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EVA 15 narrowly misses terrain impact in Los Angeles area

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Friday morning 12/16 (flight was scheduled to depart 12/15 at 11:30), EVA Air flight 15 was misdirected out of LAX, and had to make a last minute maneuver to avoid the San Gabriel mountains above Altadena/Pasadena, CA (abc7.com) More...

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TorstenHoff
Torsten Hoff 20
I downloaded the KML file from the track and opened it in Google Earth.

The flight passed almost directly over Mount Wilson, which has an elevation of 5710 feet but is festooned with all sorts of tall antennas. EVA 15 was at 5300 feet as it was initiating a turn to the right to avoid the mountains, and climbing at about 2.5 times the rate it was just moments earlier.

Had the pilots not taken action, investigators would be combing through the wreckage right now.
rtjorgenson
Ryan Jorgenson 13
http://imgur.com/a/R2bso

Adding altitude labels and an aeronautical chart, looks like it came within approximately 1,000 feet of terrain.
TorstenHoff
Torsten Hoff 10
The 6201 foot label in the first image you provided is almost directly behind the installations on Mount Wilson, so they were less than 500 feet above the top of the mountain, but still below the tops of the antennas. And this is after they took action to avoid CFIT.
david.baker
David Baker 17
Here is the google earth view of the flight path.

http://imgur.com/a/7mm1J
davidrbarnes
David Barnes 6
Mr Baker: These are a fantastic representation of the flight path and a great visualization of the proximity to obstacles. Thanks for posting!
TorstenHoff
Torsten Hoff 4
I did some research and found that the tallest antenna on Mount Wilson is a 975-footer owned by KCBS TV.
joelwiley
joel wiley 3
According to the graph, at these times:

Fri 01:25:07 34.2184 -118.0676 73° East 317 317 6,200 2,364 Climbing
Fri 01:25:24 34.2204 -118.0370 96° East 323 323 6,600 1,273 Climbing

They were flying just South of 5700' Mt Wilson.
tbpera
Tom Pera 5
wow... sounds like controller "lost the picture"... confused... south south...why not a heading??? sounds overwhelmed... had a controller forget us on approach to LAX.. approaching the mountains...pulled up.. .. "terrain terrain" ... had a good conversation with them on the ground
patpylot
patrick baker 5
reminds me of the vectoring of a Prinair flight into a mountain in the Caribbean years ago. Controller error, plain and simple. I heard the voice of the departure controller telling eva15 turn left, then realizing her error, turn right, what are you doing? I know the pilot had on his display the mountain with the height- at least he know what the hell was going on. Prinair did not have that quality of cockpit display.
bentwing60
bentwing60 2
It's called TAWS patrick. And they had TCAS. And I suspect that hearing what the "controller" was telling them in real time, They decided to fly the plane with said modern tools, ignore said "modern day controller" and beg forgiveness later. I for one would hate to chalk it up to Lady Luck, an unpredictable mistress in a dynamic environment.
tbpera
Tom Pera 5
turn south turn south... what happened to "turn right heading 180... " might have been understood better...
tyketto
Brad Littlejohn 3
true, but given the separation between EVA015 and ACA788, any turn southbound would work, regardless of it being a left or right turn. By the time both EVA and ACA were northbound, there was already 2000ft separation between them, so any turn south would work, as long would have avoided terrain.

