Report released on May 2012 mid-air collision over Warrenton, Va.
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Transportation Safety Board of Canada (TSB) released its
investigation report Thursday into the mid-air collision between a
Piper PA-28 and a Beechcraft Bonanza on May 28, 2012.
accident shows once again that the see-and-avoid principle is
inadequate for preventing collisions between aircraft flying under
visual flight rules (VFR)," said Jon Lee, TSB's
Investigator-in-Charge. "Additional defenses must be put in
place to prevent mid-air collisions among VFR aircraft."
Piper (tail number N23C) was registered to and piloted by Federal
Aviation Administration (FAA) employee Thomas Proven, and the
number N6658R) was
registered to and piloted by National Transportation Safety Board
(NTSB) employee James Duncan. Given the unique circumstances
surrounding the ownership and operation of the aircraft, the TSB
accepted delegation of the accident investigation from the NTSB in
accordance with international convention.
Beechcraft was in a shallow climb, headed southbound, being operated
VFR for the purposes of a biennial flight review. The
Piper was in level flight, under VFR, and was heading in a
southeasterly direction. The aircraft collided at approximately 1,800
feet above sea level just after 4 p.m. EDT in the area of Warrenton,
Beechcraft broke up in flight and the pilot and flight instructor on board were fatally injured. Proven, the sole occupant of the Piper,
conducted a forced landing in a pasture approximately six nautical
miles south of the Warrenton-Fauquier Airport.
TSB remains concerned that yet again, the defenses available to avert
a mid-air collision between VFR aircraft in congested airspace have
failed,” the board said in their report. “As VFR traffic
increases, additional lines of defense should be considered to reduce
the risk of a mid-air collision. These include changes in airspace
classification, increased air traffic control intervention,
ground-based and on board technology.
meaningful improvement to the ability to see-and-avoid other VFR
aircraft may require on board technology capable of directly alerting
pilots to the proximity of conflicting traffic. A number of viable
and economical on board alerting systems exist or are under
development. Had one or both of these aircraft been equipped with
some form of the technology, the risk of collision would have been
reduced. The report identified that there is a high risk of mid-air
collision in congested airspace when aircraft are not alerted to the
presence of another aircraft and rely solely on the see-and-avoid