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Safety Recommendation Details

Safety Recommendation A-16-025
Details
Synopsis: On March 5, 2015, at 1102 eastern standard time, Delta Air Lines flight 1086, a Boeing MD-88, N909DL, was landing on runway 13 at LaGuardia Airport (LGA), New York, New York, when it departed the left side of the runway, contacted the airport perimeter fence, and came to rest with the airplane’s nose on an embankment next to Flushing Bay. The 2 pilots, 3 flight attendants, and 98 of the 127 passengers were not injured; the other 29 passengers received minor injuries. The airplane was substantially damaged. Flight 1086 was a regularly scheduled passenger flight from Hartsfield-Jackson Atlanta International Airport, Atlanta, Georgia, operating under the provisions of 14 Code of Federal Regulations Part 121. An instrument flight rules flight plan had been filed. Instrument meteorological conditions prevailed at the time of the accident.
Recommendation: TO THE FEDERAL AVIATION ADMINISTRATION: Require 14 Code of Federal Regulations Part 121 operators to provide (1) guidance that instructs flight attendants to remain at their assigned exits and actively monitor exit availability in all non-normal situations in case an evacuation is necessary and (2) flight attendant training programs that include scenarios requiring crew coordination regarding active monitoring of exit availability and evacuating after a significant event that involves a loss of communications.
Original recommendation transmittal letter: PDF
Overall Status: Open - Acceptable Response
Mode: Aviation
Location: New York, NY, United States
Is Reiterated: No
Is Hazmat: No
Is NPRM: No
Accident #: DCA15FA085
Accident Reports: Runway Excursion During Landing Delta Air Lines Flight 1086 Boeing MD-88, N909DL, New York, New York March 5, 2015
Report #: AAR-16-02
Accident Date: 3/5/2015
Issue Date: 10/6/2016
Date Closed:
Addressee(s) and Addressee Status: FAA (Open - Acceptable Response)
Keyword(s):

Safety Recommendation History
From: NTSB
To: FAA
Date: 3/27/2017
Response: You wrote that existing regulations in section 121.417, Crewmember Emergency Training, require training on crew communication and coordination during emergencies, including the individual crewmembers’ responsibility to remain at assigned exits and actively monitor exit availability. You also described the existing guidance in FAA Order 8900.1, volume 3, chapter 23, section 6, which you believe is related to this recommendation. Order 8900.1 provides guidance to your inspectors on how to perform their oversight responsibilities. We reviewed the information that you provided, and, although it addresses flight crews and cabin crews training together as well as cabin crews initiating an evacuation when one is needed, it does not address cabin crewmembers remaining at their assigned exits nor procedures to use when communications inside the cabin unexpectedly fail. We issued this recommendation because in our investigation of the Delta flight 1086 accident, we found that the cabin crewmembers did not stay at their assigned exits, and that Delta Air Lines training did not address this issue. We were also unable to find any FAA guidance regarding this situation. We find that the communication system frequently fails in accidents involving an unplanned emergency evacuation. In the Delta flight 1086 accident, problems caused by the communication systems’ failure and the lack of appropriate training or procedures for dealing with this common situation contributed to the flight attendants (FAs) leaving their assigned exits. You wrote that you are reviewing Advisory Circular (AC) 120-48, “Communication and Coordination Between Flight Crewmembers and Flight Attendants,” and that you may revise it to include scenario-based training involving a communication loss. Such a revision would address item 2 in this recommendation; however, none of the information discussed in your letter addresses item 1 (FAs staying at their assigned exits). Please describe your plans to address this need. Pending the revisions to AC 120-48 that address communication systems failures and a requirement for FAs to stay at their assigned exits, Safety Recommendation A-16-25 is classified OPEN--ACCEPTABLE RESPONSE.

From: FAA
To: NTSB
Date: 12/27/2016
Response: -From Michael P. Huerta, Administrator: We reviewed the existing guidance in Title 14. Code of Federal Regulations (14 CFR). Crew coordination regarding active monitoring of exit availability and evacuating after a significant event that involves a loss of communications is addressed in our current guidance. Section 121.417, Crewmember Emergency Training. requires training on crew communication and coordination during emergencies. According to this section, both emergency training and indoctrination training should include training on individual crewmember responsibilities to remain at assigned exits and actively monitor exit availability. In addition, each training program must provide the emergency training set forth in this section with respect to each airplane type. model, and configuration, each required crewmember. and each kind of operation conducted. insofar as appropriate for each crewmember and the certificate holder. We also reviewed the applicable guidance addressing the issue of flight Attendants (FAs) remaining at their assigned exits actively monitoring exit availability. FAA Order 8900.1. Volume 3, Chapter 23. Section 6. Paragraph 3- 1861, Unwarranted Evacuations. Requires inspectors to review air carrier emergency evacuation procedures and training to ensure that they adequately address the following: • Flight crews and FAs are trained to recognize and act promptly in situations requiring emergency evacuation; • FAs are trained to carry out an emergency evacuation on their own initiative in the event that the flight crew is incapacitated or otherwise prevented from participating: and • FAs are trained to recognize when evacuation equipment is inoperative or faulty. Act promptly in preventing the use of such equipment, and quickly divert evacuating passengers to useable exits. We recognize the importance of crewmembers having the opportunity to experience crew coordination and teamwork during required training drills. Even though this is highly desirable. it is not always possible because of the difference in the number, domicile location, and scheduling of FAs and flightcrew members. Nevertheless. air carriers use a variety of methods to ensure that crewmembers understand the procedures and actions of each other during emergency situations. The guidance in FAA Order 8900.1. Volume 3. Chapter 23. Section 6. Paragraph 3- 1862. Emergency Evacuation and Ditching Drills. states that certificate holders should be aware of the desirability of Flightcrew and FAs performing emergency evacuation and ditching drills together. Further. certificate holders should be aware that when this is not possible. training programs should address the roles of other crewmembers during an emergency evacuation and/or ditching. We are reviewing Advisory Circular (AC) 120-48, Communication and Coordination Between Flight Crewmembers and Flight Attendants. and are considering a revision to include scenario-based training involving a loss of communication.