A near miss is like a crystal ball that shows you what could go wrong before it does: The scalpel that almost nicks an artery, the gas valve that nearly ignites, the machine that jams inches from a worker’s arm—these aren’t flukes, they’re warnings. Documenting and investigating near misses can reveal risks before they turn deadly. But too often, we dismiss them as luck instead of lessons.
The mid-air collision at Ronald Reagan Washington National Airport (DCA) on January 29, 2025—a tragedy that killed all 67 onboard—shows the cost of ignoring warning signs.
Every near miss is a data point. Documenting them turns scattered close calls into meaningful patterns in process breakdowns and equipment failures. Without records, you’re stuck with vague hunches, unable to spot the trends that demand action.
Every near miss is an opportunity to find and fix cracks in the system. Investigating them with Cause Mapping® root cause analysis reveals not just what happened, but why - whether it’s overworked staff, skipped maintenance or unclear procedures. Identifying these causes allows companies to proactively implement solutions to reduce risk.
But that’s only possible if near misses are taken seriously. Ignore them, and you’re begging for trouble. The proof? Look no further than DCA, where years of near misses foreshadowed a tragedy and where chances to act were squandered.
The aviation industry tracks near misses like a hawk, and the airspace around DCA has been a hotspot for years. The National Transportation Safety Board (NTSB) examined data1 on encounters between helicopters and commercial planes near DCA from 2011 to 2024, and the numbers tell a story of risk on repeat:
These data are a drumbeat of warning signs. Pilots have reported near misses with helicopters for years, including evasive maneuvers, as well as a close call on January 28, 2025 (the day before the crash). The NTSB data demanded action: adjust helicopter routes, enforce altitude caps and rethink night operations. Yet, despite the red flags, meaningful changes didn’t come.
January 29, 2025, marked the tragic breaking point. American Airlines Flight 5342, a regional jet from Wichita with 64 souls onboard, was approaching on runway 33 at DCA. An Army Black Hawk helicopter on a training flight crossed its path at 300 feet—100 feet above its designated limit. The jet’s left wing clipped the chopper, and both plummeted into the Potomac River. No survivors.
The fireball lit up the night, but the real shock was the backstory: this wasn’t an unforeseen disaster. Helicopter Route 4, used by the Black Hawk, sat just 75 feet below runway 33’s approach path—a razor-thin margin in a crowded sky. Pilots, controllers, and reports had flagged the danger for years, but the FAA and military didn’t take decisive action. Post-crash, the NTSB called it an “intolerable risk” and pushed for immediate bans on helicopter operations near runways 15 and 33. The FAA has adopted the NTSB’s recommendations2, but unfortunately, it came too late for 67 lives.
The DCA tragedy isn’t just an aviation lesson, it’s a warning for any industry. Near misses are crystal balls showing what could happen. Document them, investigate them, and make changes—or roll the dice on regret. Flight 5342’s fate is a reminder of the cost of inaction.
So, what’s your next near miss telling you? Listen now—or pay later.
Want to see our initial explanation and interim investigation file? Take a look!
1 - NTSB Accident Reports: Aviation Investigation Report AIR-25-01 & Aviation Investigation Preliminary Report
2 - The FAA has adopted the NTSB’s recommendations