About Maneuvering in Fatal Cirrus Accidents - Pull early, pull often! - Safety and Training Programs - Cirrus Owners and Pilots Association

About Maneuvering in Fatal Cirrus Accidents

As COPA members may know from frequenting the COPA discussion forums, we have several members who believe that eliminating maneuvering accidents will greatly reduce the accident rate.

Often, these beliefs are posted during discussions of egregious violations of safe flight procedures, such as unauthorized aerobatics or buzzing.

The claim states that maneuvering appears as a large percentage of fatal accidents. Furthermore, they posit that maneuvering accidents are intentional acts. So, the posters seem to believe that pilots can eliminate low-level maneuvering and that would reduce the accident rate – a lot!

I’ve always wondered about that.

How many such maneuvering accidents happen? And what changes would make the greatest impact on reducing accidents?

Since reducing the accident rate is something that we all can agree needs attention, eventually, I got around to looking more closely at the data.

NTSB data on maneuvering in fatal accidents

When the NTSB published their Review of U.S. Civil Aviation Accidents, Calendar Year 2010, (PDF, 73 pages), they included this chart as Figure 34, Phase of flight for personal flying accidents, 2010.

Note that the largest number of fatal accidents, 57 out of 190 or 30%, occurred during Maneuvering phase. Obviously, if we could make a significant dent by reducing those Maneuvering accidents, then surely the fatal accident rate would go down.

Cirrus fatal accidents involving maneuvering

Then I took a closer look at all of the Cirrus accidents that were listed in the NTSB database of aviation accidents since the SR20 went into production in mid-1999. Searching for all accidents in Cirrus aircraft (Make = Cirrus, Category = Airplane, Amateur Built = No) involving maneuvering (Broad Phase of Flight = Maneuvering) yielded 23 records.

Wow, 23 Cirrus accidents involved maneuvering! That is a bunch and certainly looks like a productive area for reducing accidents.

Upon closer examination, those 23 also include 5 non-fatal accidents and 1 pre-production accident. So, if 17 fatal accidents involving maneuvering could be avoided among the 90 fatal Cirrus accidents in the NTSB database, then we would see about 20% fewer fatal Cirrus accidents. That seemed worth pursuing.

What happened in those 17 fatal Cirrus accidents?

Here is my brief narrative of each fatal Cirrus accident that was classified by the NTSB as involving maneuvering flight.

  • Parish, NY, 2002
    Double fatality due to a spin while practicing stalls using aggressive maneuvers by two pilots with low time-in-type
  • Las Vegas, NM, 2002
    Fatal CFIT while attempting to reverse course in VFR-in-IMC conditions
  • Hill City, MN, 2003
    Fatal loss of control while attempting to reverse course in VFR-in-IMC conditions
  • Belgrade, MT, 2004
    Fatal CFIT due to a stall during photo mission tracking a slow motor glider over a ridge
  • Coconut Creek, FL, 2005
    Fatal loss of control in IMC due to spatial disorientation, avionics confusion, and operational confusion
  • Lancaster, CA, 2006
    Fatal loss of control while attempting return to airport procedure during primary flight instruction for private pilot with a CFI
  • Stuart, FL, 2006
    Fatal loss of control while attempting to reverse course after reporting avionics problems, perhaps due to pitot/static issues
  • Manhattan, NY, 2006
    Fatal loss of control while attempting a box-canyon turn over the East River and overflying high-rise buildings with a CFI in the right seat
  • Statesville, NC, 2006
    Fatal loss of control during go-around after missed approach
  • Paso Robles, CA, 2007
    Fatal loss of control after abrupt climb to avoid terrain in mountain wave wind conditions
  • Lindsay, OK, 2008
    Fatal loss of control attempting to correct for overshooting final approach course during practice power-off landing with CFI who had zero time in a Cirrus
  • Deltona, FL, 2009
    Fatal spin while practicing slow flight and stalls with a CFI
  • Rock Hill, SC, 2009
    Fatal CFIT while attempting return to airport procedure for unknown reasons
  • Agua Dulce, CA , 2010
    Fatal loss of control while attempting to reverse course in VFR-in-IMC conditions
  • Fredonia, AZ, 2011
    Fatal CFIT during attempt to change course in night VMC conditions
  • Carrollton, TX, 2011
    Fatal loss of control during second missed approach involving fuel exhaustion
  • Duck Creek Village, UT, 2012
    Fatal CFIT while attempting to out-climb terrain at high density altitude in SR20

Oddly, the Boynton Beach, FL, fatal Cirrus accident in 2001 that involved unauthorized aileron-roll aerobatics was not coded with any phase of flight in the NTSB database.