Besides, at the 1:49 mark of the LiveATC clip, the controller gives the call of a right turn heading 180, and more importantly, gets the proper readback from EVA015.
tbpera
Tom Pera 1
yep... you're right
rtjorgenson
Ryan Jorgenson 1
Exactly.
Myran
So so.
Tom Pera has a strong point here if you encloude the difference in English spoken by so many different origin.
I work at sea and would definitly prefere "turn right to 180 degress".
Also because, with all respect Mr Littlejohn, there is stictly right hand trafic in the air so all manouvres should if possible keep to the right but in a stress situation a pilot normally driving in left hand trafic maybe might instinctivly react by a left turn. In my humble opinion it is allways better to encloude exactly what you ask for if possible, not as much as necessary in a situation that needs quick respons. Please excuse my "rusty" English.
blucenturion
blucenturion 4
"Right hand traffic in the air?" Where'd you get that idea? Under radar vectors, either direction may be issued.
tyketto
EVA15 was not in a traffic pattern. He was departing under IFR, in Class B airspace. Traffic patterns would not apply.
joelwiley
joel wiley 1
Mark Twain's literary rule 13. Use the right word, not its second cousin.
k6yaz
stuart landau 5
The news report from a local Los Angeles television station does not do justice to the extent of this story. EVA 015 was given instructions many times for turns during the vectoring period. They read back the instructions correctly but did not comply. There was a heavy jet climbing behind them also northbound to the left of 015 which is why the controller did not want them to climb above 5000. the controller instructed 015 to turn westbound to pass under the Air Canada heavy at one point; again they read back the vector but did not comply. The controller had a "loose cannon" in her area of responsibility. Someone left their brains in their flight bag. I work on Mount Wilson and take it personally.
SteveDietrich
Steve Dietrich 1
I think the did not comply came from looking at the higher terrain directly ahead and to the right. If it was clear they were probably seeing the red lights of Mt Wilson above their altitude.

As others noted we need to see the communications vs the aircraft location and altitude.
k6yaz
stuart landau 3
The towers on Mount Wilson do not have obstruction lights because of the observatory. It also was in the clouds and the mountain top is dark. The location and altitude information is available on the Internet in sync with the audio. The crew just did not comply with ATC instructions; but read each back as required. Remember; the controller had other traffic in her area of responsibility, not just EVA 015. Despite the early hour, there were several departures from LAX at about the same time.
k6yaz
stuart landau 3
In both the audio recordings that I heard, the controller instructions preceding EVA 015 read-back, of the heading change from 090 to 180, was missing; all you hear the controller say is “climb and maintain 7000”. EVA 015 responds with “left heading 180, climbing to 7000” (it should have been right to 180; they were going east). The two recordings were slightly different. Kind of strange that the important fragment of the controller's transmission was missing. In any case, the controller corrected the EVA 015 incorrect turn in a very short time (“turn right 180”), and they again were told to now expedite their right turn to 180. EVA read-back both instructions correctly, but did not turn.

The voice recordings may have been from a scanner, and it may have missed the beginning of the initial controller instructions to turn from 090 to 180 degrees. Even if the controller said left to 180 once (not on the recordings), she corrected herself several times and EVA 015 crew did nothing but fly north toward high terrain, below the tops of the mountains a few miles ahead, while in a high speed climb. Anyone who has mind-freeze, should not be in a cockpit. I assume that their terrain alert (“too low terrain and pull up”) also was sounding all this time, but it isn't heard on their radio transmissions.
bentwing60
bentwing60 3
TAWS might have saved the day on this one, and I hope to read the final report.
garykoenig
Gary Koenig 2
This incident brings to mind the 1998 UA 747 (UA 863 bound for SYD) near-miss with San Bruno mountain, as detailed in a WSJ article dated 3/19/1999. Obviously completely different circumstances (engine failure, co-pilot's actions called into question, ATC not in play), but the mountain and TV antennas bits do 'rhyme'.

In this case, as a civilian, one of the last things I'd ever want to hear a controller say is "what are you doing", much less the controller's confusing jabbering. Fortunately, everyone involved is alive to tell the tale (like UA 863).
gearup328
Peter Steitz 2
Question: Were they in IMC or was it a VFR climb. Could they see the Mount Wilson and antennas?
30west
30west 1
It was an IFR climb, don't know if they were in VMC or IMC at the time.
bentwing60
bentwing60 2
It's hard to see mountains in the dark. Again, I think TAWS saved them. Read up on Reba McEntire's chartered Hawker out of Brown field on 26 March 1991. Less happy ending. On a brighter note, good work to all on the Wilber Esquire early departure!
bentwing60
bentwing60 1
My point was not to highlight the lack of professionalism of the crew on that flight, which is really staggering, but to point out the fact that they never "saw" the mountain. Rising terrain is virtually invisible on a dark night, and the cute little lights on the towers are almost as obscure.
gearup328
Peter Steitz 1
Thanks 30west all commercial flights like this are on an IFR flight plan but was the weather IMC? If not then the crew should have seen Mt. Wilson and avoid it without any problem? It's like avoiding being vectored into a thunderstorm. You tell ATC this isn't going to work.
30west
30west 0
Peter you're question inter-mixed IMC and VFR as an either/or proposition. As we both know, one IMC (and VMC) refers to conditions encountered during flight and the other VFR (and IFR) to operating rules under which the flight is operated. They are not mutual exclusive.
gearup328
Peter Steitz 1
Ok, should have said IMC or VMC. Slip up on my part. Fingers move faster than mind. Someone mentioned that it was dark. I must have not considered this. Hard to see a rock in the dark. Their terrain avoidance should have been giving them a huge red blob and would probably have begun the "pull up", "pull up". I don't know what manufacturer and model their TAWS is.
30west
30west 1
Peter, my fingers have the same malfunction quite often. ;-) Hope your not flying for the Holidays, Merry Christmas! Fly safe.
gearup328
Peter Steitz 1
Thanks and no I am not. Let me add after thinking a bit--I sometimes do--They probably had EGPWS or Enhanced Ground Proximity Warning System. It uses GPS and a known database. It would have first shouted "Terrain", Terrain". Then in a certain time based on closure to the rock it would have given the "Pull Up" command. This is what I had with the Honeywell Primus 1000 and 2000 systems. A caution though---it does not know about towers on the rock. Merry Christmas to you and have a safe New Year. I am wearing my Santa tie today--the same one I wore when I was flying 14 years ago over this holiday period.

