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Policy/procedure, general

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NTSB finding · Organizational issues › Management › Policy/procedure

All 15 cases7 in the probable cause
Cases
15
In the probable cause
7 (47%)
Fatal cases
5
NTSB code
04021000

NTSB has coded findings and defining events since 2008. Earlier cases used its older occurrence and cause codes, so they aren’t counted here.

When and where

In green, cases where NTSB made it part of the probable cause; in gray, a factor or other finding. Findings are coded with the final report, often a year or more after the event, so the latest years are incomplete.

Cases per year

2008In the probable causeFactor only2026

Where

Open the map
Query with SQL
duckdb -csv -c "SELECT year(c.\"eventDate\") AS year, count(DISTINCT f.case_mkey) AS cases,
    count(DISTINCT f.case_mkey) FILTER (WHERE f.\"inProbableCause\") AS in_probable_cause
  FROM 'https://openairdocs.org/data/latest/ntsb_findings.parquet' f JOIN 'https://openairdocs.org/data/latest/ntsb_case_detail.parquet' c ON c.\"mKey\" = f.case_mkey
  WHERE starts_with(f.\"findingCode\", '04021000') AND c.\"eventDate\" >= DATE '2000-01-01'
  GROUP BY 1
  ORDER BY 1"

Prints the counts as CSV. It reads the release’s Parquet files over HTTPS, so there’s nothing to download first. Install DuckDB to run it.

In the same cases

Defining events
Aircraft models

Aircraft matched to the registry by N-number and date.

Other findings
Query with SQL
duckdb -csv -c "WITH matched AS (SELECT DISTINCT case_mkey, aircrafts_position FROM 'https://openairdocs.org/data/latest/ntsb_findings.parquet' WHERE starts_with(\"findingCode\", '04021000'))
  SELECT * FROM (
  SELECT 'Defining event' AS kind, e.\"tier2Number\" AS code, max(e.\"eventTier2Name\") AS name, count(DISTINCT f.case_mkey) AS cases
  FROM matched f JOIN 'https://openairdocs.org/data/latest/ntsb_events.parquet' e ON e.case_mkey = f.case_mkey AND e.aircrafts_position = f.aircrafts_position AND e.\"isDefiningEvent\"
  WHERE e.\"tier2Number\" <> ''
  GROUP BY ALL
  UNION ALL
  SELECT 'Aircraft model', a.aircraft_model_code, any_value(concat_ws(' ', m.manufacturer, m.model)), count(DISTINCT f.case_mkey)
  FROM matched f JOIN 'https://openairdocs.org/data/latest/ntsb_aircrafts.parquet' a ON a.case_mkey = f.case_mkey AND a.position = f.aircrafts_position
  LEFT JOIN 'https://openairdocs.org/data/latest/faa_aircraft_model.parquet' m ON m.code = a.aircraft_model_code
  WHERE a.aircraft_model_code IS NOT NULL
  GROUP BY ALL
  UNION ALL
  SELECT 'Other finding', left(g.\"findingCode\", 8), max(g.\"tier4Name\"), count(DISTINCT g.case_mkey)
  FROM 'https://openairdocs.org/data/latest/ntsb_findings.parquet' g
  WHERE g.case_mkey IN (SELECT case_mkey FROM matched) AND NOT starts_with(g.\"findingCode\", '04021000') AND g.\"findingCode\" GLOB '[0-9][0-9]*'
  GROUP BY ALL
  )
  QUALIFY row_number() OVER (PARTITION BY kind ORDER BY cases DESC) <= 10
  ORDER BY kind, cases DESC"

Prints the counts as CSV. It reads the release’s Parquet files over HTTPS, so there’s nothing to download first. Install DuckDB to run it.

