Link by Link

This accident chain was long, and breaking it was hard


The accident chain, like most, was as obvious in retrospect as it was elusive at the time. Consider these links:

Link 1: The pilot and his four passengers absolutely, positively had to be at the destination, 300 miles away, by early the next morning. There was an event that could not be missed, even if it meant driving. A short weather delay would be OK, but a substantial one would not.

Link 2: The pilot had had a stressful week, with both professional and personal anxiety and bouts of poor sleep.

Link 3: He had gone out with friends the night before the anticipated flight, returning home well after midnight and facing an early wakeup call.

Link 4: The weather throughout the region had been miserable for more than a week, with a stubborn low pressure system leading to widespread thunderstorms that would pop up unexpectedly and hang on for hours with little movement. Away from the storms, ceilings were well above minimums but VFR flight was marginal at best.

Link 5: The pilot had a fresh IPC, after a flight that pleased the instructor, but not the pilot himself.

Link 6: The airplane the pilot was anticipating using on the trip was a model hed flown only six times before, racking up about 12 hours in the previous six months. Though nothing fancy, its handling qualities were decidedly different from what he was used to flying.

Link 7: The destination airport was served only by a GPS approach, and the GPS receiver installed on the airplane was a model the pilot had never used to fly an approach.

Nevertheless, the pilot and his family had the bags packed into the car when he called for a final weather briefing and to file an IFR flight plan. Despite an uneasiness that gnawed in the pit of my, er, his stomach, the flight so far was a go. It was then the briefer delivered Link 8, the final blow.

The winds at the destination airport were measured at 90 degrees to the runway at 18 knots, gusting to 25, exceeding the airplanes demonstrated crosswind component, and forecast to remain so.

It finally dawned on me that although the flight I was planning certainly was possible, there were too many caution flags popping up in too many different areas to make a safe outcome reasonably certain.

I was reluctant to abort the flight for several reasons. I wanted to fly. In addition, it provided the perfect demonstration of the utility of general aviation, trading a 6-hour drive (plus a meal stop) for a 2-hour flight into a small town not served by airlines. And those four hours of not being cooped up in a vehicle with three small kids had incalculable value.

But when I added up the plusses and subtracted the minuses, I concluded that the airplane should go back into the hangar. And Im sure Dr. Joe, the airplanes owner, is glad I did.

-Ken Ibold


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