Safety recommendations, recipients, status, and linked accident/report context.
What Is This Collection?
When an NTSB investigation exposes a fixable problem, the Board issues formal safety recommendations to the FAA, manufacturers, and operators. These records track each recommendation, who received it, and how they responded. Many of the rules you train under started here.
May 26, 2022
From the Document
This report discusses the December 26, 2019, accident involving a seven-seat helicopter operated by Safari Aviation Inc. as a commercial air tour flight that encountered instrument meteorological conditions and collided into terrain in a remote, wooded area near Kekaha, Hawaii, on the island of Kauai. The pilot and the six passengers were fatally injured, and the helicopter was destroyed. Safety issues identified in this report include limited…
Requested Action: TO THE TOUR OPERATORS PROGRAM OF SAFETY: Inform your members and make information available to the broader air tour community about the circumstances of this accident, provide information about available helicopter safety technologies for reducing the risk of accidents related to inadvertent encounters with instrument meteorological conditions, and encourage air tour operators to voluntarily incorporate such features into their helicopter fleets.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open - Acceptable Response
Recipient: Tour Operators Program of Safety
May 19, 2022
From the Document
The National Transportation Safety Board (NTSB) is providing the following information to urge the Federal Aviation Administration (FAA) to take action on the safety recommendations in this report. We identified transportation safety issues during one ongoing investigation and one previous investigation involving Cessna 560XL airplanes in which parking brake pressure was not fully released before attempted takeoffs, which prevented the airplanes…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Revise the type certification basis for Cessna 560XL airplanes and future derivative models to require that newly manufactured airplanes meet the parking brake indication requirements of Amendment 25-107 of Title 14 Code of Federal Regulations Part 25 section 735.
Study Focus: Review qualification and recent-experience requirements.
Response Status: Open - Unacceptable Response
Recipient: FAA
May 19, 2022
From the Document
The National Transportation Safety Board (NTSB) is providing the following information to urge the Federal Aviation Administration (FAA) to take action on the safety recommendations in this report. We identified transportation safety issues during one ongoing investigation and one previous investigation involving Cessna 560XL airplanes in which parking brake pressure was not fully released before attempted takeoffs, which prevented the airplanes…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Require Textron Aviation to include a checklist item on the Cessna 560XL pretakeoff checklist for pilots to verify that the airplane’s parking brake is fully released before takeoff is initiated.
Response Status: Open Acceptable Alternate Response
Recipient: FAA
Apr 20, 2022
From the Document
The National Transportation Safety Board (NTSB) is providing the following information to urge Cirrus Aircraft and the Federal Aviation Administration (FAA) to take action on the safety recommendations in this report. They are derived from previous investigations of Cirrus SR22T accidents in which excessive fuel introduced to the engine during takeoff climb led to engine power loss. Our examination of these investigations suggests a lack of…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Review the functional hazard assessment (FHA) recommended in Safety Recommendation A-22-7 and ensure it meets the objectives of Advisory Circular 23.1309-1E. Upon approval of the FHA, work with Cirrus to identify necessary mitigating actions and require their implementation through the appropriate means, such as an airworthiness directive.
Study Focus: Review aircraft-system operation, limitations and failure awareness.
Response Status: Closed - Acceptable Action
Recipient: FAA
Apr 20, 2022
From the Document
The National Transportation Safety Board (NTSB) is providing the following information to urge Cirrus Aircraft and the Federal Aviation Administration (FAA) to take action on the safety recommendations in this report. They are derived from previous investigations of Cirrus SR22T accidents in which excessive fuel introduced to the engine during takeoff climb led to engine power loss. Our examination of these investigations suggests a lack of…
Requested Action: TO CIRRUS AIRCRAFT: Conduct a functional hazard assessment (FHA) to identify the causes, effects, and severity levels for the SR22T excessive fuel flow hazard condition during takeoff and climb phases of flight and, based on the FHA, update the system safety assessment.
Study Focus: Review aircraft-system operation, limitations and failure awareness.
Response Status: Closed - Acceptable Action
Recipient: Cirrus Aircraft
Mar 3, 2022
From the Document
The National Transportation Safety Board (NTSB) is providing the following information to urge the Federal Aviation Administration (FAA) to take action on the safety recommendations in this report. They are derived from our investigation of a midair collision involving a de Havilland DHC-2 airplane and a Piper PA-12 airplane. The NTSB is issuing two safety recommendations to the FAA.
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Require all pilots to monitor and communicate their positions on the designated common traffic advisory frequency (CTAF) when entering and exiting dedicated CTAF areas throughout Alaska, as well as near established reporting points and airport traffic patterns within the CTAF area, unless already communicating with air traffic control.
Study Focus: Review traffic awareness and collision avoidance.
Response Status: Open - Acceptable Response
Recipient: FAA
Mar 3, 2022
From the Document
The National Transportation Safety Board (NTSB) is providing the following information to urge the Federal Aviation Administration (FAA) to take action on the safety recommendations in this report. They are derived from our investigation of a midair collision involving a de Havilland DHC-2 airplane and a Piper PA-12 airplane. The NTSB is issuing two safety recommendations to the FAA.
