NTSB · Safety Recommendation
Safety Recommendation A-14-081
Recommendation
TO THE FEDERAL AVIATION ADMINISTRATION: Advise operators of aircraft equipped with terrain awareness and warning systems (TAWS) of the circumstances of this accident, including that, in certain situations, an escalating series of TAWS warnings may not occur before impact with terrain or obstacles. Encourage operators to review their procedures for responding to alerts on final approach to ensure that these procedures are sufficient to enable pilots to avoid impact with terrain or obstacles in such situations.
Safety Issue and Context
On August 14, 2013, about 0447 central daylight time (CDT), UPS flight 1354, an Airbus A300-600, N155UP, crashed short of runway 18 during a localizer nonprecision approach to runway 18 at Birmingham-Shuttlesworth International Airport (BHM), Birmingham, Alabama. The captain and first officer were fatally injured, and the airplane was destroyed by impact forces and postcrash fire.
The scheduled cargo flight was operating under the provisions of 14 Code of Federal Regulations Part 121 on an instrument flight rules flight plan, and dark night visual flight rules conditions prevailed at the airport; variable instrument meteorological conditions with a variable ceiling were present north of the airport on the approach course at the time of the accident. The flight originated from Louisville International Airport-Standiford Field, Louisville, Kentucky, about 0503 eastern daylight time.
Response History
November 26, 2024 · NTSB Correspondence · FAA
We note that Safety Alert for Operators (SAFO) 15011, “Roles and Responsibilities for Pilot Flying (PF) and Pilot Monitoring (PM),” reinforces the importance of flightpath management (FPM) and the division of duties between the PF and PM. We also note that AC 120-123, “Flightpath Management,” includes guidance and recommended practices to help operators and training centers develop operational policies, procedures, and training to support effective FPM.
You previously reported that the FAA had included, in Order 8900.1, Volume 3, Chapter 19, “Flightcrew Member Training and Qualification Programs,” enhanced procedures and processes for using TAWS that you believed satisfied this recommendation. In response to our request for details about what changes were made, you reported that Order 8900.1 was actually not revised as previously reported, but that the effectiveness of FPM and the division of duties between the PF and PM is measured as part of your surveillance of Part 121 and 135 air carrier and operator training programs.
We point out that this recommendation asks the FAA to do the following:
• advise operators of the circumstances of this accident, including that, in certain situations, an escalating series of TAWS warnings may not occur before impact, and • encourage operators to ensure that their procedures for responding to alerts on final approach enable pilots to avoid impact with terrain or obstacles in such situations.
We do not believe the guidance contained in the SAFO, AC, or 8900.1 about FPM and how duties should be divided between the PF and PM address either of these concerns. Because your actions thus far are not responsive and you have not reported plans to take any additional actions, Safety Recommendation A-14-81 is classified CLOSED-- UNACCEPTABLE ACTION.