CEN11FA267

The pilot’s failure to maintain airplane control while on final approach with a gusting crosswind and the subsequent aerodynamic stall and spin during the attempted go-around.

The pilot was performing a landing approach with a known, gusting crosswind present. A witness stated that the airplane was being “bounced around” by the wind gusts and that it “stalled and rolled to the left.” Another witness heard the accident airplane go to full power. The airplane was then in a 15- to 30-degree left bank with a nose-down attitude before it impacted the ground. The airplane’s left wing impacted the ground first, then the airplane cartwheeled one-half turn. A postaccident examination of the airplane revealed no preimpact airframe or engine anomalies that would have precluded normal operation of the airplane. About 8 months before the accident, the airplane's annual inspection was completed, and 2 days later the airplane's recoverable data module (RDM) stopped recording data due to a failed transient voltage suppressor (TVS) and did not record data during the accident flight. The airplane underwent a 100-hour inspection about midway through the 8 month period, and the failed RDM was not detected at that time. The system does not provide a failure indication to the pilot, and there is no requirement during the 100-hour inspection to check the RDM. A likely cause of the TVS failure could have been electrical overstress: the airplane was tied down overnight, and lightning was present when the RDM stopped recording. A similar airplane sustained substantial lightning strike airframe and avionics damage while tied down and at least two other airplanes sustained lightning strikes at that time. An Air Force Research Lab report recommended that a “review of the system design be conducted to determine if a cockpit indicator could be installed to alert the pilot when data logging is not functioning."