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Establish additional common traffic advisory frequency (CTAF) areas in locations throughout Alaska at high risk of midair collisions, designate one frequency that is associated with all non-towered airports within the geographical boundaries of these CTAF areas, and define mandatory position reporting locations and reporting requirements within these areas.
Study Focus: Review traffic awareness and collision avoidance.
Response Status: Open - Acceptable Response
Recipient: FAA
Jan 27, 2022
From the Document
The National Transportation Safety Board (NTSB) is providing the following information to urge the Federal Aviation Administration (FAA) to take action on the safety recommendation in this report. This recommendation is derived from the NTSB’s investigations of two accidents involving airplanes, designed and built by Piper Aircraft Inc. (Piper), that sustained substantial damage when their rudders structurally failed in flight. For both accident…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Issue an airworthiness directive that describes the safety risk associated with the continued use of Piper Aircraft Inc. part number 40622 rudders equipped with a post made of American Iron and Steel Institute (AISI) 1025 carbon steel and that requires owners and operators to address the unsafe condition, such as by replacing them with rudders equipped with a post made of AISI 4130 low-alloy steel or its…
Study Focus: Review maintenance and airworthiness responsibilities.
Response Status: Open - Acceptable Response
Recipient: FAA
Jan 20, 2022
From the Document
The National Transportation Safety Board (NTSB) is providing the following information to urge the Federal Aviation Administration (FAA) to take action on this safety recommendation. It is derived from previous investigations and reports of aircraft accidents in which undetected carbon monoxide (CO) poisoning led to pilot impairment and subsequent fatal or serious injuries due to crashes.1 In each of these accidents, the pilot was not alerted to…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Require that all enclosed-cabin aircraft with reciprocating engines be equipped with a carbon monoxide detector that complies with an aviation-specific minimum performance standard with active aural or visual alerting.
Response Status: Open - Acceptable Response
Recipient: FAA
Jan 20, 2022
From the Document
The National Transportation Safety Board (NTSB) is providing the following information to urge the Federal Aviation Administration (FAA) to take action on this safety recommendation. It is derived from previous investigations and reports of aircraft accidents in which undetected carbon monoxide (CO) poisoning led to pilot impairment and subsequent fatal or serious injuries due to crashes.1 In each of these accidents, the pilot was not alerted to…
Requested Action: TO THE AIRCRAFT OWNERS AND PILOTS ASSOCIATION AND THE EXPERIMENTAL AIRCRAFT ASSOCIATION: Inform your members about the dangers of carbon monoxide (CO) poisoning in flight and encourage them to 1) install CO detectors with active aural or visual alerting and 2) proactively ensure thorough exhaust inspection during regular maintenance.
Study Focus: Review maintenance and airworthiness responsibilities.
Response Status: Open - Initial Response Received
Recipient: Aircraft Owners and Pilots Association, Experimental Aircraft Association
Nov 18, 2021
From the Document
This report discusses the October 17, 2019, accident involving a Saab SA-2000 airplane, operated by Peninsula Aviation Services Inc. d.b.a. PenAir flight 3296, which overran the end of runway 13 at Unalaska Airport, Unalaska, Alaska. The airplane was substantially damaged during the runway overrun; as a result, of the 3 crewmembers and 39 passengers aboard, 1 passenger sustained fatal injuries, and 1 passenger sustained serious injuries. Eight…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Identify all currently certificated transport-category airplanes for which system safety assessments for landing gear systems did not consider human error that could lead to cross-wiring of antiskid brake system components, including the wheel speed transducers, and require manufacturers of transport-category airplanes without such assessments to perform the assessments and then implement mitigations to…
Study Focus: Review surface awareness and decisions during taxi, takeoff and landing.
Response Status: Open - Acceptable Response
Recipient: FAA
Nov 18, 2021
From the Document
This report discusses the October 17, 2019, accident involving a Saab SA-2000 airplane, operated by Peninsula Aviation Services Inc. d.b.a. PenAir flight 3296, which overran the end of runway 13 at Unalaska Airport, Unalaska, Alaska. The airplane was substantially damaged during the runway overrun; as a result, of the 3 crewmembers and 39 passengers aboard, 1 passenger sustained fatal injuries, and 1 passenger sustained serious injuries. Eight…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Require the submission and consideration of system safety assessments addressing the landing gear antiskid system for the certification of future transport-category airplane designs. The certification should ensure that the system safety assessments are consistent with the intent of Advisory Circular 25.1309, System Design and Analysis, and that the assessments evaluate and mitigate the potential for human…
Study Focus: Review surface awareness and decisions during taxi, takeoff and landing.
Response Status: Closed - Unacceptable Action
Recipient: FAA
Nov 18, 2021
From the Document
This report discusses the October 17, 2019, accident involving a Saab SA-2000 airplane, operated by Peninsula Aviation Services Inc. d.b.a. PenAir flight 3296, which overran the end of runway 13 at Unalaska Airport, Unalaska, Alaska. The airplane was substantially damaged during the runway overrun; as a result, of the 3 crewmembers and 39 passengers aboard, 1 passenger sustained fatal injuries, and 1 passenger sustained serious injuries. Eight…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Require organizations that design, manufacture, and maintain aircraft to establish a safety management system.
