Aircraft Accident/Incident Report

Philadelphia, Pennsylvania 19153
Sunday, June 16, 1991 15:00 EDT

NTSB Narrative Summary Released at Completion of Accident

THE FLIGHT WAS ON A CRUISE DESCENT AT 20,000 FEET MSL WHEN IT ENCOUNTERED TURBULENCE, CAUSING INJURIES TO CABIN CREWMEMBERS INCLUDING ONE WHO WAS SERIOUSLY INJURED. THE PILOT REPORTED THAT HE WAS DEVIATING AROUND CUMULONIMBUS CLOUDS WHEN HE INADVERTENTLY ENTERED ONE. HE SAID THE SEAT BELT SIGN WAS ON AT THE TIME. THE FLIGHT PROCEEDED TO THE DESTINATION AND LANDED WITHOUT FURTHER INCIDENT.

NTSB Probable Cause Narrative

FAILURE OF THE PILOT TO ENSURE CABIN CREW MEMBERS WERE PREPARED FOR AN ENCOUNTER WITH TURBULENCE.

Event Information

Type of Event Accident
Event Date 6/16/1991
Event Day of the Week Sunday
Time of Event 1500
Event Time Zone Eastern Daylight Time
Event City PHILADELPHIA
Event State PENNSYLVANIA
Event Country --
Zipcode of the event site 19153
Event Date Year 1991
Event Date Month 6
MidAir Collision Indicator No
On Ground Collision occurred ? No
Event Location Latitude
Event Location Longitude
Event Location Airport
Event Location Nearest Airport ID
Indicates whether the acc/inc occurred off or on an airport Off Airport/Airstrip
Distance from airport in statute miles 0
Degrees magnetic from airport 0
Airport Elevation --
Weather Briefing Completeness Unknown
Investigator's weather source Weather Observation Facility
Time of the weather observation 1500 Eastern Daylight Time
Direction of event from weather observation facility (degrees) 0
Weather Observation Facility ID PHL
Elevation of weather observation facility 99999
Distance of event from weather observation facility (units?) 999
Time Zone of the weather observation EDT
Lighting Conditions Day
Lowest Ceiling Height 7000
Lowest Non-Ceiling Height 4000
Sky/Lowest/Cloud Conditions Scattered
Sky Condition for Lowest Ceiling Broken
Visibility Runway Visual Range (Feet) 0
Visibility Runway Visual Value (Statute Miles) 0
Visibility (Statute Miles) 8
Air Temperature at event time (in degrees celsius) 27
Dew Point at event time (in degress fahrenheit) 22
Wind Direction (degrees magnetic) 200
Variable Wind Indicator Unknown
Wind Speed (knots) 3
Wind Velocity Indicator Unknown
Wind Gust Indicator Unknown
Wind Gust (knots) 0
Altimeter Setting at event time (in. Hg) 29
Density Altitude (feet) --
Intensity of Precipitation Unknown
METAR weather report --
Event Highest Injury Serious
On Ground, Fatal Injuries 0
On Ground, Minor Injuries 0
On Ground, Serious Injuries 0
Injury Total Fatal --
Injury Total Minor 5
Injury Total None 272
Injury Total Serious 1
Injury Total All 6
Investigating Agency NTSB
NTSB Docket Number (internal use) 6028
NTSB Notification Source --
NTSB Notification Date Jun 2 1991 12:00AM
NTSB Notification Time 1230
Fiche Number and/or location -used to find docket information 50108
Date of most recent change to record Dec 12 2000 10:17AM
User who most recently changed record dbo
Basic weather conditions Visual Meteorological Cond
FAA District Office --

Aircraft Involved

Aircraft #1

Aircraft Registration Number PHBFG
NTSB Number BFO91LA055
Missing Aircraft Indicator N
Federal Aviation Reg. Part Part 129: Foreign
Type of Flight Plan filed None
Flight plan Was Activated? --
Damage None
Aircraft Fire None
Aircraft Explosion None
Aircraft Manufacturer's Full Name BOEING
Aircraft Model 747-400
Aircraft Series Identifier 747-400
Aircraft Serial Number
Certified Max Gross Weight 356000
Aircraft Category Airplane
Aircraft Registration Class Foreign Registered/U.S. Soil
Aircraft is a homebuilt? No
Flight Crew Seats --
Cabin Crew Seats --
Passenger Seats --
Total number of seats on the aircraft --
Number of Engines 4
Fixed gear or retractable gear Retractable
Aircraft, Type of Last Inspection Unknown
Date of Last Inspection Jan 2 2000 12:00AM
Airframe hours since last inspection --
Airframe Hours --
ELT Installed Unknown
ELT Activated Unknown
ELT Aided Location of Event Site Unknown
ELT Type --
Aircraft Owner Name KLM ROYAL DUTCH AIRLINE
Aircraft Owner Street Address SCHIPOL AIRPORT
Aircraft Owner City NETHERLANDS
Aircraft Owner State OF
Aircraft Owner Country
Aircraft Owner Zipcode
Operator is an individual? --
Operator Name KLM ROYAL DUTCH AIRLINE
Operator Same as Owner? No
Operator Is Doing Business As --
Operator Address Same as Owner? No
Operator Street Address SCHIPOL AIRPORT
Operator City NETHERLANDS
Operator State OF
Operator Country
Operator Zip code
Operator Code
Owner has at least one certificate Yes - certificate holder
Other Operator of large aircraft? No
Certified for Part 133 or 137 Operation Unknown
Operator Certificate Number --
Indicates whether an air carrier operation was scheduled or not Scheduled
Indicates Domestic or International Flight International
Operator carrying Pax/Cargo/Mail Passenger Only
Type of Flying (Per_Bus / Primary) Unknown
Second Pilot on Board Yes
Departure Point Same as Event No
Departure Airport Code AMS
Departure City AMSTERDAM
Departure State OF
Departure Country
Departure Time 0
Departure Time Zone
Destination Same as Local Flt --
Destination Airport Code BWI
Destination City BALTIMORE
Destination State MD
Destination Country
Specific Phase of Flight Landing
Report sent to ICAO? --
Evacuation occurred --
Date of most recent change to record Jan 2 2001 10:30AM
User who most recently changed record dbo
Since inspection or accident --
Event Location Runway Number and Location 0
Runway Length --
Runway Width --
Sight Seeing flight No
Air Medical Flight No
Medical Flight --