Federal Regulations Part 91 personal flight. Day visual meteorological conditions prevailed in the area and no flight plan was filed for the cross-country flight that originated from the Mitchell Municipal Airport (MHE), Mitchell, South Dakota, and was destined for Mary Skie-Lincoln County Airport (Y14), Tea, South Dakota.
The pilot reported to Sioux Falls Approach Control that he was having chest pains and was blacking out. The controller tried to get the pilot to land anywhere. The controller lost radio contact with the airplane about 1425.
According to initial information from the McCook County Sheriff's Office, they were notified by a controller that a man in a small airplane was having a medical emergency and were given an approximate location of the airplane. Search and rescue personnel along with officers from the sheriff's office were dispatched. About 1430, they were notified that air traffic control had lost all communication with the airplane. About 1435, their dispatch received notification that the airplane had been located.
According to Federal Aviation Administration (FAA) records, the pilot held a private pilot certificate with airplane single-engine land and instrument ratings. The pilot held an FAA third class medical certificate, dated October 5, 2016. On the application for that medical certificate, he reported that he had accumulated 2,250 hours of total flight tine and had accumulated 50 hours of flight time in the six months before the application. That medical certificate was issued with the following limitation: Must wear corrective lenses.
N75191 was a 1976-model Piper PA28 181, four-place, single-engine, low-wing, fixed tricycle landing gear, semi-monocoque design airplane with serial number 28-7690310. According to maintenance records, the airplane was powered by a normally aspirated, direct drive, air-cooled, horizontally opposed, carburetor equipped, four cylinder, 180-horsepower Lycoming O-360 engine with serial number L-1039-36A, which drove a two-blade fixed pitch Sensenich propeller.
At 1422, the recorded weather and MHE was: Wind 200° at 13 knots; visibility 10 statute miles; sky condition overcast clouds at 1,500 ft; temperature 1° C; dew point -3° C; altimeter 30.30 inches of mercury.
According to initial information from the McCook County Sheriff's Office, the airplane wreckage was located in a harvested crop field about 30 nautical miles and 108° from MHE. The wreckage was subsequently photographically documented. Review of the sheriff's information and photographs revealed the cockpit of the airplane was crushed. All major components of the airplane can be accounted for in the photographs. The tail of the plane was facing north. A debris field and tracks in the field showed the airplane had made contact with the ground about 600 to 800 ft north of the airplane's resting spot. The total debris field was about 600 ft long 300 ft at the widest part and was cone shaped, getting wider to the south. About 100 ft southeast of the airplane the pilot was found. The airplane wreckage was removed from the scene and was placed in a secure building.
The McCook County Coroner was asked to arrange for an autopsy to be performed on the pilot and to have toxicological samples taken.
Aircraft and Owner/Operator Information
Aircraft Make: Piper
Registration: N75191
Model/Series: PA28 181
Aircraft Category: Airplane
Amateur Built: No
Operator: On file
Operating Certificate(s) Held: None
Meteorological Information and Flight Plan
Conditions at Accident Site: Visual Conditions
Condition of Light: Day
Observation Facility, Elevation: KMHE, 1299 ft msl
Observation Time: 1422 CST
Distance from Accident Site: 30 Nautical Miles
Temperature/Dew Point: 1°C / -3°C
Lowest Cloud Condition:
Wind Speed/Gusts, Direction: 13 knots / , 200°
Lowest Ceiling: Overcast / 1500 ft agl
Visibility: 10 Miles
Altimeter Setting: 30.3 inches Hg
Type of Flight Plan Filed: None
Departure Point: Mitchell, SD (MHE)
Destination: Tea, SD (Y14)
Wreckage and Impact Information
Crew Injuries: 1 Fatal
Aircraft Damage: Substantial
Passenger Injuries: N/A
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 1 Fatal
Latitude, Longitude: 43.618611, -97.381111 (est)
How sad. He tried to get it down near a farm house for help and didn't make it. RIP and condolences to the family and friends.
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