Study Focus: Review surface awareness and decisions during taxi, takeoff and landing.
Response Status: Open - Unacceptable Response
Recipient: FAA
Nov 18, 2021
From the Document
This report discusses the October 17, 2019, accident involving a Saab SA-2000 airplane, operated by Peninsula Aviation Services Inc. d.b.a. PenAir flight 3296, which overran the end of runway 13 at Unalaska Airport, Unalaska, Alaska. The airplane was substantially damaged during the runway overrun; as a result, of the 3 crewmembers and 39 passengers aboard, 1 passenger sustained fatal injuries, and 1 passenger sustained serious injuries. Eight…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Notify principal operations inspectors and frontline managers about the circumstances of this accident and emphasize the importance of existing Federal Aviation Administration guidance for detecting and mitigating the safety risks that can result when certificate holders experience significant organizational change, such as high personnel turnover, a reduction to route structures or flight schedules,…
Study Focus: Review surface awareness and decisions during taxi, takeoff and landing.
Response Status: Closed - Unacceptable Action
Recipient: FAA
Nov 18, 2021
From the Document
This report discusses the October 17, 2019, accident involving a Saab SA-2000 airplane, operated by Peninsula Aviation Services Inc. d.b.a. PenAir flight 3296, which overran the end of runway 13 at Unalaska Airport, Unalaska, Alaska. The airplane was substantially damaged during the runway overrun; as a result, of the 3 crewmembers and 39 passengers aboard, 1 passenger sustained fatal injuries, and 1 passenger sustained serious injuries. Eight…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Revise Order 8900.1, Flight Standards Information Management System, to include a formalized transition procedure to be used during a changeover of certificate management team personnel responsible for overseeing a certificate holder that is undergoing significant organizational change (for a reason described in volume 6, chapter 2, section 18 of the order) to ensure that incoming personnel are fully aware…
Study Focus: Review surface awareness and decisions during taxi, takeoff and landing.
Response Status: Closed - Unacceptable Action
Recipient: FAA
Nov 18, 2021
From the Document
This report discusses the October 17, 2019, accident involving a Saab SA-2000 airplane, operated by Peninsula Aviation Services Inc. d.b.a. PenAir flight 3296, which overran the end of runway 13 at Unalaska Airport, Unalaska, Alaska. The airplane was substantially damaged during the runway overrun; as a result, of the 3 crewmembers and 39 passengers aboard, 1 passenger sustained fatal injuries, and 1 passenger sustained serious injuries. Eight…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Include the runway design code for runways of intended use among the criteria assessed when authorizing a scheduled air carrier to operate its airplanes on a regular basis at an airport certificated under Title 14 Code of Federal Regulations Part 139.
Study Focus: Review surface awareness and decisions during taxi, takeoff and landing.
Response Status: Open - Acceptable Response
Recipient: FAA
Nov 18, 2021
From the Document
This report discusses the October 17, 2019, accident involving a Saab SA-2000 airplane, operated by Peninsula Aviation Services Inc. d.b.a. PenAir flight 3296, which overran the end of runway 13 at Unalaska Airport, Unalaska, Alaska. The airplane was substantially damaged during the runway overrun; as a result, of the 3 crewmembers and 39 passengers aboard, 1 passenger sustained fatal injuries, and 1 passenger sustained serious injuries. Eight…
Requested Action: TO EUROPEAN UNION AVIATION SAFETY AGENCY: Identify all currently certificated transport-category airplanes for which system safety assessments for landing gear systems did not consider human error that could lead to cross-wiring of antiskid brake system components, including the wheel speed transducers, and require manufacturers of transport-category airplanes without such assessments to perform the assessments and then implement mitigations to…
Study Focus: Review surface awareness and decisions during taxi, takeoff and landing.
Response Status: Open - Acceptable Response
Recipient: European Aviation Safety Agency
Nov 18, 2021
From the Document
This report discusses the October 17, 2019, accident involving a Saab SA-2000 airplane, operated by Peninsula Aviation Services Inc. d.b.a. PenAir flight 3296, which overran the end of runway 13 at Unalaska Airport, Unalaska, Alaska. The airplane was substantially damaged during the runway overrun; as a result, of the 3 crewmembers and 39 passengers aboard, 1 passenger sustained fatal injuries, and 1 passenger sustained serious injuries. Eight…
Requested Action: TO THE EUROPEAN UNION AVIATION SAFETY AGENCY: Require the submission and consideration of system safety assessments addressing the landing gear antiskid system for the certification of future transport-category airplane designs. The certification should ensure that the system safety assessments are consistent with the intent of Acceptable Means of Compliance 25.1309, Systems Design and Analysis, and that the assessments evaluate and mitigate the…
Study Focus: Review surface awareness and decisions during taxi, takeoff and landing.
Response Status: Open - Acceptable Response
Recipient: European Aviation Safety Agency
Nov 18, 2021
From the Document
This report discusses the October 17, 2019, accident involving a Saab SA-2000 airplane, operated by Peninsula Aviation Services Inc. d.b.a. PenAir flight 3296, which overran the end of runway 13 at Unalaska Airport, Unalaska, Alaska. The airplane was substantially damaged during the runway overrun; as a result, of the 3 crewmembers and 39 passengers aboard, 1 passenger sustained fatal injuries, and 1 passenger sustained serious injuries. Eight…
Requested Action: TO THE EUROPEAN UNION AVIATION SAFETY AGENCY: Require organizations that design, manufacture, and maintain aircraft to establish a safety management system.
