N744Z

Substantial
Fatal

PIPER PA46-500TPS/N: 4697134

Accident Details

Date
Saturday, December 11, 2021
NTSB Number
CEN22FA069
Location
Steamboat Springs, CO
Event ID
20211211104385
Coordinates
40.459893, -106.857280
Aircraft Damage
Substantial
Highest Injury
Fatal
Fatalities
1
Serious Injuries
0
Minor Injuries
0
Uninjured
0
Total Aboard
1

Probable Cause and Findings

The pilot’s failure to adhere to the published instrument approach procedure, which resulted in controlled flight into terrain.

Aircraft Information

Registration
N744Z
Make
PIPER
Serial Number
4697134
Engine Type
Turbo-shaft
Model / ICAO
PA46-500TPP46T
Aircraft Type
Fixed Wing Single Engine
No. of Engines
1

Registered Owner (Historical)

Name
COWBOY AIR LLC
Address
936 STEAMBOAT BLVD
Status
Deregistered
City
STEAMBOAT SPRINGS
State / Zip Code
CO 80487-9077
Country
United States

Analysis

HISTORY OF FLIGHTOn December 10, 2021, about 1809 mountain standard time, a Piper PA46-500TP, N744Z, was substantially damaged when it was involved in an accident near Steamboat Springs, Colorado. The pilot and sole occupant was fatally injured. The airplane was operated under Title 14 Code of Federal Regulations (CFR) Part 91 as a personal flight.

A review of archived Federal Aviation Administration (FAA) automatic dependent surveillance-broadcast (ADS-B) data revealed that the airplane departed Cody, Wyoming (COD), about 1705 and was en route to Steamboat Springs/Bob Adams Field (SBS). FAA air traffic control data showed that the pilot was operating on an instrument flight rules flight plan and at 1757 was cleared by an air traffic controller to conduct the RNAV (GPS)-E instrument approach procedure at SBS (see figure 1).

Figure 1: Published Instrument Approach Procedure

For terrain clearance, the procedure required the airplane to cross the final approach fix PEXSA at or above 9,700 ft mean sea level (msl) and WAKOR, the next waypoint located 2.2 nm from runway 32 threshold, at or above 8,740 ft msl. The ADS-B data showed that the accident airplane crossed PEXSA about 9,100 ft msl and WAKOR about 8,200 ft msl respectively.

The procedure allowed for a descent to the minimum descent altitude of 8,140 ft msl or 1,258 ft above ground level after passing WAKOR. The missed approach point for the procedure was the runway 32 approach end, and then required a climbing left turn to 11,300 ft msl and indicated the pilot should proceed direct to the HABRO waypoint to enter a holding pattern. Immediately after passing WAKOR, the airplane made a left turn as shown in figure 2 and descended to an altitude of about 7,850 ft msl. The airplane subsequently began to climb, and the last ADS-B data point recorded at 1808:49 indicated an altitude of about 8,125 ft msl and was located about 3.5 miles north of the accident site.

Figure 2: A Google Earth plot showing the accident aiplane’s ground track in the vicinity of the KSBS terminal area. An FAA published approach plate for the RNAV (GPS)-E approach has been overlaid with a 50% opacity. A yellow pin has been added indicating the position of the wreckage. METEOROLOGICAL INFORMATIONA search of the FAA contract automated flight service station Leidos indicated that they had no contact with the pilot nor did any third-party vendors utilizing the Leidos Flight Service system on December 10 or 11, 2021. A search of ForeFlight indicated that they had an account with the pilot who filed an IFR flight plan through their system for the flight between COD to SBS. Before the accident flight the pilot did not view any weather imagery but did enter the flight route into the system, which generated a general route briefing. As a part of that briefing, the pilot was provided the current METAR for SBS, which indicated a broken cloud ceiling of 4,500 ft and 7 sm visibility. WRECKAGE AND IMPACT INFORMATIONThe airplane first impacted Emerald Mountain about 8,172 ft msl on a heading of about 164° as evidenced by broken and cut tree branches. After the initial impact, the airplane bounced and came to rest about 8,216 ft msl, and sustained substantial damage to the fuselage, tail and both wings.

A postaccident examination of the airframe, engine, and propeller revealed no pre-accident mechanical malfunctions or anomalies that would have precluded normal operation. The positions of the landing gear and flap actuator were consistent with both being in transit at the time of impact. ADDITIONAL INFORMATIONData recovered from the Garmin GPS revealed that the airspeed varied between 89 and 110 knots during the instrument approach. 14 CFR 97.3 states that approach category is determined by either the reference landing speed (VREF), if specified, or if VREF is not specified, 1.3 VSO at the maximum certificated landing weight. The Piper PA46-500TP Pilot’s Operating Handbook did not specify a VREF but did state that VSO at maximum certificated landing weight was 69 knots. When multiplied by a factor of 1.3, the resultant value was 89.7. 14 CFR 97.3 further stated that if the speed was less than 91 knots, the airplane would fall into a Category A approach category and if it was between 91 knots, but less than 121 knots, it would fall into a Category B approach category. The instrument approach procedure for a Category A aircraft required 1¼ sm flight visibility for landing and a Category B aircraft required 1 ½ sm flight visibility for landing. It could not be determined if the pilot decided his approach category based upon 1.3 VSO or the actual approach speed flown.

Data Source

Data provided by the National Transportation Safety Board (NTSB). For more information on this event, visit the NTSB Records Search website. NTSB# CEN22FA069