More on maneuvering phase of flight

However, when I review those 17 accidents for maneuvering, I find other factors that seem to dominate rather than intentional acts.

A quick web search for "NTSB maneuvering phase of flight" produced an AOPA Air Safety Institute article Watch this! That article also exhorts pilots to avoid intentional low-level maneuvers:

"Low-level maneuvering was the leading fatal phase of flight again this year as it has been for the last five, holding steady at about 20 percent," wrote ASF Executive Director Bruce Landsberg. "In the vast majority of cases, the accelerated stall, impact with wires, a building, or an object, should not be considered a surprise."

 20% from the AOPA? 30% from the NTSB? 20% in Cirrus fatal accidents?

Yet, those maneuvering Cirrus accidents listed above seem to involve these several factors other than intentional low-level maneuvering.

VFR in IMC or loss of control in IMC

7 of the 18 fatal Cirrus accidents involved maneuvering while in instrument conditions. Some were VFR-in-IMC scenarios: Las Vegas, NM; Hill City, MN; Auga Dulce, CA; Fredonia, AZ. Some were IFR flights: Coconut Creek, FL; Stuart, FL; Statesville, NC.

Note that the Cirrus community has experienced more loss of control in IMC accidents than these; these were the only ones with maneuvering coded as the phase of flight.

Practice maneuvers

Another 5 of 18 accidents happened while practicing flight maneuvers: Parish, NY – stalls without instructor; Lancaster, CA* -- second attempt of return to airport with low-time CFI; Lindsay, OK* -- simulated power-off landing with zero time CFI; Deltona, FL* -- stalls with instructor; Rock Hill, SC – return to airport solo.

* Note three of those five accidents had a CFI in the right seat conducting an instructional flight.

Fuel exhaustion

One accident involved fuel exhaustion during a missed approach: Carrollton, TX

Low-level maneuvers

After removing all of those accidents from consideration, we are left with only 4 that involved low-altitude maneuvers:

  • Belgrade, MT, 2004
    Fatal CFIT due to a stall during photo mission tracking a slow motor glider over a ridge
  • Manhattan, NY, 2006
    Fatal loss of control while attempting a box-canyon turn over the East River and overflying high-rise buildings with a CFI in the right seat
  • Paso Robles, CA, 2007
    Fatal loss of control after abrupt climb to avoid terrain in mountain wave wind conditions
  • Duck Creek Village, UT, 2012
    Fatal CFIT while attempting to out-climb terrain at high density altitude in SR20

That smaller set of low-level maneuvering accidents results in a much smaller percentage of Cirrus fatal accidents, just 4 of 90 or less than 5%. That better comports with my expectation that the phase the NTSB calls maneuvering includes much more than intentional low-level buzzing or impacting trees, wires or buildings.

Lessons from maneuvering in Cirrus fatal accidents

So, what changes would make the greatest impact on reducing the fatal accident rate?

Here is my list of take away lessons to reduce the fatal accidents involving maneuvering:

  1. Improve in-flight discipline when flying in IMC (a factor in 7 of 18 fatal Cirrus accidents)
  2. Practice procedures with Cirrus knowledgeable instructors (a factor in 5 of 18)

From this analysis, I conclude that the Cirrus community does not have a large proportion of intentional maneuvering accidents. Only 4 of 90 fatal accidents involved low-level maneuvers.

However, the Cirrus community does have a history of poor airmanship and poor judgment.  Better training would help here.

We are not done yet.

 

Cheers
Rick

Comments
  • Thanks Rick. As usual an awesome job. On a quick read though I didn't see the fatal barrel roll n Florida that occurred in the last year or so. Is it not yet in the NTSB database because a probable cause hasn't been determined?

  • @bmyers1: Bill, the Boynton Beach, FL, accident does have a probable cause but does not have a phase of flight coded in the online database. When I inquired with the NTSB, they confirmed that the phase of flight should be "Maneuvering-Aerobatics". So, consider this a data problem.

    Cheers

    Rick

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