Study Focus: Review surface awareness and decisions during taxi, takeoff and landing.
Response Status: Open - Initial Response Received
Recipient: European Aviation Safety Agency
Nov 18, 2021
From the Document
This report discusses the October 17, 2019, accident involving a Saab SA-2000 airplane, operated by Peninsula Aviation Services Inc. d.b.a. PenAir flight 3296, which overran the end of runway 13 at Unalaska Airport, Unalaska, Alaska. The airplane was substantially damaged during the runway overrun; as a result, of the 3 crewmembers and 39 passengers aboard, 1 passenger sustained fatal injuries, and 1 passenger sustained serious injuries. Eight…
Requested Action: TO THE SAAB GROUP: Redesign the wheel speed transducer wire harnesses for the Saab 2000 airplane to prevent the harnesses from being installed incorrectly during maintenance and overhaul.
Study Focus: Review surface awareness and decisions during taxi, takeoff and landing.
Response Status: Open - Acceptable Response
Recipient: Saab Aircraft of America, Inc.
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Work with stakeholders to standardize the distribution of pilot weather reports (PIREPs) across and within air traffic control facilities to ensure they are disseminated to only those facilities and air traffic controller positions for which each PIREP applies.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open - Acceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Determine how to harmonize current and future eddy dissipation rate algorithm performance in operational environments and publish the results of this determination.
Response Status: Open - Acceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Incorporate the automatic dependent surveillance-broadcast (ADS-B) weather capability in the next version of the automatic dependent surveillance-broadcast technical standard order.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open - Unacceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: After the automatic dependent surveillance-broadcast (ADS-B) technical standard order is revised as recommended in Safety Recommendation A-21-28, require that aircraft flown in Title 14 Code of Federal Regulations Part 121 air carrier operations be retrofitted with automatic dependent surveillance-broadcast weather capable ADS-B equipment.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open - Unacceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Require automatic dependent surveillance-broadcast weather (ADS-B Wx)-equipped aircraft to broadcast ADS-B Wx information when operating in airspace requiring automatic dependent surveillance-broadcast capability as defined by Title 14 Code of Federal Regulations 91.225.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open - Acceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Distribute graphical airmen’s meteorological information advisories, significant meteorological information advisories, and center weather advisories to air traffic controllers as controller-selectable layers on current and future controller radar displays in air route traffic control centers and terminal radar approach control facilities.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open - Unacceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Work with local safety councils to develop training on the use of the advisories developed for Safety Recommendation A-21-32.
Study Focus: Review training practices and proficiency.
Response Status: Open - Unacceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: In collaboration with the National Weather Service, operationalize a turbulence nowcast, such as the graphical turbulence guidance nowcast.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open - Acceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Develop air traffic control guidelines for use of the turbulence nowcast operationalized in accordance with Safety Recommendations A-21-34 and A-21-44.
Response Status: Open - Acceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Incorporate total lightning and hail information as selectable layers on air traffic controller radar displays in air route traffic control centers and terminal radar approach control facilities.
Response Status: Open - Unacceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: After the action in Safety Recommendation A-21-36 is completed, provide training to air traffic controllers on the use of the controller-selectable total lightning and hail information.
Study Focus: Review training practices and proficiency.
Response Status: Open - Unacceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Conduct a study of how aircraft accelerations vary along the length of the aircraft during turbulence encounters, including differences among aircraft types operated by Title 14 Code of Federal Regulations Part 121 air carriers, and publish the study findings.
Response Status: Open - Unacceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Conduct a study to determine the factors that affect caregivers’ decisions about the use of child restraint systems (CRSs) when traveling on a Title 14 Code of Federal Regulations Part 121 air carrier airplane with children under the age of 2 and to understand the challenges associated with using CRSs; publish the study findings.
Response Status: Open - Acceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: After the action in Safety Recommendation A-21-40 is completed, use the study findings to direct the Federal Aviation Administration’s efforts to increase child restraint system usage.
Response Status: Open - Acceptable Response
Recipient: FAA
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE NATIONAL WEATHER SERVICE: Work with the Federal Aviation Administration to modify airmen’s meteorological information (AIRMET) advisory issuing practices to include graphical AIRMET advisories with higher granularity, taking into account the effect it would have on all National Airspace System users.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Closed - Acceptable Action
Recipient: United States Department of Commerce, National Oceanic and Atmospheric Administration, National Weather Service
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO THE NATIONAL WEATHER SERVICE: Work with the Federal Aviation Administration to operationalize a turbulence nowcast, such as the graphical turbulence guidance nowcast.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open - Acceptable Response
Recipient: United States Department of Commerce, National Oceanic and Atmospheric Administration, National Weather Service
Sep 7, 2021
From the Document
Turbulence-related accidents are the most common type of accident involving air carriers operating under Title 14 Code of Federal Regulations (CFR) Part 121. From 2009 through 2018, the National Transportation Safety Board (NTSB) found that turbulence-related accidents accounted for more than a third of all Part 121 accidents; most of these accidents resulted in one or more serious injuries but no aircraft damage. This NTSB safety research…
Requested Action: TO AIRLINES FOR AMERICA, THE NATIONAL AIR CARRIER ASSOCIATION, AND THE REGIONAL AIRLINE ASSOCIATION: Coordinate with your member airlines to develop and implement a program to increase child restraint system (CRS) usage in airplanes; this effort should include collecting data to determine the program’s effectiveness at increasing CRS usage.