[This poster has been suspended.]

AWAAlum
AWAAlum 5
Not certain, but I wonder if you may be mixing up your Peters.
joelwiley
joel wiley 4
Congrats. I think you get the 'first sighting award' despite the lack of caps.
AWAAlum
AWAAlum 2
I can only be perfect most of the time.
gearup328
Peter Steitz 1
You're right. The board is mixing up the "Peters". I'm still alive and well.
davidrbarnes
David Barnes 2
Gunner:

A bit off topic, but I was curious the etymology of your family name. When I Googled it, however, the only thing to come up was your page here on FlightAware and a link to your posts.

Would you be kind enough to satisfy my curiosity?
gearup328
Peter Steitz 1
Worried about Gunner? So am I but I gave him a good answer to his question.
gearup328
Peter Steitz 1
I'm Peter Steitz--not "Peter". I have not been kicked off. Been a member here a long time and enjoy reading and posting some educational entries. Gunner Flerginski, I have a post where I explained the latest EGPWS terrain avoidance electronics. Much better than the first generation of these systems. It uses a database of terrain and real time GPS position. It displays terrain that is higher than you in red and will announce "terrain, terrain" and if you don't avoid it will announce "pull up, pull up". This is a simple explanation and you will need to learn it when flying in such an aircraft.
joelwiley
joel wiley 2
I think I'll wait for the instant replay from the FAA/NTSB. I'd like to see a timestamped ATC transcript and match that with the AC locations. Is an ATC routinely taken offline for this type of investigation or did the publicity have something to do with it? Speaking of publicity, how often does this occur and not hit the news?
irwinjim99
James Irwin 2
An ATC departure error....a little retraining in LAX ops and language!!
vulcancruiser
There's an opening at TRACON.....a 777 with better lingo skills and situational awareness could have caught this and it would have been long forgotten.....murphy at it again.....
rdlink
That ATC needs a permanent timeout. A lot of people were lucky that her mistakes compounded on top of other mistakes did not cost a whole boatload of lost souls.
SteveDietrich
Steve Dietrich 3
It's clear that the controller made a series of mistakes and that the airplane was a lot closer to disaster than admitted.

When she issued the turn to the south (with sarcasm that should have been reserved for her mirror) the crew may well have been getting terrain alerts and seen that a left turn was the safer turn.

Regardless of what she wanted she failed to give the proper instructions - turn left to x, turn right to x or turn left or right to X . But she just said turn south . duh

Where was her supervisor, If the track discussion is correct then terrain alerts should have been going off in approach control.

Sadly one of the things that the Obama administration did was to eliminate preferences for controller candidates with military experience and also candidates who had successfully completed training at one of the approved schools. In addition there were tapes which documented that some applicants were getting coaching on their applications.
k6yaz
stuart landau 0
Why turn this into a gender and political discussion? Go back into your cave. Look at the actions of the flight crew; they did not comply with the vectors. They were not into a "own navigation" phase of the departure.
MKEHammer
Atrocious phraseology! "heading of"... no use of the word "correction"... "nine" instead of "niner"... --- it all adds to the train running off the track. She stepped all over EVA's readbacks and failed to maintain control of the frequency - ensuring EVA heard and understood her instructions.
k1mgy
Mark Richards 2
I've searched through the standard ICAO phrase book and am coming up short. "What are you doin'", and "turn south" are missing.

