Aircraft Accident/Incident Report

Dana Point, California 92624
Saturday, November 19, 2005 14:03 PST

NTSB Narrative Summary Released at Completion of Accident

The airplane impacted the ocean following a departure from controlled cruise flight. The airplane had decelerated from 120 knots to approximately 60 knots while maintaining an altitude of 3,500 feet mean sea level (msl), then descended as rapidly as 7,000 feet per minute, finally spiraling toward the ocean in a corkscrew manner before it impacted the water. No pre-accident anomalies were noted with any systems examined, and no distress calls or communications preceded or followed the upset. The autopsy report on the 51-year-old airline transport pilot was consistent with a condition known as left ventricular hypertrophy (LVH), a substantially thickened main heart chamber. It also noted moderate to severe coronary artery disease with evidence of at least one prior small heart attack. The combination of coronary artery disease and LVH would have substantially increased the risk for sudden cardiac death in this pilot. There was no evidence that the pilot was aware of his heart disease. The behavior of the aircraft cannot be explained by any reasonable scenario in which the 11,500-hour pilot was deliberately controlling the aircraft. Therefore, it seems likely that the pilot was unable to control the aircraft, an inability that can reasonably be explained by an incapacitating cardiac event.

NTSB Probable Cause Narrative

The pilot's inability to maintain aircraft control, which resulted in a loss of airspeed and a stall/spin. The inability of the pilot to maintain control of the airplane was likely due to an incapacitating cardiac event.

Event Information

Type of Event Accident
Event Date 11/19/2005
Event Day of the Week Saturday
Time of Event 1403
Event Time Zone Pacific Standard Time
Event City Dana Point
Event State CALIFORNIA
Event Country --
Zipcode of the event site 92624
Event Date Year 2005
Event Date Month 11
MidAir Collision Indicator No
On Ground Collision occurred ? No
Event Location Latitude 332460N
Event Location Longitude 1174090W
Event Location Airport --
Event Location Nearest Airport ID --
Indicates whether the acc/inc occurred off or on an airport Off Airport/Airstrip
Distance from airport in statute miles --
Degrees magnetic from airport --
Airport Elevation --
Weather Briefing Completeness --
Investigator's weather source Weather Observation Facility
Time of the weather observation 1353 Pacific Standard Time
Direction of event from weather observation facility (degrees) 310
Weather Observation Facility ID SNA
Elevation of weather observation facility 56
Distance of event from weather observation facility (units?) 20
Time Zone of the weather observation PST
Lighting Conditions Day
Lowest Ceiling Height --
Lowest Non-Ceiling Height --
Sky/Lowest/Cloud Conditions Clear
Sky Condition for Lowest Ceiling None
Visibility Runway Visual Range (Feet) --
Visibility Runway Visual Value (Statute Miles) --
Visibility (Statute Miles) 10
Air Temperature at event time (in degrees celsius) 28
Dew Point at event time (in degress fahrenheit) -3
Wind Direction (degrees magnetic) --
Variable Wind Indicator Variable
Wind Speed (knots) 4
Wind Velocity Indicator --
Wind Gust Indicator Not Gusting
Wind Gust (knots) --
Altimeter Setting at event time (in. Hg) 30
Density Altitude (feet) --
Intensity of Precipitation --
METAR weather report --
Event Highest Injury Fatal
On Ground, Fatal Injuries --
On Ground, Minor Injuries --
On Ground, Serious Injuries --
Injury Total Fatal 4
Injury Total Minor --
Injury Total None --
Injury Total Serious --
Injury Total All 4
Investigating Agency NTSB
NTSB Docket Number (internal use) 21545
NTSB Notification Source FAA
NTSB Notification Date Nov 20 2005 12:00AM
NTSB Notification Time --
Fiche Number and/or location -used to find docket information DMS
Date of most recent change to record May 29 2007 12:24PM
User who most recently changed record NTSB\lema
Basic weather conditions Visual Meteorological Cond
FAA District Office WP-LGB-FSDO

Aircraft Involved

Aircraft #1

Aircraft Registration Number N546BC
NTSB Number LAX06FA043
Missing Aircraft Indicator --
Federal Aviation Reg. Part Part 91: General Aviation
Type of Flight Plan filed None
Flight plan Was Activated? No
Damage Destroyed
Aircraft Fire None
Aircraft Explosion None
Aircraft Manufacturer's Full Name Cessna
Aircraft Model T210N
Aircraft Series Identifier --
Aircraft Serial Number 21063663
Certified Max Gross Weight 4000
Aircraft Category Airplane
Aircraft Registration Class --
Aircraft is a homebuilt? No
Flight Crew Seats --
Cabin Crew Seats --
Passenger Seats --
Total number of seats on the aircraft 6
Number of Engines 1
Fixed gear or retractable gear Retractable
Aircraft, Type of Last Inspection Annual
Date of Last Inspection Oct 1 2005 12:00AM
Airframe hours since last inspection 38.4
Airframe Hours 4839.4
ELT Installed Yes
ELT Activated No
ELT Aided Location of Event Site No
ELT Type --
Aircraft Owner Name T.R. Builder Corp.
Aircraft Owner Street Address 270 Newport Center Dr. Ste 200
Aircraft Owner City Newport Beach
Aircraft Owner State CA
Aircraft Owner Country USA
Aircraft Owner Zipcode 92660
Operator is an individual? No
Operator Name --
Operator Same as Owner? Yes
Operator Is Doing Business As --
Operator Address Same as Owner? Yes
Operator Street Address --
Operator City --
Operator State --
Operator Country --
Operator Zip code --
Operator Code --
Owner has at least one certificate None
Other Operator of large aircraft? --
Certified for Part 133 or 137 Operation --
Operator Certificate Number --
Indicates whether an air carrier operation was scheduled or not --
Indicates Domestic or International Flight --
Operator carrying Pax/Cargo/Mail --
Type of Flying (Per_Bus / Primary) Personal
Second Pilot on Board No
Departure Point Same as Event No
Departure Airport Code SDM
Departure City San Diego
Departure State CA
Departure Country USA
Departure Time 1335
Departure Time Zone PST
Destination Same as Local Flt --
Destination Airport Code SNA
Destination City Santa Ana
Destination State CA
Destination Country USA
Specific Phase of Flight Cruise
Report sent to ICAO? --
Evacuation occurred --
Date of most recent change to record May 4 2007 10:28PM
User who most recently changed record STAM
Since inspection or accident Time of Accident
Event Location Runway Number and Location NA
Runway Length --
Runway Width --
Sight Seeing flight No
Air Medical Flight No
Medical Flight --