| 31
August 1986 - Aeromexico
498 |
Aeroméxico Flight 498, registration XA-JED, was a Douglas DC-9-32
en route from Mexico City, Mexico to Los Angeles International Airport,
Los Angeles, California, United States (with stops in Guadalajara, Loreto,
and Tijuana) on August 31, 1986. N4891F, callsign Piper 4891 Foxtrot,
was a privately-operated Piper PA-28-181 Archer owned by the Kramer
family en route from Torrance to Big Bear City, California. The two
aircraft collided in mid-air over Cerritos, California, killing all
67 aboard both aircraft and 15 people on the ground. In addition, 8
persons on the ground sustained minor injuries from the crash.
The Piper aircraft, N4891F, with the pilot and two passengers aboard,
had departed Torrance, California at approximately 11:40 PST. At approximately
11:46, Flight 498 began its descent into Los Angeles with 58 passengers
and six crew members aboard. At 11:52, the Piper's engine collided with
the left horizontal stabilizer of the DC-9; shearing off the top of
the Piper's cockpit, killing the pilot and both passengers. The heavily-damaged
Piper fell onto an empty playground at Cerritos Elementary School.
The DC-9 inverted and fell to the earth in a residential neighborhood
at Holmes Avenue and Reva Circle in Cerritos, killing 15 on the ground
and all 64 passengers and crew. The impact and fire destroyed five houses
and damaged seven more. A fire sparked by the crash contributed significantly
to the damage. When the air traffic controller assigned to Flight 498
could not find the aircraft on the radar, he called up an inbound American
Airlines jet for assistance. The pilot on American Airlines Flight 333
replied said that he saw a large smoke plume off to his left, indicating
that Flight 498 had crashed.
The National Transportation Safety Board investigation found that N4891F,
the Piper, had deviated into the LAX Terminal Control Area. It was out
of radio contact with air traffic control, which had been distracted
by another flight entering his control area without having received
clearance.
Moreover, the Piper was not equipped with a Mode C transponder, which
would have indicated its altitude, and LAX had not been equipped with
automatic warning systems. Finally, apparently neither pilot sighted
the other aircraft because neither attempted any evasive maneuvers,
even though they were in visual range. When an autopsy revealed significant
arterial blockage in the heart of the Piper's pilot, there was public
speculation that he had suffered a heart attack, causing incapacitation
and contributing to the collision; however, further forensic evidence
discounted this, and error on the part of the Piper pilot was determined
to be the main contributing factor to the collision.
As a result of this accident and other near mid-air collisions (NMAC)
in terminal control areas, the Federal Aviation Administration required
that all commercial aircraft be equipped with traffic alert and collision
avoidance systems (TCAS), and required that light aircraft operating
in dense airspaces be equipped with "Mode C" transponders
that could report three-dimensional position.
A jury ruled that the Aeroméxico plane bore no fault, instead
deciding that Kramer and the FAA each acted equally negligently and
had equal responsibility. U.S. District Judge David Kenyon agreed with
the notion that the FAA shared responsibility.

Download
the full NTSB report
Transcript of the Cockpit Voice Recorder (CVR)
|
COAST = Coast Approach Control
LA APP = Los Angeles TRACON (Approach Control)
RDO-1 = Radio transmission - Captain
CAM = Cockpit Area Microphone
CAM-1 = Cockpit Area Microphone - Captain
CAM-2 = Cockpit Area Microphone - First Officer
COMPANY = Aeromexico Company at Los Angeles IAP
@ = Expletive deleted
* = Unintelligible word
( ) = Questionable text
(( )) = Editorial insertion
Communications between Los Angeles
Approach and other flights are not included in this transcript.
