NTSB Abstract AAR-09/06

Aviation Accident Report
Loss of Control and Crash
Marlin Air
Cessna Citation 550, N550BP
Milwaukee, Wisconsin
June 4, 2007

NTSB Number: AAR-09/06
NTIS Number: PB2009-910406

PDF Document (1.97 MB)

Executive Summary: On June 4, 2007, about 1600 central daylight time, a Cessna Citation 550, N550BP, impacted Lake Michigan shortly after departure from General Mitchell International Airport, Milwaukee, Wisconsin (MKE). The two pilots and four passengers were killed, and the airplane was destroyed. The airplane was being operated by Marlin Air under the provisions of 14 Code of Federal Regulations Part 135 and departed MKE about 1557 with an intended destination of Willow Run Airport, near Ypsilanti, Michigan. At the time of the accident flight, marginal visual meteorological conditions prevailed at the surface, and instrument meteorological conditions prevailed aloft; the flight operated on an instrument flight rules flight plan.

The National Transportation Safety Board determined that the probable cause of this accident was the pilots’ mismanagement of an abnormal flight control situation through improper actions, including failing to control airspeed and to prioritize control of the airplane, and lack of crew coordination. Contributing to the accident were Marlin Air’s operational safety deficiencies, including the inadequate checkrides administered by Marlin Air’s chief pilot/check airman, and the Federal Aviation Administration’s (FAA) failure to detect and correct those deficiencies, which placed a pilot who inadequately emphasized safety in the position of company chief pilot and designated check airman and placed an ill-prepared pilot in the first officer’s seat.

The safety issues discussed in this report include pilot actions and coordination, the need for image recording equipment on airplanes not equipped with flight data recorders, autopilot panel design, control yoke wiring installations, identification of circuit breakers for use in emergencies, aural and visual alerts to pitch trim-in-motion, aileron trim power and sensitivity, human factors in airplane design, FAA appointment of check airmen, the scope of Regional Aviation Safety Inspection Program inspections, avenues for expressing safety concerns to federal authorities, and the safety ramifications of an operators’ financial health.

Related information:

NTSB Board Meetings | Publications