NTSB CAROL · Event
Event ERA19FA154
Aircraft involved
Probable cause & findings
A loss of control and impact with terrain while maneuvering.
Factual narrative
HISTORY OF FLIGHT
On April 22, 2019, about 0915 eastern daylight time, an experimental, amateur-built Wheeler Express Series 2000, N625J, was destroyed when it was involved in an accident near Cleveland, North Carolina. The pilot was fatally injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. According to the airplane owner, the pilot planned to depart Statesville Regional Airport (SVH), Statesville, North Carolina, and fly the airplane to Twin Lakes Airport (8A7), Mocksville, North Carolina, for an avionics upgrade. The pilot departed SVH at 0901. The owner stated that he watched the airplane depart runway 28, travel west, and then turn back to the east before he lost sight of it. Around 0900, a witness who was located 4.5 miles northeast of SVH reported that he heard an airplane’s engine. When he saw the airplane, he could see that the right wingtip was down. The airplane then rolled quickly inverted while heading eastward. A second witness located 1 mile east of the accident site stated that around 0910, he saw what he thought might be a radio-controlled airplane heading straight down, that he heard loud engine noises that changed pitch. The airplane then fell below the tree line and did not reappear. He later realized that he might have witnessed the accident when he heard that an airplane had crashed. The accident airplane’s owner arrived at 8A7 about 1040, and the airplane had not arrived. He made several phone calls to the pilot without success. He returned to SVH to see if the pilot had returned while other pilots at 8A7 departed in airplanes to search the area. At 1300, the Federal Aviation Administration (FAA) issued an alert notice for the missing airplane, which was found in a field 4 hours later.
AIRPLANE INFORMATION
The Owner’s Flight Manual, Maneuver Limits, stated that: Aerobatics that may impose high loads should not be attempted. The important thing to remember in flight maneuvers is that the airplane is very clean aerodynamically and will build speed with the nose down…Intentional spins are prohibited.
WRECKAGE AND IMPACT INFORMATION
All the airplane’s major components were found at the accident site. Both wings were highly fragmented and were found on the right and left side of the main wreckage near their mounting locations. The wings were detached from the fuselage, and both flaps and ailerons had completely separated. The upper and lower wing skins were fragmented, and pieces were found near the main wreckage. The empennage was displaced upward and forward and had come to rest slightly aft of the main wreckage. The rudder, vertical stabilizer, and horizontal stabilizer were fragmented. Control continuity was confirmed from all flight control surfaces to their respective cockpit controls through overload breaks and fractures. The cockpit throttle control assembly was separated, and the throttle control lever was found extended fully aft in the closed (idle) position, and the throttle shaft handle was bent about 90° in the direction of the instrument panel. The cockpit mixture control assembly was found in the full-forward, full-rich mixture position. The engine crankcase was broken in multiple locations with significant impact-related damage on the front of the crankcase. The six cylinders remained attached to the engine; however, the Nos. 5 and 6 cylinders were only partially attached. All the engine accessory components were separated from the crankcase except for the fuel pump, oil pump, and starter adapter. One of the magnetos and most of the throttle and fuel metering assembly were not found. The propeller hub remained intact and displayed impact damage. Two of the three propeller blades were broken from the hub; one of the propeller blades was not found. The propeller blade that remained attached to the hub displayed significant S-bending, twisting, and leading-edge gouging. A large portion of the blade tip was separated and found in the impact crater. The remaining propeller blade had broken from the hub at the propeller blade shank, and a portion of the tip was separated. The blade displayed twisting deformation as well as leading-edge gouging. Both airplane entry door locking assemblies were found with their locking pins in the closed/locked position.
