ERA15FA313

The pilot's improper decision to delay turning toward a suitable runway once he realized that an engine failure had occurred, which resulted in his having inadequate altitude to glide to a suitable runway, and the New York terminal radar approach control LaGuardia Airport area controller's provision of erroneous emergency divert airport information to the pilot. Contributing to the accident were (1) the Federal Aviation Administration's lack of a requirement to periodically review and validate radar video maps, (2) the failure of the engine crankshaft due to a bearing shift, and (3) the pilot's impairment due to his abuse of amphetamine and underlying medical condition(s).

The commercial pilot was conducting an on-demand air taxi flight. The passenger reported that, while they were in cruise flight (about 6,500 ft mean sea level, according to radar data), he heard a loud "pop" sound and saw a flicker of light from the engine area, followed by an "oil smell." The engine then began to "sputter" and lost power. The pilot attempted to restart the engine without success. The pilot reported the problem to air traffic control (ATC); however, he did not declare an emergency. The New York terminal radar approach control (N90) LaGuardia Airport (LGA) departure controller subsequently provided the pilot with the relative locations of several nearby airports, and the pilot determined that he was closest to Republic Airport (FRG), Farmingdale, New York, but that he did not have sufficient altitude to reach it. The LGA controller then provided vectors to Bethpage Airport, an alternate airport depicted on his radar video map (RVM), and noted that, although the airport was closed, there was a runway there. The controller provided vectors to Bethpage for a forced landing, but the pilot reported that he did not see the runway. The next several transmissions between the controller and the pilot revealed that the pilot was unable to acquire the Bethpage runway (because it no longer existed) while the controller continued to provide heading and distance to it. The controller subsequently lost radar contact with the pilot, and the airplane eventually crashed into a railroad grade crossing cantilever arm before coming to rest on railroad tracks. The investigation revealed that the runway the controller was directing the pilot to no longer existed; industrial buildings occupied the location of the former airport and had been there for several years. However, the runway was depicted on the controller's RVM because it had not been removed following the closure of the airport. If the RVM had not shown Bethpage as an airport, the controller might have provided alternative diversion options, including nearby parkways, to the pilot, which would have prevented him from focusing on a runway that did not exist. Further investigation revealed that the Federal Aviation Administration (FAA) did not require periodic review and validation of RVMs and had no procedures to ensure that nonoperational airports were removed from RVMs systemwide. Since this accident, the FAA has revised and corrected its internal procedures to ensure all nonoperational airports are removed from RVMs in the United States. An examination of the engine revealed that the crankshaft failed at the No. 2 main journal. The No. 2 main bearings were heat damaged and extruded into the crank cheek. The No. 2 main bearing supports had bearing shift and fretting signatures. The No. 2 main bearing had rotated in the bearing support. Contact with the crankshaft by the main bearing initiated the fracture of the crankshaft. The engine maintenance records did not reveal evidence of a recent engine repair in this area. Torque values obtained during the engine disassembly did not reveal evidence of an undertorqued condition. The engine had operated about 1,427 hours since its last major overhaul. Toxicological testing detected amphetamine, oxycodone, oxymorphone, losartan, 7-amino-clonazepam, and acetaminophen in the pilot's blood and/or urine. It is unlikely that the losartan and acetaminophen impaired the pilot's judgment. The direct effects of clonazepam, which is used to treat panic disorder or seizures, did not contribute to the accident; however, it could not be determined whether the pilot's underlying medical conditions contributed to the accident. The exact effects of oxycodone on the pilot at or around the time of the accident could not be determined. The level of amphetamine was significantly higher than the therapeutic range, indicating that the pilot was likely abusing the drug and that he was impaired by it at the time of the accident. The combination of the pilot's use of drugs and his medical conditions likely significantly impaired his psychomotor functioning and decision-making and led to his delay in responding appropriately to the in-flight loss of engine power and, therefore, contributed to the accident. Review of radar data revealed that 2 minutes 18 seconds had elapsed and that the airplane had lost about 2,000 ft of altitude while continuing on a westerly heading before the pilot turned the airplane toward FRG. If the pilot had turned immediately after he realized the engine had lost power, he would have had adequate altitude to glide to a suitable runway.

