Date: 201203
Local time of day: 0001-0600
Location: ZZZ.Airport, US
Aircraft: Skylane 182/RG Turbo Skylane/RG
Operating under: Part 91
Flight plan: VFR
Flight phase: Climb
Airspace: Class C ZZZ
ATC / advisory: TRACON ZZZ
Reporter organization: Government
Reporter function: Departure; Approach
Reporter qualification: Air Traffic Control Fully Certified
Human factors: Situational Awareness; Communication Breakdown; Confusion
Anomaly: ATC Issue All Types; Flight Deck / Cabin / Aircraft Event Illness / Injury; Inflight Event / Encounter Fuel Issue; Inflight Event / Encounter Weather / Turbulence
Detector: Person Air Traffic Control
Result: Air Traffic Control Provided Assistance
Contributing factors: Weather; Procedure; Human Factors
Primary problem: Human Factors

Narrative: A C182 was vectored to an ILS runway approach. He had obtained the weather from ASOS and was issued airport NOTAMS. He appeared to be on final; was issued no observed traffic; advised to cancel IFR on frequency; and told to change to advisory frequency. Another aircraft; a Cherokee; called ready at the airport. I noticed that the C182 had appeared to no longer be established on final and was not descending. I attempted contact without results. I then asked the Cherokee if he could contact the C182 and have the C182 return to my frequency. The C182 replied that he would like a vector to the airport and that he had a problem. I had him maintain 5;000 and canceled approach clearance and asked what his problem was and how I could assist. He said that he was vomiting and that he wanted to be vectored to the airport in hopes of visually being able to descend. He got the town in sight and canceled IFR. I acknowledged cancellation and told the C182 about the Cherokee that was going to depart the Runway 28 northwest-bound. I released the Cherokee; advised him of the C182 over the airport that was descending; and had him report airborne. The airport is in the extreme south part of our airspace in mountainous terrain with poor RADAR coverage. After the Cherokee reported airborne; I had him report either 5 northwest of the airport or reaching 5;000. As the Cherokee reported and was RADAR identified; the C182 called me back. I had started a position relief briefing; but decided to handle the C182 before being relieved. The C182 reported having lost ground contact.  I issued him a VFR beacon code but received no RADAR response from the aircraft.  I issued him an IFR clearance to the Class C airport as it was good VFR weather and afforded better RADAR coverage and issued him a new IFR beacon code. The C182 declined the Class C airport as he did not have enough fuel to make it to the Class C airport. I re-cleared the C182 to the airport. The C182 RADAR acquired 9 miles southwest of the airport in mountainous terrain below MSA. The C182 was able to climb to our MVA of 5;000. I advised him that it would require 28 flying miles to be vectored to the ILS runway approach. He replied that he wasn't sure he had enough fuel to do so as both needles were indicating zero or extremely low. I offered other closer approaches at the airport but he replied he wanted to stick to the ILS. My RADAR team members helped by taking all other traffic on another scope and frequency and calling the airport and advising emergency aircraft inbound. We also asked the airport about weather conditions. They replied that it was very bad there and had no suggestions that would help. The Cherokee was solicited for PIREPS to help the C182. I vectored him to a good turn on for the approach and ensured his turn to final. I held on to him to make sure that he was established. On a three mile final; he mentioned that his needles were giving him no indication and asked for the localizer frequency. I asked him to stand by as I had flipped the approach pages to try to find an approach that he could do that wouldn't have been as many flying miles. Another pilot blurted out the frequency which is the airport VOR frequency and in haste I issued it as well.  I advised the pilot of his position and his need to descend out of 5;000 as he only had 2-3 miles to descend and no fuel. He descended out of 5;000 and I lost RADAR. I was waiting for some response from pilot; heard none and attempted contact. Pilot advised he had over-shot airport and was in valley south of the airport with no ground or RADAR contact in the mountains not on the published missed. Pilot seemed confused; sick; disoriented; and was asking about tracking the back course in to the airport with no ground contact; there is no back course approach to the airport. I issued him the MSA and read him the missed after his report of climbing out of 3;800 and had him turn to the missed approach climbing right turn to heading of 360 after climbing runway heading to 3;300. Pilot was able to climb to 5;000 even though he did not believe that he had enough fuel to do so. I kept him close to final and advised him of his position in case he had to turn back to the airport to land. I realized my error about the localizer frequency and issued and confirmed that he had it dialed into his radio. As he was extremely close to final; I confirmed that his needles were alive. I had to vector him slightly to the northwest to be able to turn him back for the approach. I gave him a normal approach clearance. I confirmed that his frequency was correct and that his needles were alive.  The needles were working. When he was at an appropriate point I gave him a turn to 190 to put him on final. Established on final; I told him to start his descent now and issued the decision height. I then gave him airport position until I lost RADAR contact at 3 miles. I advised the pilot RADAR contact lost; asked him to advise IFR cancellation this frequency; and that a change to advisory frequency was approved. The airport manager advised that the aircraft landed safely.




Synopsis: TRACON Controller chronicled an emergency event when a C182 was encountering weather; experiencing fuel issues; having navigational difficulties and was having problems communicating with ATC.