The FAA's lead in to their "official investigation" (as opposed to an unofficial white-wash), reads, "The controller issued the EVA pilot a series of instructions to get him to turn south".

Obviously the controller and whoever wrote that garbage from FAA went to the same American public primary school, with the exception that only the FAA's author attended Harvard.
joelwiley
joel wiley 1
FAA published a report on this? Was unable to locate one. Do you have a link?
gearup328
Peter Steitz 1
The FAA is hiring anyone who speaks English--maybe.
redcataviation
Sidney Smith 2
Where this controller is going she won't have to worry about her phraseology any more,..."did you want to upgrade to a large meal from a medium-or-do you want a bigger one...?"
whherron
William Herron 1
"...was given an incorrect instruction by a controller based in San Diego to turn left instead of right."

A controller based in *San Diego* was working traffic in the LAX area? Does Coast TRACON go that far south? Or did the newsie mess it up?
tyketto
Brad Littlejohn 2
SoCal TRACON is located near Miramar, just north of San Diego. It covers the entire LA Basin area, from south of the Angeles National Forest to the US/Mexico border, east of Oxnard/Camarillo out to Palm Springs. they are a combined facility, consisting of separate sectors, instead of separate TRACONs in separate buildings.
pthomas745
Pa Thomas 1
Poor crew resource management by EVA......several minutes pass after the turn was corrected...and nothing.
joelwiley
joel wiley 0
I think I'll wait for the report to come out (maybe on Netflix?).
Myran
Agree. Thank you !
Myran
Excuse me, my thanks was ment to Mr David Baker.
WeatherWise
WeatherWise 1
I don't know the name of the departure route this aircraft was taking but having grown up near LAX,when there was only a handful of departure routes, when the airport is "turned around" and departures are to the east, normally it's a straight east climb with a right turn south to the Seal Beach VOR. I'm not grasping why the crew wasn't questioning the controller about a left hand turn of ANY kind if there wasn't one on the outbound legs of the departure procedure. Controller error yes but the errant turn was not questioned and the flight proceeded towards the mountains.
rtjorgenson
Ryan Jorgenson 2
Ventura 7 sid, basically runway heading then radar vectors to VTU when the airport operates east. The crew was instructed to fly heading 090, followed by climb to 7000. There was no explicit northbound turn from any audio I've heard.
30west
30west 4
Ryan, The first "clue" that things are headed south (no pun intended) that I picked up in the audio is when the controller gives a heading change with a climb to 7,000. Her transmission was blocked in the audio clip, but Eva heard it and responded "LEFT turn heading 180, maintain 7,000. Obviously, on a 090 heading, it would be a RIGHT turn. He turned left and flew 360 +/- before the excitement on the frequency began. The faulty read back went un-noticed by the controller.

I believe that the confusion by the crew on which way to turn and the controller not catching the LEFT turn read back error was the beginning in the chain of events that lead to this incident.
Highflyer1950
Highflyer1950 2
I think you are right. Even when EVA reconfirmed heading of 090, the controller should have included the turn direction to 180! Everyday domestic routing is taken for granted by most local carriers, but for these international types, me included when half way around the world, I still prefer turn direction and heading. It's far to easy for atc transmissions to get cut short.
WeatherWise
WeatherWise 3
Thanks for the info. I listened to the audio several times and shortly after the controller hands off Delta to center, EVA 15 says "Turn left heading 180" which would send him northbound and in almost a 360 degree turn to head back on a southerly course. I gathered this transmission was a read back of the controllers instruction.
30west
30west 2
WW, I agree. The question is, did the controller actually say "left" when she meant "right" or say "right" in her instructions to the crew and the pilot gave a fault read back. Either way, the controller should have caught his read back as not what she intended to convey. At that time she should have immediately corrected him and issued the instructions again....."EVA Air 15, negative, turn right heading 180, climb and maintain 7,000".
gw100001
gw100001 0
Are you going to question every controller command with limited info Mr. Monday Morning Quarterback? How many NASA reports do you submit every year?
mbattin
mike B 1
Don't worry- the union will protect this incompetent controller- she'll be trying to kill people with her attitude tomorrow.
SteveDietrich
Steve Dietrich 1
http://www.latimes.com/local/lanow/la-me-ln-faa-investigation-20161221-story.html

LA TIMES reports she is no longer controlling anything but that does not guarantee that she will not be back. I'm still not clear if LAX tower or SoCal gave the initial wrong turn but in any event her performance was totally unacceptable.

