History of Flight
On December 22, 2015, about 1127 Pacific standard time, a Piper PA-32R-301T, N323PA, was destroyed when it impacted terrain near Castro Valley, California, while conducting an instrument approach to Metropolitan Oakland International Airport (OAK), Oakland, California. The private pilot was fatally injured. Instrument meteorological conditions (IMC) were present in the area, and an instrument flight rules (IFR) flight plan was filed for the flight, which departed Lincoln Municipal Airport (LHM), Lincoln, California, about 1050. The airplane was owned and operated by the pilot.
Air traffic control radar and voice communication information revealed that the pilot contacted the Northern California Terminal Radar Approach Control facility shortly after takeoff and requested an IFR clearance to OAK. The pilot was issued a discrete transponder code and an IFR clearance. About 1122, the airplane was established on a heading of 160° at about 4,000 ft mean sea level (msl). The controller cleared the pilot for the instrument landing system (ILS) approach to runway 28R, instructing a right turn to 260° to intercept the localizer and to descend to 3,400 ft msl until established. The controller advised the pilot the airplane was 1 mile north of the GROVE fix, but radar data showed it was 1 mile north of NAGVY.
The pilot acknowledged and began descending but did not turn right. About 30 seconds later, the controller provided a heading of 300° to intercept the localizer. The pilot acknowledged and began a right turn, but the airplane crossed the localizer and tracked south of the course. About 1124, the controller asked if the pilot had visual contact with the airport; the pilot replied, "I'm still in the weather." About 1125, the controller asked if established on the localizer; the pilot replied, "I'm re-establishing." When asked about glideslope, the pilot stated he was receiving it but was "off glideslope" and "too high." At that time, the airplane was at 2,600 ft msl, below the segment minimum of 3,400 ft msl.
The controller issued a low altitude alert, cancelled the approach clearance, and instructed the pilot to turn right to 300° and climb to 4,000 ft. The pilot acknowledged, but the airplane turned left and did not climb. The controller then instructed a turn north to 360° and asked the pilot to verify climbing and turning. The pilot replied, "360 and climbing." The airplane turned right to the north and climbed to 3,700 ft before descending. Shortly after, the pilot stated, "I'm losing it." No further transmissions were received, and radar contact was lost.
Personnel Information
The pilot held a private pilot certificate with ratings for airplane single-engine land and instrument airplane. He held a third-class medical certificate issued in August 2015 with a limitation requiring corrective lenses. According to his logbook, he had accumulated about 1,262 total hours, of which about 960 hours were in the accident airplane make and model. He had about 43 total hours of actual instrument flight experience (3.5 hours in the preceding 6 months) and about 82 hours of simulated instrument experience. His most recent flight review and instrument proficiency check were conducted on November 21, 2015.
Aircraft Information
The airplane was manufactured in 2001 and registered to the pilot in July 2007. It was equipped with a Lycoming TIO-540-AH1A, 300-horsepower, turbocharged, reciprocating engine and a Hartzell HK732B constant-speed propeller. The most recent annual inspection was completed on November 17, 2015, at a total time of 1,479.8 hours. The airplane was equipped with Garmin 430 and 530 panel-mounted GPS units, an electrically-driven standby attitude indicator, and a two-axis autopilot that interfaced with the horizontal situation indicator (HSI).
Meteorological Information
The 1126 automated weather observation at Livermore Municipal Airport (LVK), about 8 miles east, reported wind from 260° at 15 knots, 10 miles visibility, broken clouds at 1,300 and 3,200 ft, temperature 15°C, dew point 12°C, and altimeter 29.82 inches Hg. The 1154 observation at Hayward Executive Airport (HWD), about 7 miles west, reported wind from 270° at 11 knots, 9 miles visibility, broken ceiling at 3,900 ft, overcast ceiling at 5,000 ft, temperature 14°C, dew point 12°C, and altimeter 29.85 inches Hg. A weather computer model balloon sounding for the accident site about 1100 showed clouds likely from the surface through 6,000 ft msl, with drizzle and light rain. Weather satellite imagery showed clouds moving northwest to southeast. Weather radar animation showed light precipitation. The area forecast, issued at 0345, included overcast ceilings at 1,000 ft agl and visibilities of 3 to 5 miles in light rain and mist. AIRMET advisories issued between 0645 and 0730 warned of moderate turbulence below 18,000 ft, IMC due to precipitation and mist, and mountain obscuration. Instrument conditions were forecast to improve between 1000 and 1300, but mountain obscuration was forecast to continue beyond 1300.
Wreckage and Impact Information
The accident site was on a heavily-wooded hillside about 12 nautical miles southeast of OAK at an elevation about 1,400 ft. The initial impact point was identified by fallen trees and branches. The wreckage path extended downhill about 300 ft on a magnetic heading about 330°. The cockpit and cabin area was largely consumed by a post-crash fire. The wreckage was recovered to a secure facility due to heavy fragmentation. All major components were accounted for, with no evidence of inflight breakup. Flight instruments and autopilot were destroyed by impact and fire. Control cables remained attached with overstress separations. The fuel selector was in the left tank position; the filter was free of contaminants. The landing gear was retracted at impact. Wing flap actuator threads corresponded to a flaps-retracted position. The propeller separated at the crankshaft flange; blades exhibited torsional twisting and s-bending. The engine was heavily damaged; crankshaft could not be rotated. Spark plugs showed normal wear. Internal examination of connecting rods, crankshaft, and camshaft revealed no preimpact mechanical anomalies. Accessories were separated; left and right magnetos destroyed. The primary vacuum pump drive and rotor/vanes were not located; standby vacuum pump exhibited impact damage. Turbocharger components showed impact damage but no evidence of foreign object ingestion. Fuel injection servo and flow divider showed no anomalies. The fuel pump diaphragm tear was consistent with tensile overstress from impact, per NTSB Materials Laboratory examination.
Additional Information
The FAA Civil Aeromedical Institute's publication "Introduction to Aviation Physiology" defines spatial disorientation as a loss of proper bearings or mental confusion as to position, location, or movement relative to the earth. Factors contributing to spatial disorientation include changes in acceleration, flight in IMC, frequent transfer between VMC and IMC, and unperceived changes in aircraft attitude. The publication states that pilots flying in IMC are more susceptible to fatigue and anxiety, and emotional upset can disrupt mental processes, increasing vulnerability to illusions. The FAA's Airplane Flying Handbook (FAA-H-8083-3A) describes hazards when the ground or horizon are obscured, noting that the vestibular sense (motion sensing by the inner ear) can confuse pilots, generating false sensations of attitude change.