# NTSB LAX04LA034: Canadair T33, N99192, Santa Clarita, CA, November 2, 2003 - Type: NTSB accident investigation - Classification: Accident · Fatal · Limited investigation · Final report - Date: November 2, 2003, 15:55 local (23:55 UTC) - Place: Santa Clarita, CA - Coordinates: 34.366664, -118.5 - Nearby events: https://openairdocs.org/map.md?lat=34.3667&lon=-118.5000&mi=10 - Phase of flight: [Maneuvering](https://openairdocs.org/ntsb-phases/450) (OpenAirDocs' grouping) - Highest injury: Fatal - Injuries: 1 fatal - Status: Completed, report October 31, 2006 - Report: Approved by Office Director - Parties: Rolls-Royce, Federal Aviation Administration - NTSB case key (mKey): 58325 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=LAX04LA034 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/58325/pdf - Page: https://openairdocs.org/ntsb/LAX04LA034 ## Probable cause the pilot's failure to maintain adequate clearance from terrain during low altitude maneuvers. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - In flight collision with terrain/water, maneuvering - terrain condition - ground - low altitude flight/maneuver - intentional, pilot in command (cause) - altitude/clearance - not maintained, pilot in command (cause) ## Analysis The airplane collided with terrain during low altitude maneuvers. Witnesses heard the loud engine noise, which got their attention. The airplane was very low, just several hundred feet above the ground. The airplane turned and the left wing went straight up and down, and then the airplane turned upright. It went into a second left turn, but this time it went straight down. It seemed to spin, and the engine was loud the whole time. Witnesses said that the airplane looked symmetrical; they could see both wings and tip tanks. Some witnesses thought that the engine sounded erratic for a short while, but then noted that it was loud until impact. An experienced pilot in the T33 trained the accident pilot, and said that the pilot was very conscientious. The pilot would not always wear his G-suit, when they routinely practiced aerobatics. They would land at a nearby airport, refuel, and then return to Van Nuys. Another pilot reported that the pilot did not unpin all six ejection pins. He would pull the canopy pins, but not the seat pins. There was a pin on the floor on each side of the seat, and he normally left both seat pins in. The pilot had called his wife to tell her that he was going flying near the high desert practice area. He was going to do aerobatics, fly around, and come back. The airplane was highly fragmented, and investigators could not establish control continuity. The engine sustained mechanical damage, and displayed evidence of rotation under power at impact. ## Factual narrative On November 2, 2003, about 1555 Pacific standard time, an experimental Canadair T33, N99192, collided with terrain near Santa Clarita, California. The pilot/owner was operating the airplane under the provisions of 14 CFR Part 91. The commercial pilot, the sole occupant, sustained fatal injuries; the airplane was destroyed. The personal local flight departed Van Nuys, California, at 1547. Visual meteorological conditions prevailed, and no flight plan had been filed. The primary wreckage was at 34 degrees 22 minutes north latitude and 118 degrees 30 minutes west longitude. One witness was bicycling south on Sierra Highway. He heard a high wind noise, and then the airplane roared up really fast over him. It came southbound over his left shoulder about 200 feet above him. It continued south parallel to the Sierra Highway. As it came by parallel to him, he could see the bottom of the airplane. It was in almost a 90-degree bank to the left. It was not going down or diving. It was really loud like it had a wide open throttle. He stopped cycling. As the airplane went by, it continued to roll until the nose went low. He could see the whole airplane and it was symmetrical. It hit the ground about 4 to 6 seconds later. He lost sight of it just before impact due to stores and trees. There was silence just before impact; he heard no pops or booms. The terrain was level in the valley with hills to the left. Another witness heard a jet that was low. He couldn't see it because trees were in the way. He heard popping like a couple of little booms. He thought that there was trouble with the power. The airplane went by a tree and the engine went back to sounding strong. He saw the airplane with one wing pointed toward the ground. As he looked toward the sky, he was looking at the bottom of the airplane. The airplane was symmetrical; he could see both wings and tip tanks. When it passed him, he was looking at the belly, and it was running good. It went over a hill, and was gone for a long while when he heard the crash and saw smoke. A witness on Sierra Highway heard a loud engine noise, which got her attention. The airplane was very low, about 100 feet, and she ducked. She could see the pilot. It was coming from the other side of the highway at an angle. The left wing was straight up and down, and then the airplane turned upright. It went into a second left bank, but this time it went straight down. It seemed to spin, and she heard four big booms on the way