Newest cases · 15

NTSB ERA20LA160Accident · No injuriesClass 3 · LimitedFinal reportHughes 369 · Pylesville, MDThe loss of engine power due to fuel starvation as a result of unporting of the fuel tank supply pickup while the helicopter was maneuvered to move a conductor wire. Contributing to the accident was the helicopter’s inappropriate configuration for the type of…Apr 25, 2020 · N9159F · Substantial damageNTSB DCA20MA002Accident · 1 fatalClass 1 · MajorFinal reportSaab 2000 · Unalaska, AKThe landing gear manufacturer’s incorrect wiring of the wheel speed transducer harnesses on the left main landing gear during overhaul. The incorrect wiring caused the antiskid system not to function as intended, resulting in the failure of the left outboard…Oct 18, 2019 · N686PA · Substantial damageNTSB CEN18LA309Accident · 1 fatalLimited investigationFinal reportCameron A 250 · Hartsel, COThe passengers’ fall from the basket after landing when the basket tipped over.Aug 3, 2018 · N2025J · No damageNTSB ERA18LA117Accident · No injuriesClass 3 · LimitedFinal reportStanley Lancair · Sebring, FLThe failure of ground personnel to obtain permission from airport management to conduct engine test runs; adequately monitor the area behind the B737 for traffic; and install barricades to prevent access behind the running airplane, which resulted in the…Mar 28, 2018 · C-GSQQ · Substantial damageNTSB DCA15FA085Accident · No injuriesClass 1 · FieldFinal reportMcdonnell Douglas MD 88 · New York, NYthe captain's inability to maintain directional control of the airplane due to his application of excessive reverse thrust, which degraded the effectiveness of the rudder in controlling the airplane's heading. Contributing to the accident were the captain's…Mar 5, 2015 · N909DL · Substantial damageNTSB WPR15LA025Accident · No injuriesLimited investigationFinal reportCessna 172S · Santa Monica, CAThe separation of a section of a propeller blade due to fatigue cracking. Contributing to the accident was the operator’s failure to comply with the manufacturer’s maintenance and inspection instructions.Oct 26, 2014 · N353MV · Substantial damageNTSB CEN13FA075Accident · 1 fatalField investigationFinal reportHughes 369 · Childress, TXThe improper maintenance of the helicopter fuel system that resulted in erroneous fuel gauge indications and the pilot’s inadequate fuel management, both of which resulted in fuel exhaustion during a long-line hover. Also causal was the lack of company…Nov 27, 2012 · N28MP · Substantial damageNTSB CEN13IA059Incident · No injuriesIncident investigationFinal reportFairchild SA227-AC · Minneapolis, MNLoose electrical connections to the hydraulic system and anomalies in the hydraulic shuttle valve and power pack, which resulted in an uncommanded gear unlock and collapse of the left main landing gear. Contributing to the accident was the operator’s failure…Nov 10, 2012 · N619BA · Minor damageNTSB OPS12IA535Incident · No injuriesIncident investigationFinal reportLas Vegas, NVFederal Aviation Administration procedures that do not ensure separation in the event of a go-around during simultaneous independent runway operations on runways that do not physically intersect but whose flight paths intersect.Apr 27, 2012 · No damageNTSB ERA10GA320Accident · 3 fatalFinal reportCessna T210L · Lock Haven, PAThe total loss of engine power resulting from the fatigue failure of the engine's number 2 cylinder exhaust valve. The fatigue failure was due to valve guide wear that led to excessive clearance between the valve and valve guide. Contributing to the accident…Jun 21, 2010 · N30266 · Substantial damage
See all 15 cases
Query with SQL
duckdb -csv -c "SELECT c.\"ntsbNumber\", c.\"eventDate\", c.\"eventType\", c.\"eventCity\", c.\"eventStateOrRegion\", a.n_number, a.\"aircraftMake\", a.\"aircraftModel\", c.\"highestInjuryLevel\", c.\"totalFatal\", c.\"completionStatus\", c.report_url
  FROM 'https://openairdocs.org/data/latest/ntsb_case_detail.parquet' c LEFT JOIN 'https://openairdocs.org/data/latest/ntsb_aircrafts.parquet' a ON a.case_mkey = c.\"mKey\" AND a.position = 1
  WHERE c.\"mKey\" IN (SELECT f.case_mkey FROM 'https://openairdocs.org/data/latest/ntsb_findings.parquet' f WHERE starts_with(f.\"findingCode\", '04021000'))
  ORDER BY c.\"eventDate\" DESC, c.\"ntsbNumber\" DESC"

Prints the whole list as CSV. It reads the release’s Parquet files over HTTPS, so there’s nothing to download first. Install DuckDB to run it.