Response Status: Open - Acceptable Response
Recipient: National Air Carrier Association, Inc., Regional Airline Association, Airlines for America (formerly Air Transport Association of America, Inc.)
May 13, 2021
From the Document
On May 13, 2019, about 1221 Alaska daylight time, a float-equipped de Havilland DHC-2 (Beaver) airplane, N952DB, and a float-equipped de Havilland DHC-3 (Otter) airplane, N959PA, collided in midair about 8 miles northeast of Ketchikan, Alaska. The DHC-2 pilot and four passengers sustained fatal injuries. The DHC-3 pilot sustained minor injuries, nine passengers sustained serious injuries, and one passenger sustained fatal injuries. The DHC-2 was…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Identify high-traffic air tour areas and require, through a special federal aviation regulation or other means, that Title 14 Code of Federal Regulations Parts 91 and 135 air tour operators that operate within those areas be equipped with an Automatic Dependent Surveillance-Broadcast Out- and In-supported (ADS-B) traffic advisory system that 1) includes both visual and aural alerts, 2) is driven by an…
Response Status: Open - Unacceptable Response
Recipient: FAA
May 13, 2021
From the Document
On May 13, 2019, about 1221 Alaska daylight time, a float-equipped de Havilland DHC-2 (Beaver) airplane, N952DB, and a float-equipped de Havilland DHC-3 (Otter) airplane, N959PA, collided in midair about 8 miles northeast of Ketchikan, Alaska. The DHC-2 pilot and four passengers sustained fatal injuries. The DHC-3 pilot sustained minor injuries, nine passengers sustained serious injuries, and one passenger sustained fatal injuries. The DHC-2 was…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: In the high-traffic air tour areas identified in Safety Recommendation A-21-15, require that all non–air tour aircraft operating within the airspace be equipped with Automatic Dependent Surveillance-Broadcast Out. (ADS-B)
Study Focus: Review airspace access, restrictions and coordination.
Response Status: Open - Unacceptable Response
Recipient: FAA
May 13, 2021
From the Document
On May 13, 2019, about 1221 Alaska daylight time, a float-equipped de Havilland DHC-2 (Beaver) airplane, N952DB, and a float-equipped de Havilland DHC-3 (Otter) airplane, N959PA, collided in midair about 8 miles northeast of Ketchikan, Alaska. The DHC-2 pilot and four passengers sustained fatal injuries. The DHC-3 pilot sustained minor injuries, nine passengers sustained serious injuries, and one passenger sustained fatal injuries. The DHC-2 was…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Require the installation of Automatic Dependent Surveillance-Broadcast Out- and In-supported (ADS-B) airborne traffic advisory systems that include aural and visual alerting functions in all aircraft conducting operations under Title 14 Code of Federal Regulations Part 135.
Response Status: Open - Unacceptable Response
Recipient: FAA
May 13, 2021
From the Document
On May 13, 2019, about 1221 Alaska daylight time, a float-equipped de Havilland DHC-2 (Beaver) airplane, N952DB, and a float-equipped de Havilland DHC-3 (Otter) airplane, N959PA, collided in midair about 8 miles northeast of Ketchikan, Alaska. The DHC-2 pilot and four passengers sustained fatal injuries. The DHC-3 pilot sustained minor injuries, nine passengers sustained serious injuries, and one passenger sustained fatal injuries. The DHC-2 was…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Review current and future supplemental type certificate installation instructions and flight manual supplements to ensure they provide provisions to prevent the inadvertent disabling of the broadcast of pressure altitude data, by design, where practicable.
Study Focus: Review qualification and recent-experience requirements.
Response Status: Open - Unacceptable Response
Recipient: FAA
May 13, 2021
From the Document
On May 13, 2019, about 1221 Alaska daylight time, a float-equipped de Havilland DHC-2 (Beaver) airplane, N952DB, and a float-equipped de Havilland DHC-3 (Otter) airplane, N959PA, collided in midair about 8 miles northeast of Ketchikan, Alaska. The DHC-2 pilot and four passengers sustained fatal injuries. The DHC-3 pilot sustained minor injuries, nine passengers sustained serious injuries, and one passenger sustained fatal injuries. The DHC-2 was…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Ensure that checklists for all Capstone Program (phase 2) aircraft include verification that the Garmin GSL 71 control head selector knob is in the ON position and that the unit is in ALT mode before takeoff.