down, which took 10-15 seconds. She saw the airplane for about 30 to 40 seconds. The engine was loud the whole time. Other witnesses confirmed that the airplane turned and continued to roll to the left until the nose was pointing straight toward the ground. It maintained this vertical attitude until ground impact. Most of the witnesses said the loud whine of the engine drew their attention to the airplane. They all said the airplane was within several hundred feet of the ground. The engine was loud until impact. Some witnesses thought the engine sounded erratic for a short while, and then it sounded like it was operating again prior to the roll to vertical. An experienced pilot in the T33 set up a training program for the accident pilot. It comprised a minimum of 8 to 10 flights. The syllabus included stalls, maximum performance maneuvers, aerobatics, approaches, and simulated flameouts. They had done spin training about 2 to 3 years ago. He said that the pilot was very conscientious. The pilot had restored the airplane; the cockpit was better than when the airplane was new. From doing his own maintenance, the accident pilot knew how everything worked. For their practice sessions, they would go to Mojave. It was about 30 minutes to the high desert practice area. The pilot would not always wear his G-suit, and they routinely practiced aerobatics. They would land at Mojave, refuel, and then return to Van Nuys. Another pilot reported that he had flown with the accident pilot several times. He knew that the airplane had an annual inspection about a month ago. Their first flight was 1/2 hour. The accident pilot briefed the ejection system every time; this included how to eject, and pointing out the safety pins and the ejection handle. There was one for the canopy actuator, one to blow the canopy, and two for each seat. He did not unpin all six pins; he would pull the canopy pins, but not the seat pins. There was a pin on the floor on each side of the seat, and he normally left both seat pins in. The right side pin held the handle down. From talking to the pilot's wife, he knew that the pilot had called her to tell her that he was going flying near Mojave. He would do aerobatics, fly around, and come back. The National Transportation Safety Board investigator-in-charge (IIC) and an investigator from Roll-Royce examined the wreckage. The airplane was highly fragmented, and the IIC could not establish control continuity. The centrifugal compressor was dual stage. There was a double entry impeller and rotating guide vanes. The engine had a single stage turbine. The engine sustained mechanical damage. The compressor exhibited mechanical damage. The forward side of the double entry impeller vanes bent opposite the direction of rotation. The forward steel rotating guide vanes bent in the direction opposite of rotation. The turbine shaft remained connected, but exhibited torsional twisting forward of the toothed flange that protruded from the turbine disk. The turbine wheel blades bent opposite the direction of rotation. The turbine rotating nozzle guide vanes bent opposite the direction of rotation. The turbine wheel case was crushed; it housed the engine accessories. The Rolls-Royce representative noted evidence of metal diffusion on the turbine blades and vanes. He stated that the shafting displayed continuity throughout the engine. He determined that the compressor impeller, turbine, and turbine shaft displayed evidence of rotation at impact. ## Aircraft - Registration: [N99192](https://openairdocs.org/deregistered/N99192-2017-03-24), registration cancelled 2017-03-24, S/N 21118, built 1953 (OpenAirDocs) - Reported make and model: Canadair T33 - Registry model: [Canadair T-33](https://openairdocs.org/model/canadair-t-33) (registry code 1901204) (OpenAirDocs) - Registry engine: [Rolls-Royce NENE](https://openairdocs.org/engine/rolls-royce-nene) (registry code 54542, turbo-jet) (OpenAirDocs) - Category: Airplane - Serial number: 21118 - Airframe hours: 3780 - Engines: Rolls-Royce NENE turbo jet - Damage: Destroyed - Flight: Personal, Part 91 - Registered owner: Daniel M. Lavigna, Jr. - Airworthiness certificate: Special, Experimental (Special) - Last inspection: AAIP, October 1, 2003 - Departed: VNY, Van Nuys, CA ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 62; injuries: fatal; commercial; airplane ratings: multi-engine land, single-engine land; instrument ratings: airplane; medical: class 2; seat: front; toxicology performed; flight hours: 3,395 total, 275 in this make and model, 3,280 as pilot in command, 23 in the last 90 days, 5 in the last 30 days ## Weather - Conditions: Visual (VMC), Day - Wind: 210° at 9 knots - Visibility: 10 statute miles - Lowest ceiling: 7,500 ft broken - Temperature: 61 °F, dew point 39 °F - Altimeter: 29.92 inHg - Observed at: VNY, 10 nm away ## 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 20031102036539A](https://openairdocs.org/incident/20031102036539A), Nov 2, 2003: Cndair T33, Canyon Country, CA, Destroyed, 1 fatal. (-23) Aircraft impacted into mobile home park in a near vertical wings level attitude. Aircraft was destroyed/melted beyond recognition due to high energy… 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.