Accident North American T-28C Trojan N537Z,
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ASN Wikibase Occurrence # 32286
 
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Date:Saturday 24 May 2003
Time:12:25
Type:Silhouette image of generic T28 model; specific model in this crash may look slightly different    
North American T-28C Trojan
Owner/operator:Private
Registration: N537Z
MSN: 140537
Total airframe hrs:8675 hours
Engine model:Wright R-1820-86B
Fatalities:Fatalities: 2 / Occupants: 2
Aircraft damage: Destroyed
Category:Accident
Location:Sherman Oaks, 4 miles SE of Van Nuys, California -   United States of America
Phase: En route
Nature:Private
Departure airport:Van Nuys, CA (VNY)
Destination airport:Thermal, CA (TRM)
Investigating agency: NTSB
Confidence Rating: Accident investigation report completed and information captured
Narrative:
On a standard instrument departure procedure, the airplane came out of the clouds in a steep, nose down, inverted attitude and collided with terrain. The weather at the departure airport was 1,700-foot overcast with the tops ranging from about 4,000 to 4,500 feet. The mode C altitude reporting system on board the airplane initially was reporting 1,400 msl, but the pilot reported climbing out of 2,300 msl. Air traffic control made numerous queries about the altitude anomalies and repeatedly asked the pilot to recycle the transponder. In this aircraft, the transponder control head was mounted on the lower right side avionics rail abeam the pilot's seat back. The pilot would have to look down, to the right, and aft to alter any settings on the transponder during flight. The airplane was climbing on a southeasterly course. After a minute ATC issued a left turn to 040 degrees. The pilot acknowledged the course change, but the recorded radar track continued in a southeasterly direction until its last recorded point. Twenty-three seconds after the pilot acknowledged the course change and reported leaving 3,000 feet, he asked ATC if it was a left or right turn to 040. ATC instructed the pilot to turn off the transponder's mode C function. There were no further recorded transmissions from the pilot. The last recorded mode C data occurred 17 seconds after the pilot's last transmission. The mode C altitude reports from the airplane varied from 1,300 feet to a high of 4,100 feet, and erratically fluctuated between those values. The airplane came out of the clouds in a steep, nose down, inverted position, and heading in a northeasterly direction. The wreckage was located north of the last recorded radar position.
Probable Cause: The pilot's in-flight loss of control due to spatial disorientation. Factors in the accident were the distraction caused by the malfunctioning mode C altitude reporting system, and the location of the transponder control head, which necessitated repeated pilot head movements to the right and down while in instrument meteorological conditions.

Accident investigation:
cover
  
Investigating agency: NTSB
Report number: LAX03FA162
Status: Investigation completed
Duration:
Download report: Final report

Sources:

NTSB: https://www.ntsb.gov/_layouts/ntsb.aviation/brief.aspx?ev_id=20030530X00745&key=1

Location

Revision history:

Date/timeContributorUpdates
27-Sep-2008 01:00 ASN archive Added
19-Sep-2011 14:45 Dr. John Smith Updated [Date, Time, Aircraft type, Registration, Cn, Operator, Total fatalities, Total occupants, Other fatalities, Location, Country, Phase, Nature, Departure airport, Destination airport, Source, Damage, Narrative]
08-Dec-2017 18:45 ASN Update Bot Updated [Time, Cn, Operator, Departure airport, Destination airport, Source, Narrative]

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