Response Status: Open - Acceptable Response
Recipient: FAA
May 13, 2021
From the Document
On May 13, 2019, about 1221 Alaska daylight time, a float-equipped de Havilland DHC-2 (Beaver) airplane, N952DB, and a float-equipped de Havilland DHC-3 (Otter) airplane, N959PA, collided in midair about 8 miles northeast of Ketchikan, Alaska. The DHC-2 pilot and four passengers sustained fatal injuries. The DHC-3 pilot sustained minor injuries, nine passengers sustained serious injuries, and one passenger sustained fatal injuries. The DHC-2 was…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Update the Aeronautical Information Manual and the Pilot’s Handbook of Aeronautical Knowledge to include the limitations inherent in visual scans for traffic and the benefits and best practices of using cockpit displays of traffic information to supplement visual scans to help overcome these limitations.
Response Status: Closed - Acceptable Action
Recipient: FAA
May 13, 2021
From the Document
On May 13, 2019, about 1221 Alaska daylight time, a float-equipped de Havilland DHC-2 (Beaver) airplane, N952DB, and a float-equipped de Havilland DHC-3 (Otter) airplane, N959PA, collided in midair about 8 miles northeast of Ketchikan, Alaska. The DHC-2 pilot and four passengers sustained fatal injuries. The DHC-3 pilot sustained minor injuries, nine passengers sustained serious injuries, and one passenger sustained fatal injuries. The DHC-2 was…
Requested Action: TO FOREFLIGHT: Update your traffic alerting algorithms so that traffic targets for which there is no altitude information are assumed to be at the same altitude as the ownship (that is, the aircraft receiving the target data).
Response Status: Closed - Acceptable Action
Recipient: ForeFlight
May 13, 2021
From the Document
On May 13, 2019, about 1221 Alaska daylight time, a float-equipped de Havilland DHC-2 (Beaver) airplane, N952DB, and a float-equipped de Havilland DHC-3 (Otter) airplane, N959PA, collided in midair about 8 miles northeast of Ketchikan, Alaska. The DHC-2 pilot and four passengers sustained fatal injuries. The DHC-3 pilot sustained minor injuries, nine passengers sustained serious injuries, and one passenger sustained fatal injuries. The DHC-2 was…
Requested Action: TO TAQUAN AIR: Revise the checklists for your fleet of aircraft to ensure they include verification that the Garmin GSL 71 control head selector knob is in the ON position and that the unit is in ALT mode before takeoff.
Response Status: Open - Await Response
Recipient: Taquan Air
May 13, 2021
From the Document
On May 13, 2019, about 1221 Alaska daylight time, a float-equipped de Havilland DHC-2 (Beaver) airplane, N952DB, and a float-equipped de Havilland DHC-3 (Otter) airplane, N959PA, collided in midair about 8 miles northeast of Ketchikan, Alaska. The DHC-2 pilot and four passengers sustained fatal injuries. The DHC-3 pilot sustained minor injuries, nine passengers sustained serious injuries, and one passenger sustained fatal injuries. The DHC-2 was…
Requested Action: TO AVIATION INDUSTRY GROUPS (AIRCRAFT OWNERS AND PILOTS ASSOCIATION, EXPERIMENTAL AIRCRAFT ASSOCIATION, NATIONAL BUSINESS AVIATION ASSOCIATION, TOUR OPERATORS PROGRAM OF SAFETY, TONGASS AIRCRAFT PILOTS ASSOCIATION, AND HELICOPTER ASSOCIATION INTERNATIONAL): Inform your members about the circumstances of this accident and encourage them to take the following actions: (1) become familiar with the traffic display equipment installed in their…
Response Status: Open - Acceptable Response
Recipient: Aircraft Owners and Pilots Association, Experimental Aircraft Association, National Business Aviation Association, Tour Operators Program of Safety, Helicopter Association International, Tongass Aircraft Pilots Association
May 13, 2021
From the Document
On May 13, 2019, about 1221 Alaska daylight time, a float-equipped de Havilland DHC-2 (Beaver) airplane, N952DB, and a float-equipped de Havilland DHC-3 (Otter) airplane, N959PA, collided in midair about 8 miles northeast of Ketchikan, Alaska. The DHC-2 pilot and four passengers sustained fatal injuries. The DHC-3 pilot sustained minor injuries, nine passengers sustained serious injuries, and one passenger sustained fatal injuries. The DHC-2 was…
Requested Action: TO THE NATIONAL ASSOCIATION OF FLIGHT INSTRUCTORS AND THE SOCIETY OF AVIATION AND FLIGHT EDUCATORS: Inform your members of the circumstances of this accident and incorporate instruction on including the traffic display when scanning for traffic through an aircraft’s windows in both initial and recurrent pilot training.
Study Focus: Review training practices and proficiency.
