# NTSB CHI03LA063: Beech A36, N5677X, Grand Rapids, MI, February 1, 2003 - Type: NTSB accident investigation - Classification: Accident · No injuries · Limited investigation · Final report - Date: February 1, 2003, 08:00 local (13:00 UTC) - Place: Grand Rapids, MI - Coordinates: 42.880832, -85.522781 - Nearby events: https://openairdocs.org/map.md?lat=42.8808&lon=-85.5228&mi=10 - Phase of flight: [Enroute](https://openairdocs.org/ntsb-phases/400) (OpenAirDocs' grouping) - Highest injury: No injuries - Injuries: 2 uninjured - Status: Completed, report September 30, 2003 - Report: Approved by Office Director - Parties: FAA-Grand Rapids, Michigan-FSDO - NTSB case key (mKey): 56478 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=CHI03LA063 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/56478/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=56478 - Page: https://openairdocs.org/ntsb/CHI03LA063 ## Probable cause The pilot's failure to maintain aircraft control which resulted in the overload of the aircraft. Spatial disorientation, an inoperative turn coordinator, and the pilot's misinterpretation of the flight instruments were contributing factors. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - Loss of control - in flight, cruise - electrical system,circuit breaker - disengaged (contributing factor) - flight/nav instruments,turn and bank indicator - inoperative (contributing factor) - weather condition - low ceiling (contributing factor) - flight/navigation instrument(s) - misjudged, pilot in command(cfi) (cause) - aircraft control - not maintained, pilot in command(cfi) (cause) - spatial disorientation, pilot in command(cfi) (contributing factor) - Abrupt maneuver, descent - uncontrolled - airframe - overload (cause) - pull-up - abrupt, pilot in command(cfi) (cause) - airspeed - high, pilot in command(cfi) (contributing factor) ## Analysis The airplane received substantial damage during a high speed pull-up while recovering from an unusual attitude after a loss of control during an instrument training flight in actual instrument meteorological conditions. The ceiling was reported to be overcast at 700 feet above ground level. The airplane subsequently returned to the departure airport. The certified flight instructor who was on-board the airplane reported that pre-departure checks of the flight instruments were normal. He said that, during the flight the gyroscopic flight instrument became unusable. A postaccident examination revealed that the turn coordinator circuit breaker was in the open position. Further testing revealed no detectable defects in the gyroscopic flight instruments and instrument pressure system. ## Factual narrative On February 01, 2003, about 0800 eastern standard time, a Beech A36, N5677X, piloted by a certified flight instructor (CFI) and dual student, sustained substantial damage during a recovery from an unusual attitude after a loss of control during instrument flight. The non-instrument rated dual student held a private pilot certificate with a single engine land rating. The 14 CFR Part 91 training flight was operated in instrument meteorological conditions (IMC) with an instrument flight plan. No injuries were reported. The flight originated from the Gerald R. Ford International Airport (GRR), Grand Rapids, Michigan, about 10 minutes prior to the loss of control. The destination has not been determined. The weather reporting station located at the departure airport recorded the ceiling and visibility as overcast ceiling at 700 feet above ground level, and 7 statute miles respectively. The report was taken about 4 minutes prior to the accident. The CFI reported that prior to departure checks of the engine and flight instruments were normal. He stated that the takeoff was uneventful. Shortly after takeoff the airplane entered IMC. The CFI said he noticed that the airplane was in a 30 degree bank and he applied right aileron to correct. He said that a subsequent scan of the turn coordinator showed wings level. He said that another scan of the attitude indicator showed a bank angle in excess of 60 degrees. The CFI stated that he assumed control of the airplane and determined that the gyroscopic instruments were not usable. According to the CFI, the airplane exited IMC in an unusual, high speed, nose down, left bank attitude and the he used right aileron and up elevator to recover. The CFI regained control below the overcast and returned to the departure airport. The airplane was substantially damaged due to the pull up during recovery. A postaccident examination of the airplane was conducted. The wings, horizontal stabilizer skins