Please refer to the NTSB/AAR-87/07 report for a transcript that
includes these communications.
|
| Time |
Source |
Content |
| 11:41:21 |
RDO-1 |
Coast Approach good morning, this
is Aeromexico four ninety eight is level one zero thousand |
| 11:41:27 |
COAST |
Aeromexico four ninety eight, Coast
Approach good morning, roger one zero thousand proceed direct Seal
Beach El Toro altimeter two niner niner six |
| 11:41:35 |
RDO-1 |
Direct Seal Beach altimeter two niner
niner six |
| 11:42:35 |
CAM-? |
* * |
| 11:43:36 |
COAST |
Aeromexico four ninety eight, cross
one zero miles southeast of Seal Beach at and maintain seven thousand |
| 11:43:44 |
RDO-1 |
One zero miles seven thousand Aeromexico
four ninety eight |
| 11:44:54 |
RDO-1 |
Aeromexico four ninety eight is leaving
one zero thousand for seven thousand |
| 11:44:58 |
COAST |
Aeromexico four ninety eight roger |
| 11:46:15 |
CAM-1 |
They are runways twenty four right
and ah left |
| 11:46:46 |
CAM |
((Sound of LAX ATIS starts)) |
| 11:46:59 |
COAST |
Aeromexico four ninety eight contact
Los Angeles Approach one two four point niner |
| 11:47:03 |
RDO-1 |
One two four point niner, good day |
| 11:47:04 |
CAM |
((ATIS ends)) |
| 11:47:05 |
COAST |
Good day |
| 11:47:23 |
CAM-2 |
--- departure |
| 11:47:24 |
CAM-1 |
One seven and twenty four |
| 11:47:28 |
RDO-1 |
Los Angeles Approach good morning,
this is Aeromexico four sixty four four ninety eight uh we're leaving,
we're level one, correction seven thousand |
| 11:47:34 |
CAM-2 |
* |
| 11:47:37 |
CAM-1 |
Yes man |
| 11:47:39 |
LA APP |
Aeromexico four ninety eight Los
Angeles Approach depart Seal Beach three two zero vector ILS two
five left final approach, do you have Information Uniform |
| 11:47:46 |
RDO-1 |
Affirmative two five left runway |
| 11:47:49 |
CAM |
((Sound similar altitude alert tone)) |
| 11:47:50 |
CAM-2 |
Two two zero for the runway --- |
| 11:48:09 |
CAM |
((Sound of attendent call tone)) |
| 11:48:14 |
CAM-2 |
Course two four nine --- |
| 11:48:15 |
CAM-1 |
Flight director up |
| 11:48:16 |
CAM-2 |
Flight director up |
| 11:48:31 |
CAM-? |
* |
| 11:49:35 |
RDO-1 |
Aeromexico * |
| 11:49:40 |
COMPANY |
(Aeromexico four nine eight go ahead) |
| 11:49:41 |
CAM |
((Sound of tone)) |
| 11:49:41 |
COMPANY |
* * Aeromexico four ninety eight
estimate fifteen minutes, you have assigned gate one hundred and
nineteen and ninteen one one nine awaiting your arrival |
| 11:49:52 |
RDO-1 |
Thany you (four one) eight nine |
| 11:50:05 |
CAM |
((Unintelligible female voice)) |
| 11:50:08 |
LA APP |
Aeromexico four ninety eight, reduce
speed to two one zero |
| 11:50:46 |
LA APP |
Aeromexico four ninety eight, taffic
ten o'clock one mile northbound, altitude unknown |
| 11:50:50 |
RDO-1 |
Roger four ninety eight |
| 11:51:03 |
LA APP |
Aeromexico four ninety eight reduce
speed to one niner zero then descend and maintain six thousand |
| 11:51:09 |
RDO-1 |
One niner zero an then descend and
maintain six thousand |
| 11:51:20 |
CAM-2 |
* |
| 11:51:30 |
CAM-1 |
Thank you |
| 11:51:44 |
LA APP |
Aeromexico four ninety eight maintain
your present speed |
| 11:51:48 |
RDO-1 |
Roger Aeromexico four ninety eight
uh what speed do you want, we're reducing to two niner to one niner
zero |
| 11:51:57 |
LA APP |
Okay, you can hold what you have
sir, and we have a change in plans here, stand by |
| 11:52:00 |
RDO-1 |
All right we'll maintain one nine
--- nine zero |
| 11:52:10 |
CAM-1 |
Oh @ this can't be |
| 11:52:18 |
LA APP |
Aeromexico four ninety eight, expect
the ILS runway two four right approach localizer frequency is one
zero eight point five |
| 11:52:32 |
|
((End of tape)) |
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