Reagan National Midair NTSB Hearing Day 3: Collision Avoidance & Safety Culture
NTSB News Talk – Aviation Accidents, Safety Investigations & Pilot LessonsShow Notes
On this episode of NTSB News Talk, Max Trescott covers the third and final day of the NTSB’s investigative hearing into the January 2024 midair collision near Washington’s Reagan National Airport between a PSA Airlines CRJ-700 and a U.S. Army UH-60L Black Hawk. Day 3 featured Panel 4: Collision Avoidance Technology and Panel 5: Safety Data and Safety Management Systems. The hearing opened with spatial disorientation testimony and interviews with Army pilots about Route 4 altitude protections they incorrectly believed would keep them clear of Runway 33 arrivals. NASA’s Dr. Stephen Casner explained that cockpit traffic displays can help pilots spot targets up to eight times faster than by visual scan alone. Experts detailed ADS-B system complexities — including the two incompatible broadcast frequencies (UAT and 1090ES) — and reviewed the limits of pre-ADS-B collision avoidance technology. The UH-60L Black Hawk lacks integrated traffic displays, relying instead on iPads with Stratus receivers, which Army policy prohibits the flying pilot from using. Portable ADS-B In devices provide only partial traffic pictures unless paired with ADS-B Out, limiting situational awareness. Discussions turned to TCAS: its nuisance alert problem, differences for helicopter operations, and why the CRJ-700 lacks a certified ADS-B In solution. The NTSB Chairwoman confronted the FAA over its 17-year refusal to mandate ADS-B In, despite repeated post-collision recommendations. The Army is now procuring 1,685 Stratus/iPad sets for priority units, but operational use will still be limited at low level. FAA data revealed 366 TCAS resolution advisories within 10 nm of DCA from 2023–2025. Testimony noted that crews involved in RAs are typically not notified unless a deviation occurs. Panelists debated safety culture, just culture, and leadership removals at DCA Tower after the accident. A controller supervisor described the pre-accident culture as “robust,” but post-accident changes removed key institutional knowledge. The hearing also exposed gaps in PSA pilot special-qualification training for DCA — including no information on helicopter routes or operations — and examined simulator results showing that circling to Runway 33 can double or triple pilot workload compared to a straight-in to Runway 1. Closing testimony on future ACAS XR technology indicated it could have alerted the Black Hawk crew 73 seconds before impact, with potential nationwide deployment by 2027. Max weaves these details into a narrative showing how technological shortfalls, flawed assumptions, procedural gaps, and cultural challenges all converged in this tragic midair — and what reforms could prevent a repeat. NTSB Docket on Reagan National midair collision Check out our other Aviation News Talk Network podcasts: UAV News Talk Podcast Rotary Wing Show Podcast Aviation News Talk
More from NTSB News Talk – Aviation Accidents, Safety Investigations & Pilot Lessons
A Boeing 767 lands more than 3,700 feet down a Miami runway and overruns the pavement, killing five people on the ground. A Cirrus SR22 crashes during a second go-around, killing all five aboard. And a Cessna 421 loses both engines after being fueled with Jet A instead of avgas. In Episode 41 of NTSB News Talk, aviation safety experts Max Trescott and Rob Mark examine the critical decisions behind these accidents and the lessons pilots can take away. The newly released Miami Boeing 767 preliminary report raises serious questions about tailwinds, unstable approaches, airspeed warnings, and a go-around attempted far too late. A new NTSB final report on a fatal Cirrus SR22 crash at Kill Devil Hills reveals striking flight-data evidence of excessive pitch and an aerodynamic stall. The hosts also discuss Diamond DA40 crashed in mountainous terrain near Eldorado Springs, Colorado, a deadly Piper JetProp icing encounter over Wisconsin, a Gulfstream air ambulance crash following reported electrical problems, a Beech Bonanza fuel-starvation accident involving a congressman, a fatal nighttime Piper crash, and a midair collision between gliders. From fuel management and emergency procedures to stall prevention and go-around proficiency, this episode highlights a fundamental truth: even experienced pilots cannot afford to skip the basics.