were wrinkled. Further examination revealed that the wing and horizontal stabilizer spars were damaged. During the examination, the turn coordinator circuit breaker was found in the open position. A run up and taxi test confirmed that the primary and backup instrument pressure systems were operational. The pressure gyroscopic instruments functioned without noticeable defect during the test. Additionally, the turn coordinator circuit breaker was reset and no noticeable defects in operation were found during the test. Subsequent to the taxi testing, the artificial horizon indicator (AHI) was removed for further examination. Bench testing of the AHI was performed by a certified repair station under the supervision of a Federal Aviation Administration official. The testing of the AHI revealed that the unit was in an airworthy condition. ## Aircraft - Registration: [N5677X](https://openairdocs.org/aircraft/N5677X), registered now, S/N E-2797, built 1993 (OpenAirDocs) - Reported make and model: Beech A36 - Registry model: [Beech A36](https://openairdocs.org/model/beech-a36) (registry code 1151604) (OpenAirDocs) - Registry engine: [Continental IO-550 series](https://openairdocs.org/engine/continental-io-550-series) (registry code 17042, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: EZ797 - Engines: Continental IO 550B 300 horsepower reciprocating - Damage: Substantial damage - Flight: Instructional, Part 91 - Operator: Larry L. Brown - Registered owner: Hole Shot Racing Inc. - Airworthiness certificate: Standard, Utility - Last inspection: Annual, December 2, 2002, 14 hours before - Departed: GRR, Grand Rapids, MI - Destination: Unknown - Flight plan: IFR - Airport: KGRR, Gerald R. Ford International ## Flight crew As NTSB recorded them. NTSB leaves out names. - Flight instructor; age 37; injuries: none; commercial; airplane ratings: single-engine land, multi-engine land; instrument ratings: airplane; medical: class 1, valid medical--no waivers/lim.; seat: right; flight hours: 1,230 total, 16 in this make and model, 1,160 as pilot in command, 87 in the last 90 days, 25 in the last 30 days, 0 in the last 24 hours - Pilot; injuries: none ## Weather - Conditions: Instrument (IMC), Day - Wind: 300° at 9 knots - Visibility: 7 statute miles - Lowest ceiling: 700 ft overcast - Temperature: 32 °F, dew point 30 °F - Altimeter: 29.88 inHg - Observed at: GRR ## FAA reports on this event (1) The FAA's own accident and incident reports, matched to the aircraft by N-number and date (OpenAirDocs). - [Accident 20030201002649A](https://openairdocs.org/incident/20030201002649A), Feb 1, 2003: Beech A36, Grand Rapids, MI, Substantial damage. (-23) They departed grr IFR to ffc. At 1250:38 they were cleared for take off. At 1252:48 they were cleared to contact departure. At 1254:49 they contacted grr… ## Other investigations on N5677X (1) From the NTSB's public API. Aircraft are matched to registry aircraft by N-number and event date, checked against the reported serial number, make and model; the registry's history has gaps, so older matches can be wrong. Compare the reported make and model. - [NTSB CEN26FA086](https://openairdocs.org/ntsb/CEN26FA086), Jan 8, 2026: Beech A36 (N5677X), Sabine Pass, TX, substantial damage, 1 fatal, investigation ongoing ## Docket (4 files) The files NTSB released with the investigation on July 30, 2003, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=56478. 687 KB in all. - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (item 1, .PDF, 287 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40382950&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1-Redacted.PDF - Record of Interview (item 2, .PDF, 67 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40187979&FileExtension=.PDF&FileName=Record%20of%20Interview-Master.PDF - FAA Inspector's Statement (item 3, .PDF, 79 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40187980&FileExtension=.PDF&FileName=FAA%20Inspector%27s%20Statement-Master.PDF - Information From Duncan Aviation (item 4, .PDF, 254 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40187981&FileExtension=.PDF&FileName=Information%20From%20Duncan%20Aviation-Master.PDF From the NTSB's public API. Aircraft are matched to registry aircraft by N-number and event date, checked against the reported serial number, make and model; the registry's history has gaps, so older matches can be wrong. Compare the reported make and model. --- OpenAirDocs.org is an independent research project of [Contrail Labs](https://contraillabs.com/). It is not affiliated with the FAA or the NTSB. Source documents are U.S. government works in the public domain.