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Safety Recommendation Details

Safety Recommendation A-04-055
Details
Synopsis: On July 13, 2003, about 1530 eastern daylight time, Air Sunshine, Inc. (doing business as Tropical Aviation Services, Inc.), flight 527, a Cessna 402C, N314AB, was ditched in the Atlantic Ocean about 7.35 nautical miles west-northwest of Treasure Cay Airport (MYAT), Treasure Cay, Great Abaco Island, Bahamas, after the in-flight failure of the right engine. Two of the nine passengers sustained no injuries, five passengers and the pilot sustained minor injuries, and one adult and one child passenger died after they evacuated the airplane. The airplane sustained substantial damage. The airplane was being operated under the provisions of 14 Code of Federal Regulations Part 135 as a scheduled international passenger commuter flight from Fort Lauderdale Hollywood/International Airport, Fort Lauderdale, Florida, to MYAT. Visual meteorological conditions prevailed for the flight, which operated on a visual flight rules flight plan.
Recommendation: The Safety Board recommends that the Federal Aviation Administration: Issue a flight standards information bulletin to principal operations inspectors of all Part 135 single-pilot operators that carry passengers and operate over water, which familiarizes them with the circumstances of the Air Sunshine flight 527 accident and emphasizes the need for pilots to provide timely emergency briefings. The bulletin should state that these briefings should include, at a minimum, information about the location and operation of the on-board emergency equipment and exits.
Original recommendation transmittal letter: PDF
Overall Status: Closed - Acceptable Alternate Action
Mode: Aviation
Location: Treasure Cay, Bahamas
Is Reiterated: No
Is Hazmat: No
Is NPRM: No
Accident #: MIA03FA141
Accident Reports: In-Flight Engine Failure and Subsequent Ditching Air Sunshine, Inc., Flight 527, Cessna 402C, N314AB, About 7.35 Nautical Miles West-Northwest of Treasure Cay Airport
Report #: AAR-04-03
Accident Date: 7/13/2003
Issue Date: 10/21/2004
Date Closed: 9/13/2005
Addressee(s) and Addressee Status: FAA (Closed - Acceptable Alternate Action)
Keyword(s): Briefings: Passenger, Part 135

Safety Recommendation History
From: NTSB
To: FAA
Date: 9/13/2005
Response: The Safety Board notes that on May 13, 2005, the FAA issued Notice 8400.82, "Passenger Briefings in Part 135 Single-Pilot Operations," to POIs of Part 135 single-pilot operators. The notice requires POIs to inform their operators of the circumstances of the Air Sunshine accident and emphasizes that pilots must provide timely emergency briefings that include information on the location and operation of on-board emergency equipment and exits. In its previous letter on this recommendation, the Safety Board asked the FAA to explain why it issued a notice as opposed to an FSIB, as recommended. In its June 24, 2005, letter the FAA provided the basis it uses to determine when a notice or an FSIB is more appropriate. In the case of this recommendation, the FAA determined that an FSIB would not be appropriate because existing regulations explicitly require passenger briefings, including the location and means for opening passenger entry doors and emergency exits, location of survival equipment, and ditching procedures and the use of required flotation equipment. The Board appreciates receiving this information. Issuance of Notice 8400.82 is an acceptable alternate action that meets the intent of this recommendation. Consequently, Safety Recommendation A-04-55 is classified "Closed--Acceptable Alternate Action."

From: FAA
To: NTSB
Date: 6/24/2005
Response: Letter Mail Controlled 7/5/2005 2:30:35 PM MC# 2050294 On May 13, 2005, the Federal Aviation Administration issued Notice 8400.82, Passenger Briefings in Part 135 Single-Pilot Operations, to principal operations inspectors of 14 CFR Part 135 single-pilot operators requiring them to inform their operators of the circumstances of the Air Sunshine accident. The notice also emphasizes that pilots must provide timely emergency briefings, which include information on the location and operation of on-board emergency equipment and exits. I have enclosed a copy of the notice for the Board's information. The Board asked the FAA to explain why it issued a notice as opposed to a bulletin. The following should clarify the FAA's action: · Handbook Bulletins for Air Transportation (HBAT) generally contain information and guidance for continuing action to be accomplished by inspectors indefinitely. Most HBATs are gathered into the handbook as permanent handbook content and are retired as bulletins. Flight Standards Information Bulletins (FSAT) (originally called FSIBs) compare to HBATs in most respects. They differ in that they generally address immediate and near-term safety issues for which action by inspectors is limited to a short term. FSATs are rarely gathered into the handbook as permanent handbook content. · A notice is an FAA directive that identifies FAA policy and provides guidance to FAA employees. A notice can be used to initiate a quick, one-time action by employees, such as a special inspection, or can be used simply to disseminate policy in a timely manner. In the latter case, the information in a notice usually becomes a permanent part of an associated FAA order. The FAA has also used notices to direct aviation safety inspectors to provide specific safety information to operators, sometimes including recommended action by operators that is not required by FAA regulations. Notices are available to inspectors via an internal information management system and to operators by way of an FAA public web site. In response to this safety recommendation, an FSAT would be inappropriate. Existing regulations explicitly require passenger briefings, including the location and means for opening passenger entry doors and emergency exits, location of survival equipment, and ditching procedures and the use of required flotation equipment. The pertinent rules are contained in 14 CFR 135.117 and cover passenger-carrying, overwater operations of all aircraft under 14 CFR Part 135, including small airplanes such as the Cessna 402C. Consequently, a notice is appropriate because it emphasizes the existing requirement that pilots provide passenger briefings. This notice meets the safety intent of the recommendation to familiarize inspectors and certificate holders and to emphasize existing requirements, yet calls for no action by inspectors that would differ from their normal functions as inspectors. If new or additional action by inspectors were called for, a handbook change or a bulletin would be appropriate.

From: NTSB
To: FAA
Date: 3/16/2005
Response: The Safety Board notes that the FAA plans to issue a notice, rather than an FSIB, which will be sent to POIs of Part 135 single-pilot operators. The notice will require that POIs inform their operators of the circumstances of the Air Sunshine accident and emphasize that pilots must provide timely emergency briefings, including information on the location and operation of on?board emergency equipment and exits. Pending issuance of the notice, Safety Recommendation A-04-55 is classified "Open--Acceptable Response." The FAA determined that in this case a notice was more appropriate than an FSIB. The Board would appreciate learning the criteria used by the FAA to decide whether a notice or an FSIB is most appropriate.

From: FAA
To: NTSB
Date: 12/30/2004
Response: Letter Mail Controlled 1/11/2005 7:56:40 AM MC# 2040747 The Federal Aviation Administration (FAA) will issue a notice, rather than a flight standards information bulletin, which will be sent to principal operations inspectors (POI) of 14 CFR Part 135 single-pilot operators. The FAA will require that POIs inform their operators of the circumstances of the Air Sunshine accident. The notice will also emphasize that pilots must provide timely emergency briefings, which include information on the location and operation of on-board emergency equipment and exits. It is anticipated that the notice will be issued by March 31, 2005. I will provide the Board with a copy of the notice as soon as it is issued.