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Safety Recommendation Details

Safety Recommendation A-10-144
Details
Synopsis: On January 4, 2009, about 1409 central standard time, a dual-engine Sikorsky S-76C++ helicopter, N748P, registered to and operated by PHI, Inc., departed controlled flight and crashed into marshy terrain about 7 minutes after takeoff. Both pilots and six passengers on board were fatally injured, and one passenger was seriously injured. The helicopter was substantially damaged. The helicopter departed Lake Palourde Base Heliport in Amelia, Louisiana, en route to the South Timbalier oil platform in the Gulf of Mexico. No flight plan was filed with the Federal Aviation Administration (FAA)1 for the 14 Code of Federal Regulations (CFR) Part 135 air taxi flight, nor was one required.
Recommendation: TO THE FEDERAL AVIATION ADMINISTRATION: Revise 14 Code of Federal Regulations 27.33 and 29.33 to require an audible low rotor revolutions per minute alarm system and master warning light for all dual-engine helicopters, even those that are equipped with a device that automatically increases power on the operating engine when the other engine fails.
Original recommendation transmittal letter: PDF
Overall Status: Closed - Unacceptable Action
Mode: Aviation
Location: Morgan City, LA, United States
Is Reiterated: No
Is Hazmat: No
Is NPRM: No
Accident #: CEN09MA117
Accident Reports:
Report #: None
Accident Date: 1/4/2009
Issue Date: 11/23/2010
Date Closed: 2/16/2017
Addressee(s) and Addressee Status: FAA (Closed - Unacceptable Action)
Keyword(s): Alert System

Safety Recommendation History
From: NTSB
To: FAA
Date: 1/24/2018
Response: The National Transportation Safety Board (NTSB) has reviewed the Federal Aviation Administration’s (FAA) notice of proposed rulemaking (NPRM) titled, “Normal and Transport Category Rotorcraft Certification,” which was published at 82 Federal Register 50583 on November 1, 2017. The NPRM proposes to amend the certification standards of normal- and transport category helicopters. The proposed changes would reduce or eliminate the need for certain special conditions currently required to obtain certification of modern rotorcraft and would also incorporate the requirements of equivalent level of safety findings that the FAA has imposed as conditions for approving certain design features. The FAA is proposing the changes to address modern designs currently used in the rotorcraft industry and to reduce the burden on applicants for certification of new rotorcraft designs. We have reviewed the NPRM and provide comments below regarding specific sections of this NPRM. Sections 27.1309 and 29.1309, “Equipment, systems, and installations.” The NPRM proposes revisions to sections 27.1309 and 29.1309, which indicate design and installation criteria for equipment, systems, and installations to ensure that they perform their intended functions under any foreseeable operating condition. Regarding proposed subsection (c), which discusses a means to alert the crew in the event of a failure, we suggest including language to indicate that the alert should occur in a timely manner. In addition, we suggest adding language to indicate that an appropriate alert, including assessment of the need for multiple sensory modality warnings, must be provided if immediate pilot awareness and immediate or subsequent corrective action is required. We note that we have previously issued recommendations to the FAA regarding the need for multiple sensory modality warnings (visual and aural) in both airplanes and helicopters. For example, after a January 4, 2009, accident involving a dual-engine Sikorsky S-76C++ helicopter that departed controlled flight and crashed about 7 minutes after takeoff from Lake Palourde Base Heliport, Amelia, Louisiana, we issued Safety Recommendation A-10-144, which asked the FAA to do the following: Revise [Title] 14 Code of Federal Regulations 27.33 and 29.33 to require an audible low rotor revolutions per minute alarm system and master warning light for all dual engine helicopters, even those that are equipped with a device that automatically increases power on the operating engine when the other engine fails. On February 16, 2017, we classified this recommendation “Closed—Unacceptable Action” after the FAA indicated (in 2015) that it was anticipating restructuring airworthiness standards but did not take timely action to address this recommendation. Although this recommendation is closed, we believe the subject is still relevant, and, in its review of sections 27.1309 and 29.1309, the FAA should consider requiring applicants to address alerting through multiple sensory modalities (visual and aural or visual and tactile) to help ensure the timely capture and direction of a pilot’s attention to the condition triggering the alert.

