N7153R

Substantial
Fatal

PIPER PA-28-140S/N: 28-21860

Accident Details

Date
Monday, October 2, 2023
NTSB Number
WPR24FA002
Location
Moab, UT
Event ID
20231002193168
Coordinates
38.751700, -109.769980
Aircraft Damage
Substantial
Highest Injury
Fatal
Fatalities
4
Serious Injuries
0
Minor Injuries
0
Uninjured
0
Total Aboard
4

Probable Cause and Findings

The pilot’s loss of visual reference to the horizon while departing during dark night, which resulted in the pilot experiencing spatial disorientation and subsequent controlled flight into terrain.

Aircraft Information

Registration
N7153R
Make
PIPER
Serial Number
28-21860
Engine Type
Reciprocating
Year Built
1966
Model / ICAO
PA-28-140P28A
Aircraft Type
Fixed Wing Single Engine
No. of Engines
1

Registered Owner (Historical)

Name
LARSEN DOUGLAS
Address
104 KEIDEL TRL
Status
Deregistered
City
MANDAN
State / Zip Code
ND 58554
Country
United States

Analysis

HISTORY OF FLIGHTOn October 1, 2023, about 2024 mountain daylight time, A Piper PA-28-140, N7153R, was substantially damaged when it was involved in an accident near Moab, Utah. The pilot and three passengers were fatally injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight.

An airport security video recorded the airplane landing at 1747 at the Canyonlands Regional Airport (CNY), Moab, Utah. According to a fixed-base-operator employee, the pilot purchased 27 gallons of fuel, parked the airplane near the fuel island, and departed the airport with his family. The occupants returned later in the evening and boarded the airplane. At 2022:47, ADS-B data showed the airplane on runway 21. The security video showed that the pilot-controlled runway lights were not illuminated at that time. At 2023:39, ADS-B data showed the airplane was about mid-runway when it departed the runway surface. At 2024:18, ADS-B data showed the airplane had drifted left of the runway centerline and had begun a right turn, about 400 ft beyond the departure end of the runway at an altitude of about 4,500 ft mean sea level (msl).

A witness, located near the departure end of runway 21, reported that he saw the airplane take off to the southwest. He stated that the runway lights were not on and that the engine was loud and smooth. The witness further saw “the light in the nose turn off,” and stated that the airplane wasn’t very high when it turned steeply to the right and stayed in the steep bank until it was parallel with the runway but in the opposite direction. The witness said that, based upon a reference light from a tower, the red light of the airplane appeared to be losing altitude before he lost sight of it and heard two sounds that were about one second apart. After the second sound, there was no longer an engine sound. The last ADS-B data point recorded around 2024 captured the airplane about 715 ft southwest of the accident site at an altitude of about 4300 ft msl, or zero ft above ground level. According to the owner of the ADS-B data provider, the reported altitude had an uncertainty of ±200 ft. PERSONNEL INFORMATIONA review of the pilot’s logbook revealed that he recorded a total of 44.8 hours of night flying experience. The last recorded night flights were September 27-28, 2023, for a total of 3.6 hours.

The pilot was a member of the South Dakota Army Reserve National Guard (SDARNG). A review of his individual flight records revealed that he had a total of 1,777.8 hours flight experience in military helicopters, but no record of fixed-wing flight experience with the SDARNG. AIRCRAFT INFORMATIONA review of maintenance records revealed that the engine was overhauled on October 19, 2019. The last annual inspection of the airframe, engine, and propeller occurred on March 20, 2023, at a tachometer time of 1842.78 hours and a total time of 4642.78 hours. METEOROLOGICAL INFORMATIONThe pilot requested a weather briefing from ForeFlight. He listed the destination as Casper/Natrona County International Airport (CPR), Casper, Wyoming, and indicated the departure would occur around 2000. Visual meteorological conditions were reported for the departure, route of flight, and destination.

A weather study revealed that moon rise occurred about 2023. Around 2027, the center of the moon’s disk was about 0.32° above the horizon. AIRPORT INFORMATIONA review of maintenance records revealed that the engine was overhauled on October 19, 2019. The last annual inspection of the airframe, engine, and propeller occurred on March 20, 2023, at a tachometer time of 1842.78 hours and a total time of 4642.78 hours. WRECKAGE AND IMPACT INFORMATIONThe airplane came to rest on a hill at an elevation of about 4649 ft msl, on a heading of about 200° magnetic. A line of debris that included the nose and main landing gear assembly extended southwest about 540 ft and included two impact points. The first point of probable impact was a 12 ft by 24-inch gouge/indentation on a hill, at an elevation of about 4635 ft msl, and was consistent with only the nose landing gear impacting the terrain. About 50 ft northeast of this point were indications of contact by the right and then the left main landing gear. About 540 ft away was a second impact mark that was within about 40 ft of the final location of the main wreckage (Figure 1).

Figure 1. Google Earth image showing the first and second points of probable impact, and the location of the landing gear. The blue arrow points in the direction of travel.

The fuselage exhibited downward bending of the engine and cowling area. The right wing separated from the fuselage. The left wing remained attached to the fuselage but exhibited substantial damage. The nosewheel separated from the strut and was found in the first impact area. Both main landing gear assemblies, including the struts, separated from the fuselage. Flight control continuity was confirmed from the cockpit to the respective primary flight controls. Postaccident examination of the airframe and engine revealed no evidence of any preimpact mechanical malfunctions or failures that would have precluded normal operation. ADDITIONAL INFORMATIONThe Airplane Flying Handbook, FAA-H-8083-3C, Chapter 11 stated, in part:

The procedure for night takeoffs is the same as for normal daytime takeoffs except that many of the runway visual cues are not available. The pilot should check the flight instruments frequently during the takeoff to ensure proper airspeed, attitude, and heading. As the airspeed reaches the normal lift-off speed, the pilot adjusts the pitch attitude to establish a normal climb by referring to both outside visual references, such as lights, and to the flight instruments. After becoming airborne, the darkness of night often makes it difficult to note whether the airplane is getting closer to or farther from the surface. The attitude indicator, vertical speed indicator (VSI), and altimeter should all indicate a positive climb. It is also important to ensure the airspeed is at best climb speed.

The pilot makes necessary pitch and bank adjustments by referencing the attitude and heading indicators. It is recommended that turns not be made until reaching a safe maneuvering altitude. Although the use of the landing lights is helpful during the takeoff, they become ineffective after the airplane has climbed to an altitude where the light beam no longer extends to the surface. The light can cause distortion when it is reflected by haze, smoke, or clouds that might exist in the climb. Therefore, when the landing light is used for the takeoff, it should be turned off after the climb is well established provided it is not being used for collision avoidance. INJURIES TO PERSONSAn autopsy of the pilot was performed by the Office of the Medical Examiner, Utah Department of Health and Human Services. The autopsy report was reviewed by the NTSB Investigator-In-Charge. According to the autopsy report, the cause of death was blunt force injuries, and the manner of death was accident.

The autopsy revealed mild coronary artery disease, which posed a slight hazard to flight safety. There was no forensic evidence that it likely contributed to this accident.

Data Source

Data provided by the National Transportation Safety Board (NTSB). For more information on this event, visit the NTSB Records Search website. NTSB# WPR24FA002