In-flight TCAS maneuvers result in flight attendant injury

Casualties unknown • Teterboro, NJ, US

A crew performed an uncoordinated maneuver following a TCAS traffic advisory, resulting in a broken leg for a flight attendant.

What happened

While cruising at 3,000 feet above mean sea level and following radar vectors for an instrument approach, the crew of the aircraft received a Traffic Advisory (TA) from the onboard Traffic Alert and Collision Avoidance System (TCAS). At the time of the advisory, the co-pilot was the pilot flying and began scanning the area for traffic. The pilot-in-command then took control of the aircraft from the co-pilot and initiated a left banking turn.

Shortly after this maneuver began, the TCAS issued a Resolution Advisory (RA) commanding a climb. In response, the pilot increased the pitch attitude, climbing approximately 800 feet while simultaneously rolling the wings level. During this period of maneuvering, the flight attendant sustained a broken left leg. The aircraft that triggered the initial advisory passed within 0.75 nautical miles laterally and 100 feet vertically of the aircraft. Neither pilot established visual contact with the other airplane.

The investigation

The flight data recorder provided details regarding the intensity of the maneuver. Data indicated a maximum angle of attack of 15.6 degrees, a maximum bank of 32 degrees, and an altitude increase to 3,778 feet within 16 seconds. The entire sequence lasted 40 seconds, with a peak rate of climb of 2,628.75 feet per minute and a maximum acceleration of 2.3 Gs.

Findings

The aircraft was operating under instrument approach instructions when the TCAS TA was issued.
Air traffic control did not consider the aircraft to be on a collision course, though they did notify the crew of the other airplane's position.
The operator's standard procedures for an RA response involve maneuvers requiring approximately +/- 0.25g.
Guidance states that following a TA, crews should search visually and only maneuver if the intruder is acquired.
Maneuvers based solely on a TA without visual acquisition are not recommended.
Flight crews are advised to monitor the vertical speed indicator (VSI) to ensure vertical speeds remain within safe limits and do not enter the prohibited area.

Probable cause

The pilot-in-command initiated an uncoordinated banking turn in response to a TCAS traffic advisory without visual acquisition of the intruder, leading to high G-forces that caused injury to a flight attendant.

Frequently asked questions

What happened in the 2006-10-31 Bombardier, Inc. CL-600-2B16 accident near Teterboro, NJ?

A crew performed an uncoordinated maneuver following a TCAS traffic advisory, resulting in a broken leg for a flight attendant.

What aircraft was involved and where did it happen?

The accident on 2006-10-31 involved a Bombardier, Inc. CL-600-2B16, registration N322FX, operated by Bombardier Business Jet Solu, at Teterboro, NJ.

What was the probable cause of the accident?

The pilot-in-command initiated an uncoordinated banking turn in response to a TCAS traffic advisory without visual acquisition of the intruder, leading to high G-forces that caused injury to a flight attendant.

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