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Though the National Transportation Safety Board concluded at a meeting Thursday that pilot error was to blame for the crash of Comair Flight 5191 in Lexington, Ky., last August, some panel members raised questions about the role of air traffic controller staffing and scheduling.

Contrary to a Federal Aviation Administration order, there was only one air traffic controller on duty at the time of the crash, and that controller was engaged in an administrative task. But at the meeting, the NTSB narrowly voted that the controller's actions were not a cause of the accident. The panel could not conclude whether the presence of another controller would have prevented the crash.

"The position of the staff is that [another controller] would not have given another set of eyes outside of the control tower," said Hilton Hall, chairman of the NTSB's Air Traffic Control Group, in his presentation to the panel. "They would have been downstairs at the radar screen."

Nine months before the crash, Duff Ortman, then the manager of the Lexington facility, wrote a memo to his staff that concluded that "our staffing rarely allows for a second controller to be assigned to the [midnight shift]." FAA supervisors had complained about understaffing at the facility as early as September 2004.

During their deliberations, NTSB members established a clear link between the accident and a subsequent decision to hire more controllers at the air traffic control facility.

"They got this verbal guidance that they had to have two staff on the midnight shift, and [the manager] did it until he couldn't do it [because he didn't have enough staff]," said Deborah Hersman, the NTSB member who led the on-the-ground investigation of the crash. "After the accident, how many air traffic controllers did they get to hire there in Lexington?"

"They hired four within the first six months, and two after," Hall replied.

"So he couldn't get the staff to do what he needed to do until after the accident?" Hersman asked.

"Yes," Hall told her.

The safety board recommended in April that the FAA adjust scheduling to make sure that air traffic controllers had sufficient sleep, improve awareness of the impact of fatigue on controller performance, and require controllers to undergo resource management skills training.

Hersman said that the schedule of the air traffic controller who was working during the crash "defines everything we know about fatigue. He was flipping days and nights -- he didn't have a lot of opportunity for sleep."

NTSB specifically recommended that the FAA work with the National Air Traffic Controllers Association on scheduling issues, which have become a political hot button since last September when the FAA imposed pay and work rules designed to increase managerial control over the workforce. The FAA is in the process of developing a fatigue awareness curriculum and has delivered resource management training at a number of facilities.

According to FAA documents, as of July 5 the agency was "convening a working group to develop shift rotations and scheduling guidelines," with no timeline for when those guidelines would be released or implemented. In communications last week with Rep. Ben Chandler, D-Ky., the agency cited formation of the working group as proof of its response to NTSB recommendations.

NATCA questioned the FAA's commitment to collaboration in the working group proceedings. The union claims that the panel is stacked with employees from the FAA's Air Traffic Organization division, and isn't giving equal status to the union's views, contrary to the NTSB's instructions.

"It's a sham," said Doug Church, NATCA's communications director. "They said they'd have controller subject matter experts who were invited to participate, but it's a lesser status."

COMMENTS

• It's amazing how many comments point fingers instead of trying to suggest solutions. Anyone who works in the airline industry knows the hours are long, pay is not the best and safety isn't always put first. Our ATC system needs serious upgrades and better staffing. In this crash, the pilots being unfamiliar should have asked for a progressive taxi. The controller can't be expected to babysit when short staffed. Listen to the audio (you can find it posted online) of the radio conversations before the crash...then you decide who all was to blame. I say that the pilots should have asked for help....any controller would have gladly given it. Kevin Obek Posted August 1, 2007 10:25 AM
• I'm sorry, Mr. Wicker, but you're way out of touch. I'm a GS13 also, but I'm also a pilot, and I sincerely appreciate the work that America's air traffic controllers do day after day. However, in this case, it seems that the reason given that the controller in Lexington was not minding the store when the Comair flight departed was that he was engaged in an "administrative task". What administrative task could he have been engaged in that was more important than monitoring a departing flight? Flight Safety is his primary reason for being there, and he apparently abrogated that responsibility to tend to a mundane administrative task. I'm sorry, but I think in this case the controller bears a significant portion of the blame for this accident. Walt McKinney Posted July 31, 2007 7:48 AM
• To GS13 I'm not impressed with your numerical ranking. Its obvious to anyone that knows the air traffic world that you don't have an understanding of its inner workings. To your comments, thank you very much for the compliment, for we where the way that was found for the system to continue and thrive so the country could retain its free, capitalistic and Democratic principles. The Government hired the very people who you and this administration choose to bash and condemn for doing nothing less than allowing the American people to board thousands of flights each day and not once at anytime during their flights ask did that Air Traffic Controller do his job? Nope, they just thank the flight attendant and the pilot for the safe flight when getting off the airplane. I guess GS13 you make me puke. Thank you to all of my fellow Controllers for being the forgotten and unknown professional voices of safety first and family last. Real Controller Posted July 30, 2007 8:33 PM