HISTORY OF FLIGHT On August 16, 2015, at 0745 eastern daylight time, a Beech C35, N5946C, collided with a railroad grade crossing cantilever arm and terrain during a forced landing in Hicksville, New York. The commercial pilot was fatally injured, and one passenger sustained serious injuries. The airplane was destroyed by impact forces and a postimpact fire. The airplane was registered to and operated by the pilot as a 14 Code of Federal Regulations (CFR) Part 135 on-demand air taxi flight. Day, visual meteorological conditions were reported near the accident site about the time of the accident, and no flight plan was filed. The flight originated from Francis S. Gabreski Airport (FOK), Westhampton Beach, New York, and was destined for Morristown Municipal Airport (MMU), Morristown, New Jersey. The pilot departed FOK about 0720 under visual flight rules, and according to Federal Aviation Administration (FAA) air traffic control (ATC) transcript information, checked in with the New York terminal radar approach control (N90) Islip departure controller while passing through 1,300 ft mean sea level (msl) 2 miles east of FOK. (For the purposes of this report, all altitudes are in msl, unless otherwise noted.) The pilot requested to climb to 6,500 ft to transition to the New York class B airspace en route to MMU. The Islip controller identified the flight at 1,500 ft and directed the pilot to squawk a mode 3 transponder code of 4356. The Islip controller transferred the flight to the John F. Kennedy International Airport (JFK), Jamaica, New York, departure controller at 0730, at which time radar data depicted the airplane was traveling westbound at 140 knots ground speed at 6,500 ft. The pilot checked in with the JFK departure controller and reiterated his request for a clearance through New York class B airspace. The JFK controller cleared the flight through the class B airspace and directed the pilot to maintain 6,500 ft. At 0738, the JFK controller transferred the flight to the LaGuardia Airport (LGA), Flushing, New York, departure controller. The pilot checked in with the LGA controller at 6,500 ft and was issued the LGA altimeter setting. About 10 seconds later, at 0738:43, as the airplane was on an easterly heading, it began a slight ascent to 6,600 ft while its groundspeed started to suddenly decrease. The pilot did not report any difficulty to the LGA controller, and the controller did not ask the pilot about the change in the flight profile. About 0740, the LGA controller directed the pilot to turn right heading 360°. The airplane was traveling at 60 knots ground speed at 5,700 ft at the time. One second later, the pilot responded that he was "having a little bit of a problem" and was considering diverting to Republic Airport (FRG), Farmingdale, New York. The LGA controller acknowledged and asked the pilot to keep him informed of the situation and to let him know if he any needed assistance. At 0740:31, the pilot advised that he was going to "have to take it down at…the closest spot." The LGA controller provided the pilot with the relative locations of LGA, JFK, FRG, and Westchester County Airport, White Plains, New York, and told the pilot that he could go anywhere he wanted to go. At 0740:55, the pilot responded that FRG was the closest airport but that he was not going to make it there. At 0741:16, the LGA controller asked the pilot to verify that he was going to FRG. The pilot responded, "yeah," and then asked the controller to verify that FRG was the closest airport. At this time, the pilot had started a left turn to the southeast, and the airplane was descending out of 4,400 ft at 70 knots groundspeed. At 0741:26, the LGA controller advised that there was also a landing strip at Bethpage, New York, at the pilot's 10-o'clock position at 5 miles and that the pilot might want to try that airport. The controller advised the pilot that he was about lined up for the runway's extended centerline. The pilot acknowledged, but part of the acknowledgement was unintelligible. At 0742:36, the pilot asked the controller to provide information on the location of the landing strip. The controller advised that the landing strip was at the pilot's 12-o'clock position at 4 miles and that the pilot was set up on the runway's extended centerline. At 0742:50, the LGA controller advised the pilot that FRG was 3 miles southeast of Bethpage in the event that the pilot wanted to go to FRG. The pilot responded that the airplane was losing altitude and that he was doing the best he could to maintain it. At 0743:36, the pilot again asked for the location of the Bethpage airport and said he was not seeing it. The controller responded that there was a landing strip at Bethpage at the pilot's 12-o'clock position at 3 miles and that FRG was at the pilot's 10-o'clock position at 6 miles. The pilot responded that he was not going to make the 6 miles to FRG. At 0744:01, the LGA controller advised the pilot that Bethpage was a closed airport but that there was a runway there at the pilot's 11-o'clock position at 1.5 miles. At 0744:35, the pilot told the controller "you gotta give me a little better heading on that if you would." The controller advised that the runway was about 10° to the right and added that there was also a parkway nearby. The pilot then asked the controller, "and FRG I got 3 miles right?" The controller responded that FRG was at the pilot's 11-o'clock position at 5 miles. The pilot stated that there was no way he was going to make it to FRG and asked the controller to "show me this strip again if you would I'm sorry." The controller responded that the Bethpage runway was at the pilot's 1-o'clock position at less than 1 mile, that it was a closed airport, and that he had no additional information about the airport. There were no further communications with the pilot. The passenger reported that they were in cruise flight when he heard a loud "pop" sound and saw a flicker of light from the engine area, followed by an "oil smell." The engine then began to "sputter" and lost power. The pilot attempted to restart the engine without success. PERSONNEL INFORMATION The pilot, age 59, held a commercial pilot certificate with airplane single engine, multiengine, and instrument airplane ratings. The pilot was issued a second-class FAA airman medical certificate on December 22, 2014, with the limitation that he must wear glasses for near vision. At that time, he reported 3,300 total flight hours. Records provided by the FAA revealed that the pilot completed a 14 CFR Part 135.299 line check on June 18, 2015. He was listed as a single-pilot operator under the name Milo Air, Inc., conducting on-demand air taxi flights. The accident airplane was the only airplane used by Milo Air. The pilot's family provided copies of two pilot logbooks; however, the latest logbook entries were dated May 13, 2008. No recent pilot logbooks were located. AIRCRAFT INFORMATION The four-seat, low wing, retractable-gear airplane, was manufactured in 1952. It was powered by a 260-horsepower Continental Motors IO-470-N engine, driving a three-bladed Hartzell model constant-speed propeller. The airplane was modified with two Beryl D'Shannon fiberglass 15-gallon auxiliary wing tip tanks in accordance with a supplemental type certificate. According to copies of maintenance logbook pages provided by the pilot's family, the most recent annual inspection of the airframe and engine was completed on June 7, 2015. At that time, the airframe total time was 6,979 hours. The airplane's original engine, a Continental E-185-11, was removed and replaced with the Continental IO-470-N engine on December 15, 1998. The total time on the engine at the last inspection was about 2,913 hours, including 1,427 hours since the last major overhaul. The engine was removed and disassembled on two occasions, on February 23, 2006, and on October 24, 2007, to facilitate inspections