Response Status: Open - Await Response
Recipient: Society of Aviation and Flight Educators, National Association of Flight Instructors
Feb 25, 2021
From the Document
This report discusses the January 26, 2020, accident involving a Sikorsky S-76B helicopter, N72EX, being operated by Island Express Helicopters Inc. as a Title 14 Code of Federal Regulations (CFR) Part 135 on-demand flight, that crashed into terrain in Calabasas, California. The pilot and the eight passengers died. Safety issues identified in this report include the pilot’s preflight weather and flight risk planning, the flight’s entry into…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Require the use of appropriate simulation devices during initial and recurrent pilot training for Title 14 Code of Federal Regulations Part 135 helicopter operations to provide scenario-based training that addresses the decision-making, skills, and procedures needed to recognize and respond to changing weather conditions in flight, identify and apply mitigation strategies for avoiding adverse weather,…
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open - Acceptable Response
Recipient: FAA
Feb 25, 2021
From the Document
This report discusses the January 26, 2020, accident involving a Sikorsky S-76B helicopter, N72EX, being operated by Island Express Helicopters Inc. as a Title 14 Code of Federal Regulations (CFR) Part 135 on-demand flight, that crashed into terrain in Calabasas, California. The pilot and the eight passengers died. Safety issues identified in this report include the pilot’s preflight weather and flight risk planning, the flight’s entry into…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Convene a multidisciplinary panel of aircraft performance, human factors, and aircraft operations specialists to evaluate spatial disorientation simulation technologies to determine which applications are most effective for training pilots to recognize the onset of spatial disorientation and successfully mitigate it, and make public a report on the committee’s findings.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Closed - Acceptable Action
Recipient: FAA
Feb 25, 2021
From the Document
This report discusses the January 26, 2020, accident involving a Sikorsky S-76B helicopter, N72EX, being operated by Island Express Helicopters Inc. as a Title 14 Code of Federal Regulations (CFR) Part 135 on-demand flight, that crashed into terrain in Calabasas, California. The pilot and the eight passengers died. Safety issues identified in this report include the pilot’s preflight weather and flight risk planning, the flight’s entry into…
Requested Action: TO ISLAND EXPRESS HELICOPTERS INC.: Participate in the Federal Aviation Administration’s Safety Management System Voluntary Program.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Closed - Unacceptable Action
Recipient: Maverick Helicopters (formerly Island Express Helicopters, Inc.)
Feb 25, 2021
From the Document
This report discusses the January 26, 2020, accident involving a Sikorsky S-76B helicopter, N72EX, being operated by Island Express Helicopters Inc. as a Title 14 Code of Federal Regulations (CFR) Part 135 on-demand flight, that crashed into terrain in Calabasas, California. The pilot and the eight passengers died. Safety issues identified in this report include the pilot’s preflight weather and flight risk planning, the flight’s entry into…
Requested Action: TO ISLAND EXPRESS HELICOPTERS, INC.: Install flight data recording devices capable of supporting a flight data monitoring (FDM) program on each helicopter in your fleet and establish an FDM program that reviews all available data sources to identify deviations from established norms and procedures as well as other potential safety issues.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open - Acceptable Response
Recipient: Maverick Helicopters (formerly Island Express Helicopters, Inc.)
Feb 11, 2021
From the Document
These recommendations derive from the NTSB’s investigation of a fatal accident involving a privately operated Cirrus SR22 that crashed while maneuvering at low altitude near Ely, Nevada, on February 15, 2019, as well as our investigation of the sinking of the amphibious passenger vessel Stretch Duck 7 on July 19, 2018, near Branson, Missouri. The NTSB is issuing two new safety recommendations to the NWS and two new recommendations to the FAA to…
Requested Action: TO THE NATIONAL WEATHER SERVICE: Revise National Weather Service Instruction 30-2111 to clearly define “outage,” “failure,” and similar terms regarding individual automated surface observing system (ASOS) sensor and component performance and to include explicit maintenance actions intended to mitigate presumed erroneous ASOS sensor reporting that does not generate failure flags in maintenance monitoring data.
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open - Acceptable Response
Recipient: United States Department of Commerce, National Oceanic and Atmospheric Administration, National Weather Service
Feb 11, 2021
From the Document
These recommendations derive from the NTSB’s investigation of a fatal accident involving a privately operated Cirrus SR22 that crashed while maneuvering at low altitude near Ely, Nevada, on February 15, 2019, as well as our investigation of the sinking of the amphibious passenger vessel Stretch Duck 7 on July 19, 2018, near Branson, Missouri. The NTSB is issuing two new safety recommendations to the NWS and two new recommendations to the FAA to…
Requested Action: TO THE NATIONAL WEATHER SERVICE: Revise National Weather Service Instruction 30-2112 to provide operational (forecasting) staff at weather forecast offices the authority to determine whether report processing for an automated surface observing system sensor at an unattended site (or other site not currently being appropriately augmented) should be turned off immediately if the sensor is believed to be reporting erroneously but does not yield…
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open - Acceptable Response
Recipient: United States Department of Commerce, National Oceanic and Atmospheric Administration, National Weather Service
Jan 7, 2021
From the Document