From: NTSB
To: FAA
Date: 2/16/2017
Response: We note that your rotorcraft directorate is not aware of any instances in which an audible low Nr alarm system and master warning light would have prevented an accident or incident. You indicated that the costs of pursuing rulemaking activity to require this design change far outweigh any benefit. We continue to believe that flight crews of helicopters that are not equipped with redundant sensory cuing, such as an audible alarm or master warning light, might not have enough warning about a decaying Nr condition to perform the necessary corrective actions. However, because you indicated that you do not intend to take the recommended action, Safety Recommendation A-10-144 is classified CLOSED--UNACCEPTABLE ACTION.

From: FAA
To: NTSB
Date: 9/15/2016
Response: -From Michael P. Huerta, Administrator: The FAA Rulemaking Management Council (RMC) tasked the Aviation Rulemaking Advisory Committee (ARAC) to setup: 1) The Rotorcraft Occupant Protection Working Group to provide advice and recommendations on occupant protection rulemaking in normal and transport category rotorcraft for older certification basis type designs that are still in production. This ARAC tasking was approved and subsequently published in the Federal Register (FR) on November 5, 2015 (80 FR 68599); and 2) The Rotorcraft Bird-Strike Protection Working Group, which was recently approved at the March 2016 RMC meeting with a tasking soon to be published in the FR. The Board stated in its letter to the FAA on July 23, 2015. that Safety Recommendation A-10-144. which does not pertain to bird-strikes, should be addressed independent of a possible general restructure of the rotorcraft airworthiness standards. We have reviewed the existing standards and guidance and have determined that changing the regulations to require an audible low rotor revolution per minute alarm system and master warning light for all dual-engine helicopters is not justified. The FA A's Rotorcraft Directorate has no data indicating that such a design requirement would have prevented an accident or incident. Consequently. we believe that the costs of pursuing rulemaking activity to require a low rotor speed warning for multi-engine rotorcraft equipped with a device that automatically increases power on the operating engine when the other engine fails, far outweighs any benefit. I believe the FAA has effectively addressed Safety Recommendation A-10-144 and consider our actions complete. I will keep the Board informed of the FAA·s progress on Safety Recommendations A-10-141, -146, and -147 and provide an update by May 31 . 2017.

From: NTSB
To: FAA
Date: 7/23/2015
Response: We point out that the recommended action is not specific to bird strikes and that it applies to Part 27 and Part 29 operations; therefore, we believe that you should begin work to address this recommendation without waiting further to determine whether a restructure of the rotorcraft airworthiness standards is necessary. We are concerned that this recommendation is almost 5 years old, and we still have received no confirmation that you will take the recommended action. Accordingly, pending our timely receipt and review of proposed regulatory changes that include the recommended audible low rotor revolutions per minute alarm system and master warning light for all dual-engine helicopters, Safety Recommendation A-10-144 is classified OPEN—UNACCEPTABLE RESPONSE.

From: FAA
To: NTSB
Date: 5/4/2015
Response: -From Michael P. Huerta, Administrator: On February 22, 2013, the FAA published the Interest in Restructure of Rotorcraft Airworthiness Standards request for comments (78 FR 12254). The comment period for the notice closed in May 2013. The FAA completed its review of all comments provided by the public, and published a notice of disposition of comments on July 31 , 2014 (79 FR 44320). As a result of our review, the FAA plans to explore the possibility of restructuring the airworthiness standards. The next step in this process is to begin an industry-led Certification Process Study (CPS). Within this CPS, industry would evaluate rotorcraft airworthiness standards, maintenance, operations, and training. At the conclusion of the CPS, industry would provide recommendations to the FAA via a CPS report, which we expect would include rulemaking recommendations. Any rulemaking recommendations would follow the formal rulemaking process. On March 2, 2015, members of the industry met with the FAA to provide a status on the CPS and to begin finalizing the industry CPS membership. The CPS effort is expected to take at least 18-24 months to complete. From the CPS, we anticipate some rulemaking recommendations from industry. Any rulemaking recommendations will follow the formal rulemaking process. I will keep the Board informed of the FAA's progress on these recommendations and provide an update by February 28, 2016.

