CEN12FA534

The pilot's failure to maintain adequate airspeed and use the appropriate flaps setting during sport-parachuting operations, which resulted in an aerodynamic stall/spin and a subsequent loss of control. Contributing to the accident was the pilot’s failure to follow company guidance by allowing more than four passengers in the door area during exit, which shifted the airplane’s center of gravity aft.

The airplane had climbed to an altitude of about 11,000 feet mean sea level (msl) with 12 parachutists seated inside the airplane on two rear-facing "straddle benches." The airplane was flying at an indicated speed of 100 mph with the flaps retracted. The operator's written guidance for "skydiving jump runs" indicated that the airspeed should be maintained at 110 to 120 mph and that the flaps should be set at 30 degrees. As the airplane arrived at the planned drop location, the parachutists stood up, opened the door, and moved farther aft in the airplane to prepare for their jump. Five of the parachutists were positioned aft of the straddle benches and were hanging onto the outside of the airplane, several of the other parachutists were standing in the door, and the remainder of the parachutists were standing in the cabin forward of the door. According to instructions on the operator's skydiver briefing card, no more than four jumpers should be allowed to occupy the door area during exit. Several parachutists heard the sounds of the airplane's stall warning system, and the airplane then suddenly rolled and began to descend. All 12 parachutists quickly exited the airplane. Several witnesses reported seeing the airplane turning and descending in an inverted nose-down attitude and then appear to briefly recover, but it then entered a nearly vertical dive, which is consistent with a loss of control event as a result of an aerodynamic stall and subsequent entry into a spin. Federal Aviation Administration (FAA) guidance indicates that the pilot-in-command (PIC) must know the weight and location of jumpers during each phase of the flight to assure that the aircraft stays within center of gravity (CG) limits and that the PIC must remain aware of CG shifts and their effects on aircraft controllability and stability as jumpers move into position for exiting the aircraft. Further FAA guidance indicated that, if a stall recovery is not promptly initiated, the airplane is more likely to enter an inadvertent spin, which can degenerate into a spiral. It is likely that the number of parachutists near the door area during exit shifted the CG aft and contributed to the aerodynamic stall/spin. The pilot suffered a serious traumatic brain injury in September 2005 as a result of colliding with a truck while bicycling; however, he did not report that injury during all subsequent FAA medical certificate applications. Persons with an injury of this severity will likely have long-term issues with cognition, attention, executive functioning, sleep disturbance, and impulsivity. However, without the results of any postinjury neuropsychological testing, the status of the pilot's cognition and decision-making during the accident flight could not be determined.

