What happened
On October 11, 2021, a Piper PA-34-220T (Seneca V) operating under a VFR-to-IFR flight plan (Z-plan) crashed into rising terrain near Löwenburg in the Siebengebirge region. The flight was a corporate mission intended to transport company employees to business appointments.
During the flight, the aircraft transitioned from visual flight rules (VFR) into instrument meteorological conditions (IMC). The pilot had pre-selected a flight level of 1,20 and maintained this altitude despite the increasing elevation of the terrain. While the aircraft was in a heading mode with altitude hold engaged, it collided with an obstacle in the terrain. The impact resulted in two fatalities (the pilot and one passenger) and the destruction of the aircraft.
The investigation
The BFU investigation focused on the pilot's flight preparation, the meteorological conditions, and the pilot's medical status. Investigators examined radar data, flight data from the Primary Flight Display, and communications with air traffic control. The investigation also reviewed the aircraft's navigation equipment, including its terrain proximity functions, and the regulatory framework regarding IFR operations in Class G airspace in Germany.
Medical examinations and autopsies were central to the investigation. While the pilot held all necessary licenses and was generally experienced, investigators discovered evidence of a significant medical event. Furthermore, the investigation looked into the communication between the pilot and the radar controller, noting that the pilot's initial radio contact did not include position or intention details, which delayed identification.
Findings
- The pilot had experienced a recent myocardial infarction (heart attack) approximately 6 to 8 hours prior to the accident, which was not known at the time of flight.
- The pilot's navigational and meteorological flight preparation was inadequate, particularly regarding the weather conditions for the VFR portion of the flight.
- The pilot failed to adequately prepare for the terrain obstacles in the area, despite having flown similar routes previously.
- The aircraft was slightly overweight by approximately 30 kg, though this was not a contributing factor to the crash.
- There were discrepancies between German national regulations for IFR flights in Class G airspace and the standardized European rules (SERA).
- Communication delays occurred because the flight plan was managed in an adjacent sector, and the pilot did not provide immediate position information upon first contact with ATC.