From: NTSB
To: FAA
Date: 3/27/2014
Response: We note that, on February 22, 2013, you published the request for comments on “Interest in Restructure of Rotorcraft Airworthiness Standards.” We also note that, after you determine whether a restructure is necessary, you will begin the process to draft and incorporate the recommended improvements to the rotorcraft bird-strike requirements and to the low rotor speed alerting requirements. Pending our timely receipt and review of proposed regulatory changes that satisfy Safety Recommendations A-10-141, 144, -146, and -147, these recommendations are classified OPEN—ACCEPTABLE RESPONSE.

From: FAA
To: NTSB
Date: 1/7/2014
Response: -From Michael P. Huerta, Administrator: At a public meeting, held in conjunction with the Helicopter Association International Heli-Expo on March 8, 20 II , the Federal Aviation Administration (FAA) discussed possible changes to the rotorcraft airworthiness standards in parts 27 and 29. These changes included Board-recommended changes to bird-strike requirements. In 2012, before an internal review of the proposed regulatory changes could be conducted, the FAA decided to explore restructuring the applicable airworthiness standards for normal and transport category rotorcraft. As a result, the FAA has placed changes to rotorcraft airworthiness on hold. On February 22, 2013, the FAA published the Interest in Restructure of Rotorcraft Airworthiness Standards request for comments (78 FR 12254). This notice is available at the following Web address: https://www. federalregister.gov/articles/20 13/02/22/20 13-03 709/interest -in-rcstructure-ofrotorcraft-airworthiness-standards. The comment period for the notice closed in May 2013. The FAA is currently reviewing all comments and will make a determination on restructuring the applicable airworthiness standards. We plan to make a decision in late fiscal year 20 14. Regardless of whether or not the FAA determines that rotorcraft airworthiness standards should be restructured, the FAA is proceeding with an internal review of all proposed regulatory changes, including those discussed during the public meeting in 2011. I will keep the Board informed of the FAA's progress on these recommendations and provide an update by October 30, 2014.

From: NTSB
To: FAA
Date: 9/20/2012
Response: We note that the FAA discussed proposed changes to the rotorcraft bird-strike requirements and to the low rotor speed alerting requirements at a regulatory review in 2011. Pending timely revision of the regulations as recommended, Safety Recommendations A-10-141 and -144 remain classified OPEN—ACCEPTABLE RESPONSE.

From: FAA
To: NTSB
Date: 6/5/2012
Response: -From Michael P. Huerta, Acting Administrator: We discussed proposed changes to the rotorcraft bird-strike requirements and to the low rotor speed alerting requirements at a regulatory review in February 2011. Drafting the new requirements will take place during the next step of the rulemaking process, which is planned to start before the end of fiscal year 2012. I will keep the Board informed of the FAA's progress on these safety recommendations and provide an updated response by March 2013.

From: NTSB
To: FAA
Date: 7/11/2011
Response: The NTSB notes that the FAA plans to address this recommendation in its upcoming rotorcraft regulatory and policy review. Pending our receipt and review of the FAA’s update on its progress in addressing this recommendation, Safety Recommendation A-10-144 is classified OPEN—ACCEPTABLE RESPONSE.

From: FAA
To: NTSB
Date: 1/31/2011
Response: CC# 201100057: - From J. Randolph Babbitt, Administrator: We are preparing for an upcoming rotorcraft regulatory and policy review to begin in the summer of 2011. We are reviewing this recommendation to determine if it should be included in the rotorcraft regulatory review. I will keep the Board informed of the FAA's progress and provide an updated response to this recommendation by December 2011.