HISTORY OF FLIGHT On August 11, 2012, about 1124 central daylight time, a Beech Aircraft Company G18S multi-engine airplane, N697Q, was substantially damaged when it impacted terrain in a residential neighborhood in Taylorville, Illinois. The commercial pilot sustained fatal injuries. Twelve parachutists on-board the airplane exited and were not injured. No persons on the ground were injured. The airplane was registered to Barron Aviation, LLC; Perry, Missouri, and operated by Barron Aviation Private Flight Services, LLC; Hannibal, Missouri, under the provisions of 14 Code of Federal Regulations Part 91, as a sport parachuting flight. Day visual meteorological conditions prevailed and no flight plan was filed. The local flight originated from Taylorville Municipal Airport (TAZ), Taylorville, Illinois, about 1100. The airplane had climbed to an altitude of about 11,000 feet mean sea level (msl) and the parachutists were seated inside the airplane on two rear facing "straddle benches". As the airplane arrived at the planned drop location, the parachutists stood up, opened the door, and moved further aft in the airplane in preparation for their jump. Five of the parachutists were positioned hanging on to the outside of the airplane with several others standing in the door and the remainder were standing in the cabin forward of the door. Several parachutists reported that they were almost ready to jump when they heard the sounds of the airplane's stall warning system. The airplane then suddenly rolled and all twelve parachutists quickly exited the airplane. Several of those who were last to exit reported that the airplane was inverted or partially inverted as they went out the door. The pilot, seated in the left front cockpit seat, did not exit the airplane. Several witnesses reported seeing the airplane turning and descending in an inverted attitude when the airplane appeared to briefly recover, but then entered a nearly vertical dive. The airplane impacted a tree and terrain in the back yard of an occupied residence. Emergency personnel who first responded to the accident scene reported a strong smell of gasoline and ordered the evacuation of several nearby homes. There was no postimpact fire. PERSONNEL INFORMATION The pilot, age 30, held a commercial pilot certificate with ratings for airplane single and multi-engine land, and instrument airplane. His private pilot certificate was initially issued on December 1, 1999, and his first rating as a commercial pilot was initially issued on January 7, 2003. The pilot's two logbooks showed entries beginning on August 7, 1999, with the last entry in pilot's logbook number two on July 22, 2012. An endorsement showed a flight review was completed on June 26, 2012. A high-performance airplane endorsement was entered on March 11, 2000. A tail wheel airplane endorsement was entered on October 28, 2001. A complex airplane endorsement was entered on December 21, 2002. On December 8, 2003, the pilot successfully completed a practical test and was issued an additional rating for airplane multi-engine land on his commercial pilot certificate. A review of the logbooks showed that as of August 22, 2012, the pilot had logged 1,425.1 hours of total flight experience in airplanes, with 33.7 of those hours in multi-engine airplanes, and a total of 255.1 of those hours in single engine airplanes with conventional gear. There was no record that the pilot had any experience prior to August 20, 2012, in any multi-engine airplanes with conventional gear. The pilot's logbook showed that his most recent flight instruction in multiengine airplanes was logged on June 10, 2005. As of March 7, 2006, the logbook showed a total of 27.8 hours of experience in multiengine airplanes. During the period from 2006 until August 20, 2012, the pilot logged two flights in multiengine airplanes. On August 23, 2008, the logbook showed 1.3 hours of pilot-in-command experience in a Piper PA-23 multiengine piston airplane with the notation that it was a "check-out flight". Another flight, estimated to be in 2008, showed 1.0 hours of pilot-in-command experience in a Beech 99 multiengine turboprop airplane with the notation "fly right seat for multi/turbine time". There were no other flights logged in multiengine airplanes until the pilot's first flight in the accident airplane, which was logged as a "familiarization and skydive checkout flight" of 0.5 hours of pilot-in-command experience on July 20, 2012. The last pilot logbook entry on July 22, 2012, showed the pilot flew the accident airplane for 3.1 hours on six skydiving flights. Based on conversations with family members, the aircraft owner, skydiver load records, and billing records from the operator, it is estimated that the pilot flew the accident airplane for an additional 2.0 hours on August 10, 2012, and an additional total of 1.5 hours on August 11, 2012. The pilot's flight experience in the accident airplane at the time of the accident was estimated as a total of 7.1 hours. There were no logbook entries or endorsements from a flight instructor, or any other evidence to show that the pilot had ever received any flight instruction in the accident airplane. AIRCRAFT INFORMATION The low-wing, retractable conventional landing gear, multi-engine airplane, serial number (s/n) BA-468, was manufactured in 1959. It was powered by two 450-horsepower Pratt and Whitney model R-985-AN-14B engines; s/n 89634, and s/n 203495. Each engine drove a Hamilton Standard; model 22D30, 2-blade metal alloy full feathering propeller. The cockpit had a pilot station on the left seat and a co-pilot station or passenger seat on the right side, with each seat equipped with a 3-point shoulder harness system. The passenger cabin had been modified with two "straddle benches" which provided aft facing seating for a total of twelve parachutists. The main cabin door had been modified for sport parachuting operations with the installation of an upward opening "roll-up" door. With the door in the open position it stowed on the inside surface of the cabin ceiling and the upper right side wall. The original maintenance records were not recovered. The aircraft owner reported that all aircraft maintenance records and logbooks had been onboard at the time of the accident and were destroyed. After the accident, the aircraft owner provided unsigned copies of reconstructed maintenance record entries which showed that an annual inspection was completed on August 5, 2012, at an aircraft total time of 13,833.0 hours. Entries on that date also noted that both engines had accumulated a total of 46.9 hours since the most recent engine overhaul. The operator estimated that the airplane had been operated for about 10 hours or less since the annual inspection was completed on August 5, 2012. METEOROLOGICAL INFORMATION At 1115, the automated weather observation station at TAZ reported wind from 330 degrees at 9 knots; skies clear of clouds, temperature 24 degrees Celsius (C), dew point temperature 9 degrees C, and an altimeter setting of 30.03 inches of Mercury. A review of pilot reports (PIREPs) for the area showed no suggestion of turbulence in the altitudes below about flight level (FL) 290. A review of the wind aloft reports also did not suggest significant shearing of the horizontal flow below about FL300, and there were no thunderstorms nearby for gravity wave generation. Further review of winds aloft reports for the area showed the wind at 10,250 feet pressure altitude was from 347 degrees true at 19 knots; the wind at 9,309 feet pressure altitude was from 348 degrees true at 22 knots; and the wind at 12,221 feet pressure altitude was from 348 degrees true at 27 knots. COMMUNICATIONS AND RADAR AND ON-BOARD VIDEO Following is a timeline of selected communications between the pilot of N697Q and Federal Aviation Administration (FAA) Air Traffic Control (ATC). A sum