The primary purpose of the NTSB is to prevent future accidents. Any "blame" they assign is in furtherance of that purpose, not punishment. So critical is this

The primary purpose of the NTSB is to prevent future accidents. Any "blame" they assign is in furtherance of that purpose, not punishment. So critical is this to the NTSB's mission that any conclusion the agency draws as to the cause of an accident cannot be submitted as evidence of civil liability[1] in court and every NTSB report includes a footnote to that effect. You'll find it on page 4 of the document you've linked. [1] The report would be hearsay in a criminal case and admissible only if the government demonstrates an exception to the rule against hearsay evidence.