HISTORY OF FLIGHT On April 4, 2011, about 1158 eastern daylight time, a Cirrus Aircraft Corporation SR22, N847C, sustained substantial damage on impact with terrain during landing on runway 27L (8,414 feet by 150 feet, asphalt) at the South Bend Regional Airport (SBN), near South Bend, Indiana. The private pilot, the sole occupant, sustained serious injuries and was transported to a hospital. The pilot subsequently died from the injuries that he sustained. The airplane was registered to Canoecouple Inc. and was operated as a rental airplane by Windy City Flyers, Inc., under the provisions of 14 Code of Federal Regulations Part 91 as a personal flight. Visual flight rules conditions prevailed for the flight, which operated on an activated instrument flight rules flight plan. The flight originated from the Chicago Executive Airport (PWK), near Wheeling, Illinois, about 1106, and was destined for SBN. Prior to the accident, as the pilot flying N847C approached SBN, he contacted the approach controller who issued N847C the current weather at SBN, which included the winds that were “3-0-0 at 1-5” and “gusts to 2-4.” After the weather brief, the pilot responded, “Roger.” The pilot was then vectored for and was cleared to conduct the instrument landing system runway 27L approach. The pilot changed to the tower frequency and the tower controller issued updated wind information and a landing clearance to land on runway 27L. The pilot did not ask for any further wind updates and the tower did not issue any prior to the airplane impacting terrain. About 1158, a witness, who worked at SBN, saw an airplane landing. He indicated that the airplane was being “bounced around” by wind gusts. He reported that the airplane “stalled and rolled to the left.” The airplane’s left wing impacted terrain first and then the airplane cartwheeled one-half turn. Another witness, who worked at a fixed base operator at SBN, stated that he heard the accident airplane go to “full” power and he looked out the line office window. The airplane was in a 15 to 30 degree left bank and it had a nose-down attitude. The airplane then impacted the ground and a puff of smoke was observed. PERSONNEL INFORMATION The pilot held a Federal Aviation Administration (FAA) private pilot certificate with an airplane single-engine land, single-engine sea, and instrument ratings. He had been issued a FAA third-class medical certificate on June 2, 2009, with a limitation for corrective lenses. The pilot reported on the application for that medical certificate that he had accumulated 217.8 hours of total flight time and 45.8 hours of flight time in the six months prior to that application. A copy of excerpts from the pilot’s logbook indicated the pilot’s last entry in his logbook was dated March 15, 2011. The pilot recorded that he had accumulated 372.1 hours of total flight time, 16.5 hours of flight time in the 90 days prior to the accident, and 5.7 hours of flight time in the 30 days prior to the accident. The pilot’s logbook showed that the pilot received 259.4 hours of dual instruction. The logbook had a certified flight instructor’s (CFI) endorsement for a flight review and an endorsement for an instrument proficiency check, which were both dated March 15, 2011. According to a recovered certificate, also dated March 15, 2011 and endorsed by the CFI as an "Authorized Cirrus Aircraft Instructor," showed that the pilot completed the course requirements for Advanced Transition Training. The CFI was employed by the airplane operator. AIRCRAFT INFORMATION N847C, a 2007 model Cirrus Aircraft Corporation SR22, serial number 3218, was a four-place single engine low-wing airplane powered by a six-cylinder, 310-horsepower, Teledyne Continental Motors model IO-550-N51 engine, with serial number 691913, that drove a three-bladed Hartzell constant speed propeller. The airplane's airworthiness certificate was issued on August 21, 2008. The Cirrus Aircraft Corporation SR22 was certified under Part 23. The airplane owner flew the airplane the day before the accident. The owner, in part, stated: I flew Cirrus N847C from Georgetown, TX (KGTU) to Chicago Executive (KPWK) via Houston, MO (M48) on April 3, 2011. The vent fan was placarded as INOP. Other than a greatly reduced volume of fresh air into the cabin, the airplane functioned as expected during all phases of flight. An airplane logbook entry showed that on March 22, 2011, a mechanic removed the blower, sent it for repairs, and updated the airplane’s weight and balance to reflect the blower removal. Airplane logbook entries showed that last airplane annual inspection was completed on August 6, 2010, and a 100-hour inspection was completed on December 15, 2010. The airplane accumulated 556.9 hours of total flight time as of the annual inspection and 654.5 hours of total flight time at the 100-hour inspection. The airplane was equipped with a Garmin Primary Flight Display (PFD) and a Multi-Function Display (MFD) for the pilot’s flight instruments. Integrated avionics units, located behind the MFD and instrument panel, functioned as the main communication hub, linking all integrated avionics system components with the PFD. A secure data (SD) card, when inserted in the top SD card slot of the MFD, can have the MFD log flight data on the SD card at 1 Hertz, generating a text file for each power cycle. The accident airplane was also equipped with a Recoverable Data Module (RDM), which was a crash-hardened flight recording device installed in the tail of the aircraft and it recorded flight and aircraft information. The RDM recorded data at 1 Hz. The RDM was designed to record airplane performance, configuration data, and navigation data to include the flight's groundspeed and global positioning system track. The Cirrus Aircraft Corporation SR22 airplane maintenance manual (AMM), in part, stated: The Aircraft Data Logger (ADL) consists of the RDM. The RDM, located in the shear web of the aft vertical spar in front of the rudder, receives airplane data from the primary GIA 63W integrated avionics unit. The ADL system is powered by 28 VDC through the 2-amp STALL WARNING circuit breaker on the Essential Bus 2 and the 3-amp FUEL QTY circuit breaker on the Main Bus 1. ... (2) Operational Tests - Aircraft Data Logger System ... (a) Set BAT 1 switch to ON position. (b) Open center armrest console and remove glove box trim to access diagnostic LED [light emitting diode]. ... (c) Verify diagnostic LED indicates normal operation with several 0.03 flashes once per second. If diagnostic LED does not indicate normal operation, refer to the following troubleshooting table. ... (d) Install glove box trim. ... (e) Set BAT 1 switch to OFF position. The AMM required an annual operational test of the ADL system. Cirrus Aircraft Corporation initially issued service bulletin (SB) 2X-31-05 R2 on April 16, 2009 and issued a revised version on August 27, 2009. SB 2X-31-05 R2, in part, stated: PURPOSE Cirrus Design recently discovered a condition on aircraft with Perspective Avionics where the Aircraft Data Logger (ADL) fails to store data correctly. Upon investigation, it was determined that the condition is caused by the Recoverable Data Module (RDM) internal software. To correct this condition, the affected RDM must be replaced with an RDM with improved software. N847C had a RDM with improved software installed on September 10, 2009. Additionally, at the airplane’s last annual inspection, the required inspection of the ADL system, indicated that the RDM was operational. The airplane's flight manual indicated that the airplane's maximum demonstrated crosswind component was 20 knots. METEOROLOGICAL INFORMATION At 1154, the recorded weather at SBN was: Wind 310 degrees at 16 knots gusting to 24 knots; visibilit