On June 21, 2019, about 1822 Hawaii-Aleutian standard time, a Beech King Air 65-A90 airplane, N256TA, impacted terrain after takeoff from HDH. The pilot and 10 passengers were fatally injured, and the airplane was destroyed by impact forces and a postcrash fire. The airplane was owned by N80896 LLC and was operated by Oahu Parachute Center LLC under the provisions of Title 14 Code of Federal Regulations (CFR) Part 91 as a local parachute jump…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Develop a system to automatically notify your inspectors of those flight instructors (within each inspector’s geographic area of responsibility) whose student pass rate in the Program Tracking and Reporting Subsystem has become substandard so that the inspectors can perform additional surveillance according to the guidance in Order 8900.1, Flight Standards Information Management System, volume 6, chapter…
Response Status: Open - Unacceptable Response
Recipient: FAA
Jan 7, 2021
From the Document
On June 21, 2019, about 1822 Hawaii-Aleutian standard time, a Beech King Air 65-A90 airplane, N256TA, impacted terrain after takeoff from HDH. The pilot and 10 passengers were fatally injured, and the airplane was destroyed by impact forces and a postcrash fire. The airplane was owned by N80896 LLC and was operated by Oahu Parachute Center LLC under the provisions of Title 14 Code of Federal Regulations (CFR) Part 91 as a local parachute jump…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Until the system proposed in Safety Recommendation A-20-40 is implemented, direct your inspectors to (1) review the Program Tracking and Reporting Subsystem on an ongoing basis to identify those flight instructors (within each inspector’s geographic area of responsibility) with a substandard student pass rate and (2) provide additional surveillance of those instructors according to the guidance in Order…
Response Status: Open - Unacceptable Response
Recipient: FAA
Aug 5, 2020
From the Document
On February 23, 2019, at 1239 central standard time, Atlas Air Inc. (Atlas) flight 3591, a Boeing 767-375BCF, N1217A, was destroyed after it rapidly descended from an altitude of about 6,000 ft mean sea level (msl) and crashed into a shallow, muddy marsh area of Trinity Bay, Texas, about 41 miles east-southeast of George Bush Intercontinental/Houston Airport (IAH), Houston, Texas. The captain, first officer (FO), and a nonrevenue pilot riding in…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Establish a confidential voluntary data clearinghouse of deidentified pilot selection data that can be used to conduct studies useful for identifying effective, scientifically based pilot selection strategies. This program should be modeled after programs like Aviation Safety Information and Analysis Sharing and Flight Operations Quality Assurance.
Response Status: Closed - Unacceptable Action
Recipient: FAA
Aug 5, 2020
From the Document
On February 23, 2019, at 1239 central standard time, Atlas Air Inc. (Atlas) flight 3591, a Boeing 767-375BCF, N1217A, was destroyed after it rapidly descended from an altitude of about 6,000 ft mean sea level (msl) and crashed into a shallow, muddy marsh area of Trinity Bay, Texas, about 41 miles east-southeast of George Bush Intercontinental/Houston Airport (IAH), Houston, Texas. The captain, first officer (FO), and a nonrevenue pilot riding in…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Convene a panel of aircraft performance, human factors, and aircraft operations experts to study the benefits and risks of adapting military automatic ground collision avoidance system technology for use in civil transport-category airplanes and make public a report on the committee’s findings.
Study Focus: Review the human factors that influence safe decisions.
Response Status: Open - Acceptable Response
Recipient: FAA
Jun 8, 2020
From the Document
On January 29, 2019, about 0650 eastern standard time, a single-engine, turbine-powered Bell 407 helicopter, N191SF, being operated as a helicopter air ambulance (HAA) flight, collided with forested terrain about 4 miles northeast of Zaleski, Ohio.1 The certificated commercial pilot, flight nurse, and flight paramedic died, and the helicopter was destroyed. The helicopter was registered to and operated by Viking Aviation, LLC, doing business as…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Require that principal operations inspectors (POI) assigned to helicopter air ambulance (HAA) operations possess helicopter and either HAA experience or experience as an assistant POI under a POI with HAA experience.
Study Focus: Review qualification and recent-experience requirements.
Response Status: Open Acceptable Alternate Response
Recipient: FAA
Jun 8, 2020
From the Document
On January 29, 2019, about 0650 eastern standard time, a single-engine, turbine-powered Bell 407 helicopter, N191SF, being operated as a helicopter air ambulance (HAA) flight, collided with forested terrain about 4 miles northeast of Zaleski, Ohio.1 The certificated commercial pilot, flight nurse, and flight paramedic died, and the helicopter was destroyed. The helicopter was registered to and operated by Viking Aviation, LLC, doing business as…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Require the National Weather Service (NWS) to add terminal doppler weather radar data to the HEMS Weather Tool overlay (as recommended in Safety Recommendation A-20-19 to the NWS).
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open Acceptable Alternate Response
Recipient: FAA
Jun 8, 2020
From the Document
On January 29, 2019, about 0650 eastern standard time, a single-engine, turbine-powered Bell 407 helicopter, N191SF, being operated as a helicopter air ambulance (HAA) flight, collided with forested terrain about 4 miles northeast of Zaleski, Ohio.1 The certificated commercial pilot, flight nurse, and flight paramedic died, and the helicopter was destroyed. The helicopter was registered to and operated by Viking Aviation, LLC, doing business as…
Requested Action: TO THE FEDERAL AVIATION ADMINISTRATION: Require the National Weather Service (NWS) to provide capability in the HEMS Weather Tool to graphically display areas of weather radar limitations, including areas where beams may lack low-altitude coverage, areas that lack radar coverage, and areas of beam blockages (as recommended in Safety Recommendation A-20-20 to the NWS).
Study Focus: Review weather hazards and how they affect planning and flight decisions.
Response Status: Open Acceptable Alternate Response
Recipient: FAA