The turbulence sent some passengers flying out of their seats, with at least one hitting the ceiling approximately 30 minutes from landing. The flight had 278 passengers and 10 crew members onboard. Meanwhile, 11 people were transported to the hospital with severe injuries while nine others were transported in stable condition. Three flight attendants were among those also taken to hospitals, according to the Associated Press.

The five-second video, which has over 40,000 views as of Monday morning, shows the plane’s ceiling, which has several dents and one large crack.

Meanwhile, the same user also posted an earlier video showing emergency personnel wheeling some of the passengers away on stretchers.

“Multiple people injured after Severe turbulence on Hawaiian Airlines,” the tweet said.

Many factors can cause turbulence, including wind, jet streams, storms or flying near another aircraft.

The AP reported that one passenger said her mother had just sat down in her seat from using the restroom and hadn’t buckled her seatbelt yet when the plane hit the turbulence, sending her mother crashing into the ceiling.

In addition, local news station KHON2 reported that one passenger said the turbulence was so severe that passengers were “floating off” their seats.

Videos have also surfaced of crew members requesting help from any passengers who may have medical experience to tend to the injured.

“Ladies and gentleman, attention all on board, do we have any trained medical personnel. Do we have any doctors, nurses, firefighters?” someone said in the video.

When the plane landed, those with minor injuries were treated at the scene. Those transported to hospitals were plagued with serious head injuries, lacerations, bruising and loss of consciousness. One of the injured was a 14-month-old child.

Flight Safety Foundation CEO Hassan Shahidi told Newsweek on Monday that the flight was at an altitude of roughly 30,000 feet when the turbulence occurred. When an airplane is at altitude, Shahidi said turbulence can be impossible to predict.

“These pockets can happen at altitude, and when it happens, it causes turbulence. Some are not severe and some, in this case, are severe,” he said. “Airplanes are designed to really go through and withstand this type of weather turbulence.”

However, the turbulence can severely injure anyone not wearing their seatbelts. Shahidi told Newsweek that two-thirds of injuries from turbulence are to those not wearing one.

On Sunday night, Hawaiian Airlines tweeted that it would thoroughly inspect the damaged aircraft before returning it to service.

The flight wasn’t the only one affected by the turbulence, however. Fox Business reported on Monday that three other Hawaiian Airlines flights were diverted Sunday because of low visibility.

According to the AP, a Hawaiian Airlines official called the event “severe” and “isolated.” One photo shared by the news outlet also showed oxygen masks hanging above empty seats after the turbulence.

The AP also reported that a Hawaiian Airlines official said the seatbelt sign was on at the time the flight hit turbulence, but some passengers weren’t wearing them.

Shahidi added that because there were injuries, the incident will be investigated by the Federal Aviation Administration (FAA) and the National Transportation Safety Board (NTSB).

Newsweek reached out to Hawaiian Airlines for comment.

Update 12/19/2022, 12:03 p.m. ET: This article has been updated to include comment from Shahidi.