WASHINGTON \uff97 The National Transportation Safety Board issued a scathing report Wednesday that blamed a fatal plane crash last year near the Bahamas on a small airline’s bad maintenance and a series of mistakes by the pilot.<\/p>\n
\nThe five NTSB members said they were so troubled by the accident and the numerous errors that led to it that they took the unusual step of ordering staff investigators to develop additional safety recommendations to improve oversight of airlines.<\/p>\n
\n“This is just outrageous,” Chairman Ellen Engleman Connors said. “This accident should not have happened.”<\/p>\n
\nDiane Parker-Diaz, 33, of Jacksonville, Fla., and her 4-year-old niece, Diante Wayna Parker, drowned after the small propeller plane ditched in the ocean on July 13, 2003, near the Abaco chain of islands in the Bahamas. <\/p>\n
\nSeven other passengers and the pilot bobbed in the water for 90 minutes until they were rescued by the Coast Guard. <\/p>\n
\nThree of the survivors were children, including Parker-Diaz’s son and daughter. One married couple held their 15-month-old girl above their heads until rescued, according to NTSB interviews of survivors.<\/p>\n
\nAir Sunshine Flight 527 from Fort Lauderdale to Treasure Cay, Bahamas, was routine until the right engine blew up as the twin-engine Cessna 402C neared its destination. <\/p>\n
\nThe plane, which holds nine passengers, is designed to fly with one engine. But the pilot could not maintain altitude and hit the water several miles from shore.<\/p>\n
\nThe NTSB blamed the crash and the deaths on several factors: <\/p>\n
\n\uff95 Air Sunshine maintenance workers improperly repaired the engine. The airline had no record of the repair, which is a violation of federal aviation regulations. At least some of the work had been done by an assistant mechanic who had never done such repairs before.<\/p>\n
\n\uff95 The pilot, identified in news reports as Hassan Moslemi, 45, of Fort Lauderdale, did not follow proper procedures for flying a plane after an engine failure. As a result, the plane could not maintain enough speed to stay aloft.<\/p>\n
\n\uff95 Moslemi also did not tell passengers to grab the life preservers that were stowed under each seat. Only four of the inflatable vests from the plane were used. Because Moslemi had failed to wear his shoulder harness, he struck his head when the plane hit the water and could not help the passengers escape. <\/p>\n
\nThe NTSB found that Moslemi had failed nine flight tests with Federal Aviation Administration inspectors before finally passing. He also had been dismissed from a cargo airline because he could not complete his training, investigators found.<\/p>\n
\n“We don’t believe this pilot was very well qualified or had the skills,” said John Clark, the NTSB’s chief aviation investigator. <\/p>\n
\nOfficials from Air Sunshine did not return calls for comment. The airline has six small planes and flies between Florida, several Bahamas locations and Puerto Rico. <\/p>\n
\nThe NTSB issued one safety recommendation calling for the FAA to remind pilots on small planes to assist passengers in an emergency. The NTSB investigates accidents but can only recommend safety improvements. <\/p>\n
\nSafety board members said more needed to be done. They ordered the staff to draft additional recommendations within 60 days. <\/p>\n
\nSeveral board members said that they were concerned that FAA inspectors did not turn up the problems discovered in the investigation. An FAA spokesman declined to comment until the recommendations are released. <\/p>\n
\nAirlines such as Air Sunshine that fly planes with fewer than 10 seats receive slightly less extensive oversight than do large airlines.<\/p>\n