Game Time Decisions

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Significant convective activity in the area calls for the pilot to exercise conservative judgment and a review of the game plan.

The Beechcraft A36 provides a comfortable cross-country environment while demanding a knowledgable pilot and, as with any aircraft, thoughtful IFR planning.

Many VFR, and inexperienced IFR, pilots mistakenly believe that an instrument rating allows you to launch into “weather.” After all, instrument pilots have been trained to fly on the gages, so making the decision to fly into the clouds shouldn’t be difficult.

Veteran IFR pilots understand the complexity of the go/no-go decision. There are weather factors that need to be addressed beforehand, and more involved flight planning techniques to stay safe. Flying in IMC is significantly more than lining up, pushing the go-lever, and climbing into what may be quickly changing conditions, even if the launch time is VFR.

Thoughtful planning for an IFR flight, even a local hop to shoot approaches, is the key to staying safe in less than ideal weather. Having the presence of mind to make judicious game-time decisions and never hesitating to change plans when the situation calls for a retreat—even if that means taxiing off the runway, and going back to the hangar to wait things out.

This also includes creating plans for alternate transportation. It can’t be said enough… little airplanes are not the airlines, even when we are flying capable cross-country machines.

Unfortunately, this pilot may not have had the required presence-of-mind for tactical and real-time decisions—the ability to get past the pressure to complete a desired flight, or both.

Pilot and Business Owner

The 46-year-old auto repair shop owner held a commercial certificate with ratings for airplane single-engine land and instrument airplane. His logbook was never found, so investigators used his most recent FAA second class medical application, dated about seven months before the accident, to estimate his experience. The pilot reported having about 950 hours of total time in all aircraft on that application. In another document the pilot reported his most recent flight review as occurring 18 months before the accident.

Radar summary image for 2115 CDT showing the accident location.

Interestingly, no mention was made by investigators of any recent instrument proficiency check. Nor did they note any local flight instructors who provided training or who volunteered information to investigators. This is unusual in NTSB reports, as investigators generally seek out individuals who knew (or flew) with the accident pilot.

Perhaps this pilot was one of the many aviators who fly under-the-radar so to speak. They are on the fringes of the aviation community; outliers who stay legal, but are never really known by others in the local aviation community. While not necessarily unsafe, it is also not the best way to learn or to hone one’s aviation knowledge.

The same was true for his experience with his airplane, a 1977 Beechcraft A36. There was no indication of the pilot’s transition training, or past flights, etc. One would have to believe that in small town of 20,000 (where the pilot ran a local business and based his aircraft) some local pilots or instructors at Hale County Airport (KPVW) in Plainview, Texas, would have volunteered information about his aviation experience.

But, with this pilot’s experience and certificates, it would be reasonable to assume he could fly an A36, especially since he had owned the aircraft for four years.

Game Time

About nine months before the accident flight, the NTSB noted the pilot sustained paint damage to his airplane during a night flight east of Pueblo Colorado. He inadvertently flew into heavy rain in a building storm. He claimed not to see the storm on XM weather or outside the aircraft until it was too late. This type of encounter can happen easily at night. But, perhaps the NTSB chose to include this tidbit as an example of the pilot’s incomplete understanding of the delay inherent in XM weather, and other similar cockpit weather— which is not real-time. This type of weather information is strategic, not tactical. It is advisory only, and apparently the pilot did not understand this.

On the evening of the accident, at 20:58 CST, the pilot received weather information, using ForeFlight, and filed an IFR flight plan from KPVW to Boerne Stage Field Airport, in Boerne Texas (5C1), 308 miles to the southeast near San Antonio, TX. Onboard were the pilot, his wife and their daughter.

GOES-13 satellite image at 2115 CDT shows the severity of the rapidly moving storm that caused the demise of an unsuspecting pilot.

There was serious weather to the west and northwest of KPVW. A severe thunderstorm had developed south of a curving cold front and a squall line formed just west of the airport. Although the sun was setting, the approaching storm should have been visible to the pilot both visually, and on his tablet. Several witnesses mentioned to investigators that they stepped outside just to see the clouds of the approaching storm.

Not only was the storm visible, but it was clearly noted as a possibility in the TAF covering the departure time for the flight and depicted on the current radar charts. SIGMETs, AIRMETs, severe thunderstorm watch and warning information, along with information in the area forecasts should have also been warnings for the pilot.

Weather towards their destination was better, albeit still conducive to rain showers or thunderstorms near areas of low pressure, but little or no weather was showing up on radar to the southeast.

KLBB WSR-88D reflectivity for the 0.5-degree elevation scan initiated at 2118 CDT with the lightning data and the unmistakable pattern of a gust front.

During this time, the current weather at KPVW had east winds at four knots, 10 miles visibility, and clear skies. The automated system noted distant lightning between 10 and 30 miles from the center of the airport.

As the pilot taxied from the ramp to runway 22, one of the witnesses watching the approaching storm was surprised anyone would be taking off with the storm approaching the airport. The witnesses reported seeing the airplane accelerate down the runway, climb into the air while making a sharp left turn before heading straight down. The engine was at full-throttle. A Garmin 496 GPS, which was removed from the wreckage, indicated the airplane only got 80 feet above the ground with a groundspeed of 86 knots. There were no survivors in the ensuing impact.

The NTSB rightfully determined the probable cause as: “The pilot’s decision to take-off ahead of an approaching severe thunderstorm, which resulted in an encounter with hazardous weather conditions that led to a loss of airplane control.”

Investigators determined there was a gust front over the airport at the time of the accident. Gust fronts are nothing to fool with. They can create severe turbulence and wind shear. They can also have a rolling motion as they move across the ground. Getting caught in a strong downdraft can cause an aircraft, which has just left terra firma, to be forced back down in a violent fashion. I believe this is what occurred.

Further evidence of potential wind shear and turbulence is in the KPVW AWOS report recorded 10 minutes after the accident. It noted winds out of the northwest at 26 knots gusting to 36 knots.

Strategy, Tactics, and Real-Time

A gust front is generated by the leading edge of cold air from inside the thunderstorm. Both shelf clouds and roller clouds are indicators of its presence.

Like a professional athlete, a pilot needs to have a game plan. In football, it’s the plays the coaches have laid out long before game time. Think of this as our what-if planning—risk management strategies that we should always have in place. The big picture that will allow winning the game or making it to our destination.

Then we have tactics—changes to the plays and plans to reflect injuries, and countermeasures the opponent has put into place. As a pilot this should be our thought process while we are still preparing for the flight. The approaching storm, this pilot faced, should have triggered changes to his plans to outplay the storm and its risks. In this case he missed a real opportunity to change the evening’s outcome.

Finally, there is real-time. The ball is snapped and some players miss blocks, others fall. The running back needs to react to the real-time situation. He will juke and stiff arm as needed to accomplish his objective—a first down. For the pilot the objective is to complete a safe flight—the ability to understand the situation for what it is and make appropriate changes. In this case it should have been to head back to the hangar, now.

Hard to Do

But therein lies the rub. We are human, and we don’t wish to disappoint, or perhaps admit to others that we (or our airplane) are not capable of getting us to our destination as planned. All of us with more than a few hundred hours have been in similar situations. It is hard to do, but we need to have the presence of mind to make the right real-time call, even if it means falling short of the first down.

This article is based on NTSB Number: CEN15FA245

Armand Vilches is a commercial pilot and instructor from Brentwood, TN. He is the 2015 Nashville District FAASTeam Honoree. His extensive background in risk management and insurance brings a unique perspective to aviation and flight instruction.

This article originally appeared in the May 2018 issue of IFR Refresher magazine.

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