Episode 40 examines a wide range of recent accidents before focusing on a troubling pattern: pilots flying with impairing OTC medications or drugs in their systems. Max Trescott and Rob Mark begin with a fatal nighttime crash of C-GPTX, a Cessna 172 in Saskatchewan and the runway overrun of Eclipse 500 N816KD at Auburn, California. They also discuss Beech Travel Air N529RB, which was flown in repeated low-level circles about 100 feet above the Pacific before crashing into the ocean, raising the possibility of an intentional act. Preliminary reports include Piper Seneca N212ML, lost near the Bahamas in convective weather; C-IFBY, a Para-Ski VX powered parachute carrying three people even though its U.S. operation did not qualify under Part 103; and Lake Amphibian N6185V, which apparently ran out of fuel just miles from Ithaca. Final reports include a fatal VFR-into-IMC accident involving N9626K, a Piper PA-28 and the crash of Ameriflight Beech C99 N130GP after a partial engine-power loss. The episode closes with four fatal-accident reports involving the active ingredients in Benadryl and Zyrtec, or cyclobenzaprine, cannabis, or morphine. The takeaway is simple: “over the counter” does not mean “safe to fly,” and pilots need to understand the FAA’s medication waiting-period guidance. Max also explains why medication effects can undermine a pilot’s own self-assessment.
New information from the NTSB is filling in the final seconds of the Amazon Prime Air Boeing 767 crash in Miami. The agency’s summary of the cockpit voice recorder shows repeated concerns about excessive speed, followed by touchdown and then, 16 seconds later, a call for a go-around. The brakes were released at a ground speed of 120 knots and go-around thrust was applied before the attempt was abandoned. Recorded data showed no indication that the speed brakes or thrust reversers were deployed. Max Trescott also revisits his ADS-B analysis of Flight 7598 and explains why he believes an automation surprise involving the Boeing 767’s vertical modes may have contributed to the airplane becoming high and fast. Then Max and Rob Mark examine the fatal KNBC AS350B2 helicopter crash in Los Angeles, including ADS-B evidence and reports of a possible low-rotor-RPM warning. Other accidents include N734ZK, a Cessna 172N crash at Montgomery-Gibbs Executive Airport, N9485P, a fatal Piper Comanche accident at a short Alaska runway, N93R, a Lockheed 12A that took off with full flaps, a fuel-exhaustion accident involving N413AW, a Pipistrel Alpha, and N188PC, a Pilatus PC-12 loss of control in IMC. The episode closes with a story from the NASA ASRS Callback newsletter about a Cirrus pilot’s successful recovery from a dangerous distraction in instrument conditions.
An Amazon Prime Air Boeing 767 crashes after overrunning Runway 30 at Miami International Airport—and ADS-B data contains an important clue about how the approach became unstable. In this episode, we analyze the September 6 crash of Prime Air Flight 7598, operated by 21 Air with Boeing 767 N1997A. The flight from San Juan initially followed an almost perfect three-degree approach toward Miami. But approximately five miles from the runway, the aircraft unexpectedly leveled near 1,600 feet. The ADS-B data shows that 1,600 feet had been entered as the selected altitude much earlier in the descent. That raises the possibility of an automation surprise, although another possibility is that the crew leveled inadvertently after disconnecting the autopilot to hand-fly. The crew then attempted to recover using a descent approaching twice the normal glide angle. The 767 crossed the displaced threshold around 175 knots, apparently touched down near 160 knots, and was still traveling about 110 knots when it left the runway. We also examine a fatal PC-12 spatial-disorientation accident, new evidence of helicopter wake turbulence in a Cessna 150 collision, and a troubling student-pilot night CFIT accident involving a CFI cross-country endorsement. FAA No Go Over the Counter Medications List
In Episode 37 of NTSB News Talk, Max Trescott and Rob Mark examine new evidence from the fatal Learjet 55 air ambulance crash in Philadelphia and several other accidents with important lessons for pilots. Brought to you by AVEMCO aircraft insurance. Support Rob and Max by making a donation at Patreon.com The Learjet 55 departed Northeast Philadelphia Airport at night into a roughly 400-foot overcast. Newly released NTSB docket material shows the aircraft initially beginning its assigned right turn before slowly rolling left. The exceptionally gradual roll raises the possibility of somatogyral illusion—a form of spatial disorientation in which the inner ear may fail to detect slow rotational movement. Investigators also examined somatogravic illusion, cockpit workload, pitch trim, and the captain’s previous training history. Both engines appeared to be producing takeoff power, making an engine failure less likely. Max and Rob also discuss two wrong-runway landings near Chicago that illustrate continuation bias and task saturation. Other accidents include a Cirrus Vision Jet striking a pipe across a closed portion of a runway at Driggs, Idaho; a fatal Cessna 150 collision with a Pennsylvania State Police helicopter; N1850N a Beechcraft Duchess accident during simulated single-engine training; and a photographer fatally struck by the wing of glider N8217W. Also, two wrong-runway landings near Chicago, N772MR (Envoy 3936) and N1128M Learjet 60. Those final incidents highlight a recurring human-factors problem: once pilots commit mentally to a plan, contradictory evidence can become surprisingly difficult to recognize.