MEDICAL AND PATHOLOGICAL INFORMATION
An autopsy of the pilot was performed by the Office of Chief Medical Examiner, Raleigh, North Carolina. The cause of death was multiple blunt force injuries. Toxicology testing of the pilot’s tissue specimens performed at the FAA's Bioaeronautical Sciences Laboratory detected 0.053 grams per heptagram of ethanol in muscle tissue samples but not in the liver tissue. The over the counter pain medication naproxen, commonly marketed as Aleve, was detected in the muscle and liver. The over the counter heartburn medication ranitidine, commonly marketed as Zantac, was detected in the muscle. Diphenhydramine, commonly marketed as Benadryl, is available over the counter in many products used to treat colds, allergies, and insomnia, and was detected in muscle and liver. No blood was available for testing. The pilot departed in the experimental amateur-built airplane in visual meteorological conditions for a flight to another airport for an avionics upgrade. Shortly after departure, a witness reported that he heard an airplane’s engine and that, when he saw the airplane it quickly rolled inverted. Another witness located close to the accident site reported that he saw the airplane heading straight down. He heard loud engine noises that changed pitch, and then the airplane fell below a tree line and did not reappear. The disposition of the wreckage was consistent with the airplane impacting terrain with significant energy and at a steep vertical angle. All the airplane’s major components were accounted for at the accident site and examination of the airframe and engine revealed no evidence of any preaccident mechanical malfunctions or failures that would have precluded normal operation. The airplane’s manual contained a statement warning against performing aerobatics in the airplane, and specifically warned that the airplane would rapidly build speed when in a nose down attitude. Based on the witness statements that describe maneuvers (the airplane rolling inverted) and a steep descent toward the ground prior to the accident, it is possible that the pilot was maneuvering the airplane before losing control and impacting the ground in a rapid descent. Based on the results of postmortem toxicological testing, the pilot was taking the sedating antihistamine diphenhydramine. This over the counter drug carries the warning that use may impair mental and/or physical ability required for the performance of potentially hazardous tasks. Compared to other antihistamines, diphenhydramine causes marked sedation. However, no blood was available for testing, and the investigation was unable to determine if the pilot had impairing levels of the potentially impairing medication diphenhydramine in his body around the time of the accident. It is likely that some or all of the ethanol identified by the toxicological testing was from sources other than ingestion. Source: NTSB Aviation Accident Database Retrieved: 2026-02-12
NTSB Findings
Hierarchical cause / factor breakdown from the FAA bulk avdata database. Each finding tagged C (Cause) or F (Factor).
- C Personnel issues-Task performance-Use of equip/info-Aircraft control-Pilot - C
Verbatim from NTSB's published report. Source file
NTSB_2019_ERA19FA154.txt.
Findings + structured fields enriched from FAA avall.mdb.
Full investigation docket on
data.ntsb.gov ↗.
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Related research
What the literature says.
Academic papers and agency reports matching this event's aircraft type or causal vocabulary (loss of control). Sourced from NASA NTRS, NTSB Safety Studies, FAA CAMI, AOPA Air Safety Institute, Embry-Riddle Scholarly Commons, arXiv, and the Semantic Scholar academic graph.
- Embry-Riddle Scholarly Commons 2025 · Journal article (JAAER)
A Scoping Review of Aviation Loss of Control Inflight Research
Loss of control – inflight (LOC-I) contributes to aircraft accidents at unacceptably high rates. Significant industry efforts and research have aimed to improve LOC-I prevention, detection, and recove…
- SKYbrary (Eurocontrol) 2024 · SKYbrary article
Loss of Control In-Flight (LOC-I) — SKYbrary Knowledge Base
SKYbrary comprehensive knowledge-base entry on Loss of Control In-Flight — definitions, contributing factors, accident case studies (Air France 447, Colgan 3407), and prevention strategies.
- NTSB Aircraft Accident Reports 2022 · Accident report
Loss of Control on Takeoff in Icing Conditions — Citation 560XL
Cessna Citation 560XL fatal takeoff icing accident, March 2018. Investigation of a Citation 560XL loss-of-control takeoff accident in icing conditions.
- Semantic Scholar 2021 · Article (Aviation)
ANALYSIS OF GENERAL AVIATION FIXED-WING AIRCRAFT ACCIDENTS INVOLVING INFLIGHT LOSS OF CONTROL USING A STATE-BASED APPROACH
Inflight loss of control (LOC-I) is a significant cause of General Aviation (GA) fixed-wing aircraft accidents. The United States National Transportation Safety Board’s database provides a rich source…
- NASA NTRS 2021 · Presentation
Use of Design of Experiments in Determining Neural Network Architectures for Loss of Control Detection
Abstract—We describe empirical methods for selecting a neural network architecture to implement belief state inference on generic commercial transport aircraft.
- NASA NTRS 2021 · Conference Paper
Use of Design of Experiments in Determining Neural Network Architectures for Loss of Control Detection
We describe empirical methods for selecting a neural network architecture to implement belief state inference on generic commercial transport aircraft.
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