A BE36 pilot fixated on a frequency change to Tower while descending through 2;200 FT on an ILS and was notified by ATC of his low altitude.

2010-01 · NASA ASRS report 871483

Date: 2010-01 · Aircraft: Bonanza 36 · Phase: approach

Anomalies: deviation-track-heading-all-types|deviation-discrepancy-procedural-clearance|deviation-discrepancy-procedural-published-material-policy|inflight-event-encounter-weather-turbulence

Synopsis

A BE36 pilot fixated on a frequency change to Tower while descending through 2;200 FT on an ILS and was notified by ATC of his low altitude.

Narrative

The flight was IFR with no passengers. I have over 1;000 hours in this aircraft and completed an IPC 3 months prior to this flight. I do not fly in IMC frequently. The en route flight was at about 5;000 FT well above the tops of an overcast layer. As I approached the airport's AWS weather was: wind 15014 gusts 20; ceiling 300 FT; visibility 1.5 SM. I felt very confident about making a good approach. As I entered the airport area I was flying with a 30 to 40 KT tailwind. Approach Control issued me vectors to the approach course for the ILS Runway 6 landing and cleared me down to 2;400 FT until on the final approach course where I was to descend to 2;200 FT. With the tailwind; when I turned onto the final approach course I felt that I was still high and fast. I extended the gear and approach flaps and was already in a descent as I passed over the final approach fix. Approach then instructed me to contact Tower. I did not have the frequency preset and therefore commenced to change the frequency. I was hand flying the approach. Some nervousness entered the scenario at this time because I already felt I was behind the situation in the approach. In the process of trying to change the frequency I repeatedly misdialed the Tower frequency -- changing the ones numbers when trying to change the tenths and vise versa. I unexplainably became fixated on this task while I continued forward and descended. I maintained my attitude but became; in retrospect; completely unaware of the final approach course; glideslope; and altitude. This seemed to go one for several minutes before I successfully entered the frequency; contacted Tower and was warned I was below the glideslope. I realized I was left of course having been affected by the new stiff crosswind and at the same time began to make visual contact with the ground structures 300-500 FT below. My descent rate was minimal and after a course correction to the right and 20 to 30 seconds of flying in visual contact with the ground; I saw the runway and landed uneventfully. Factors that led to this chain of events were: a sense of being rushed because of failing to compensate for the tailwind and altitude; the inability to perform the simple task of changing a frequency; fixation on that task and then loss of situational awareness. Nowhere throughout the approach did the obvious correct decision to declare a missed approach and start the approach enter my mind. Fatigue; illness; personal problems; medication; vertigo; and get-there-itis were not factors in this occurrence. Despite mentally planning and setting up the approach prior to arriving; the last minute perceived rush led to task fixation and loss of situational awareness. Possible solutions: 1) more instrument approaches. 2) Utilize autopilot. 3) Fly the airplane first then communicate. 4) Declare missed approach if distractions or deviations from correct flight path occur.

Source: NASA Aviation Safety Reporting System (public domain). Reports are voluntary submissions and are not verified by NASA.

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