Cessna 550MARLIN AIR INC

TO THE FEDERAL AVIATION ADMINISTRATION: Require all 14 Code of Federal Regulations Part 91K and Part 135 operators to incorporate upset recovery training (similar to that described in the airplane upset recovery training aid used by many Part 121 operators) and related checklists and procedures into their training programs.

TO THE FEDERAL AVIATION ADMINISTRATION: Require Cessna to redesign and retrofit the yaw damper and autopilot switches on the autopilot control panel in Citation series airplanes to make them easily distinguishable and to guard against unintentional pilot activation.

TO THE FEDERAL AVIATION ADMINISTRATION: Identify airplanes other than the Cessna Citation with autopilot control panel designs that may lead to inadvertent activation of the autopilot and require manufacturers to redesign and retrofit the autopilot control panels to make the buttons easily distinguishable and to guard against unintentional activation.

TO THE FEDERAL AVIATION ADMINISTRATION: Issue an airworthiness directive mandating compliance with Cessna Service Bulletin 550-24-14, "Control Wheel Electrical Cable Replacement," which was issued on January 17, 1992.

TO THE FEDERAL AVIATION ADMINISTRATION: Require Cessna to modify all Citation series airplanes by incorporating an aural pitch trim-in-motion warning and contrasting color bands on the pitch trim wheel to help pilots recognize a runaway pitch trim condition before control forces become unmanageable. (A-09-117) (This recommendation supersedes Safety Recommendation A-07-52)

TO THE FEDERAL AVIATION ADMINISTRATION: Require Cessna to replace all Citation series airplane pitch trim, autopilot, and any other circuit breakers for critical systems that a pilot might need to access during an emergency situation with easily identifiable and collared circuit breakers to aid a pilot in quickly identifying and easily pulling those circuit breakers if necessary. (A-09-118) (This recommendation supersedes Safety Recommendation A-07-54)

TO THE FEDERAL AVIATION ADMINISTRATION: Require airplane manufacturers to develop guidance on the identification of circuit breakers that pilots need to identify quickly and pull easily during abnormal or emergency situations and to provide such guidance, once developed, to operators of those airplanes.

TO THE FEDERAL AVIATION ADMINISTRATION: Require operators to implement the manufacturers’ guidance asked for in Safety Recommendation A-09-119 regarding which circuit breakers pilots need to identify quickly and pull easily during abnormal or emergency situations in their airplanes.

TO THE FEDERAL AVIATION ADMINISTRATION: Require Cessna to evaluate and limit the maximum aileron trim deflection on Citation series airplanes to that required to meet the certification control requirements for powered trim tabs, unless there is a design justification to exceed those requirements.

TO THE FEDERAL AVIATION ADMINISTRATION: Require Cessna to reduce the aileron trim sensitivity (the unexpectedly significant aileron trim deflection that results from a relatively small amount of trim knob input) on Citation series airplanes to avoid sudden and excessive aileron trim deflections.

TO THE FEDERAL AVIATION ADMINISTRATION: As an interim measure (pending an available aileron trim system retrofit), notify Citation pilots and operators of the potential hazards related to the sensitivity and responsiveness of the airplane’s aileron trim system.

TO THE FEDERAL AVIATION ADMINISTRATION: Revise check airman approval and oversight procedures to incorporate heightened surveillance during a probationary period and at other times, as warranted, for check airmen whose background evaluation uncovers a history of criminal convictions, certificate revocations, checkride failures, or other performance-related deficiencies.

TO THE FEDERAL AVIATION ADMINISTRATION: Conduct a detailed review of the oversight provided to Marlin Air to determine why the oversight system failed to detect (before and after the accident) and correct Marlin Air’s operational deficiencies, particularly in the areas of pilot hiring, training, and adherence to procedures.

TO THE FEDERAL AVIATION ADMINISTRATION: Based on the review described in Safety Recommendation A-09-125, revise the oversight system and Federal Aviation Administration Order 8900.1 as needed.

TO THE FEDERAL AVIATION ADMINISTRATION: Require all 14 Code of Federal Regulations Part 135 and Part 91K operators to provide their customers, when a business agreement or contract is finalized, with Federal Aviation Administration (FAA) contact information identified as specifically for use in expressing concerns about flight safety, thus providing customers with a clear means of communicating any safety concerns to the FAA.

TO THE FEDERAL AVIATION ADMINISTRATION: Require all 14 Code of Federal Regulations Part 91K and Part 135 operators to notify the assigned principal operations inspectors of specific adverse financial events, such as bankruptcy, court judgments related to nonpayment of recurring expenses, or termination of a credit agreement or contract by a vendor for reasons of late payment or nonpayment. Upon receipt of such information, inspectors should increase their oversight of operators who appear to be in financial distress.

TO THE AMERICAN HOSPITAL ASSOCIATION: Inform its members, through its website, newsletters, and conferences, of the Federal Aviation Administration’s (FAA) role in aviation safety with respect to medical/air ambulance services and provide FAA contact information. Further, the American Hospital Association should urge its members to communicate any safety concerns related to medical/air ambulance services to the FAA.