NTSB MAKES FINAL DETERMINATION ON ATLAS AIR CRASH
August 10, 2020
On July 14, 2020, the National Transportation Safety Board (NTSB) determined during a public board meeting that Atlas Air flight 3591 crashed in Trinity Bay, Texas because of the first officer’s inappropriate response to an inadvertent activation of the airplane’s go-around mode, resulting in his spatial disorientation that led him to place the airplane in a steep descent from which the crew did not recover. The NTSB cited the captain’s failure to adequately monitor the airplane’s flightpath and to assume positive control of the airplane to effectively intervene during the crash. The NTSB also cited the pilot selection and performance measurement practices as a contributing factor after finding that the first officer took deliberate actions to conceal his history of performance deficiencies, and that Atlas failed to evaluate the first officer’s unsuccessful attempt to upgrade to captain at his previous employer. The NTSB further found that the pilot records database, which the FAA failed to meet the deadline for implementing, would have provided the relevant information about the first officer’s long history of training performance deficiencies.
Based on the investigation, the NTSB issued six new safety recommendations to the FAA and reiterated six previously issued safety recommendations to the FAA. The new safety recommendations concern flight crew performance, industry pilot hiring process deficiencies such as the implementation of the pilot records database, and adaptations of automatic ground collision avoidance system technology. The reiterated safety recommendations seek the installation of cockpit imaging recorders on all aircraft operated under Parts 121 or 135 required to have cockpit voice and flight data recorders and address maintaining accurate pilot training records.
If you have any questions, please contact Evelyn Sahr (esahr@eckertseamans.com or 202-659-6622); Drew Derco (dderco@eckertseamans.com or 202-659-6665), or Andy Orr (aorr@eckertsemans.com or 202-659-6625).
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