I think she may have been more worried about the midair snitch than running the airplane into the mountain.
Flightdog
Roger Curtiss 1
What is the Taiwanese phraseology for "Holy Shit that was close!"
JimHeslop
Jim Heslop -2
Sum ting wong!? ....And no, not the name those bubble headed news broadcasters gave the pilots flying into the San Fran breakwater a while back either!
Myran
Well, after listening to the traffic controller, my impression is that she lead the vessles into this situation and then (in a common female way denying that she has created the situation)starts to blame EVA15 instead by this "what you doing".
Please correct me if I got this wrong here.
I might add that in my swedish ears her instructions are not that easy neither to hear or follow.
Thank you Mr Jackson Barry for this:
http://www.liveatc.net/forums/atcaviation-audio-clips/eva15-what-are-you-doing!/?action=dlattach;attach=9158
secondsam
Sam Sjogren 5
Reposting as my reply appears to have disappeared:

I once was asked by a _male_ controller in SoCal just what I thought I was doing, after executing collision avoidance vectors given to myself and an airliner launched out of LAX. I replied that I was following my clearance. After a pause, no more blaming me but simply "prepare to copy new clearance". Denial isn't gender-specific.
patpylot
patrick baker 0
years ago I took off from Clearwater/st pete into 300 overcast, tops 14,000, right turn maintain 2,000 ,right through the approaches into tampa international 36l/36r. I did as told, controllers bolloxed that one , forgot about me, then gave me hell for being where they sent me. That was eyeopening. There is a trust the controller philosophy that is not entirely earned. I am always aware of where the scope-dopes may screw up, and you should be too.

[This comment was deleted.]

WeatherWise
WeatherWise 2
And there are "chemtrails" too. Yes, I always get my top aviation news from this Right Wing rag.
WeatherWise
WeatherWise 1
Not sure why the down votes. I guess it's okay for Kent Krizman to point out that this air traffic controller's error was because she was black, based on a racist story on what amounts to be a "White Power" website.

[This poster has been suspended.]

btweston
btweston 4
"Should we write this off as just another "journalist" trying to fill space on a slow news day? "

No.

Capital LETTERS.
davidrbarnes
David Barnes 1
What's ADB-S, Wilbur Sanchesq? Using acronyms I've never heard of, Sir! Makes me thing you may not know what you're talking about on the subject.
davidrbarnes
David Barnes 1
Makes me think*
wingbolt
wingbolt 10
In my best Forest Gump voice..."Pete got suspended...AGAIN"
williambaker08
william baker 2
Amen
Highflyer1950
Highflyer1950 1
AWAAlum
AWAAlum 1
Who's Pete?
davidrbarnes
David Barnes 1
AWA, you really don't want to know.
AWAAlum
AWAAlum 1
LOL - I really did.
joelwiley
joel wiley 1
Wilbur Sanchez AKA Peter F. Hartmann Esq, both suspended, who you remember well. You just missed the shorthand.
WeatherWise
WeatherWise 2
Look for a Pedro O'Reilly coming to these forums soon.....
AWAAlum
AWAAlum 1
It's always interesting when people don't realize their writing style loudly announces their identity - every time. I not so eagerly await to see his next imagined self. Thanks, Joel.
davidrbarnes
David Barnes 1
Wingbolt: And we're surprised?
wingbolt
wingbolt 4
the interesting thing about it is right after a suspension he is on fairly good behavior. And then his instincts take over and we get to watch his death spiral.
30west
30west 4
What will be his next alias?
wingbolt
wingbolt 1
i can think of several but I don't want to end up in his "suspended" pile. Took me quite some time to figure out how to change my profile picture and not sure I can do it again!
bentwing60
bentwing60 1
It would take more than that! And look how long it took to get rid of "him". Twice.

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