Engine inspection may be a weak link in US air-safety chain. Testimony suggests less-than-rigorous adherence to FAA rules
Last September a Midwest Express twin-engine DC-9 airliner had just taken off from an airport in Milwaukee when it suddenly lost power in its right engine and 16 seconds later crashed, killing the 31 people on board. In February, the National Transportation Safety Board held public hearings where investigators questioned experts on possible causes of the crash. The plane should have flown with one engine. Pilot error was discussed. An investigation into the cause is still under way.
But other testimony disclosed potential problems with FAA inspections that could, if not corrected, have serious implications for air safety across the nation.
Specifically, the quality, depth, and frequency of FAA maintenance inspection at the jet-engine repair shop where the failed engine was overhauled were questioned. That overhaul occurred in October 1981 at a Miami jet-engine repair station called AeroThrust Inc. The engine failed on Sept. 6, 1985.
The investigators also probed a private, independent review of AeroThrust by engine builder Pratt & Whitney. P&W inspector Bruce N. Bailliff gave investigators a broad perspective on numerous so-called non-safety violations of FAA regulations the P&W review found there.
Mr. Bailliff told investigators that if the FAA strictly enforced its own regulations, there would be enough violations found at any repair facility to close it. Despite a number of minor violations, he added, AeroThrust was the best shop he had ever reviewed.
Such a kudo prompts a question: If numerous violations existed at AeroThrust, and it is one of the best jet repair shops around, how good is the FAA at inspecting and determining compliance at lesser jet repair shops?
Testimony shows inconsistencies and inadequacies in FAA inspection at AeroThrust before, during, and after October 1981. It shows:
An apparent failure of FAA inspectors to conduct regular annual in-depth inspections of AeroThrust Inc., with a two year gap between November 2, 1979 and November 5, 1981 showing no record of inspection.
An apparent failure by FAA inspectors to ascertain the qualifications of personnel operating certain test equipment at the facility as regulations require.
Testimony shows FAA inspectors did not require them to have paper credentials -- in addition to their on-the-job training -- certifying an ability to detect cracks, corrosion, and metal fatique in jet-engine parts.
An apparent failure of FAA inspectors to ensure that equipment and tools within the facility were calibrated to FAA specifications.
Tool calibration is one of the little things that engine builder Pratt & Whitney has checked in its 72 shop reviews of jet-engine overhaul facilities since 1977. Mr. Bailliff was personally involved in at least 12 such inspections.
Said Bailliff: ``I don't believe that in the past five years I've looked at a single shop that would survive close scrutiny by the FAA [if measured against FAA regulations], particularly in the area of calibration of instruments.''
How serious are such ``nonsafety'' related violations? Asked if such lesser violations, if longstanding, could lead to problems with safety, Bailliff said, ``I think that practically anything could have a potential long-term impact.''
The problem is that under deregulation many jet-engine repair stations are doing more business than they ever have. Many smaller air carriers can't afford their own engine repair facilities. It could be argued that an even higher standard of FAA inspection becomes critical.
Engine failures, though not extremely rare, are still considered an unusual and serious malfunction whose cause varies. Today's multi-engine jet airliners are certified able to fly with one failed engine -- even on take off.
Yet, identifying and dealing with the causes of engine failure are important. Much of that task is up to the engine manufacturer, and to airlines that are required to follow the FAA's rigorous maintenance code.
Ultimately, though, it is the FAA that is responsible for analyzing known hazards, identifying them as safety issues, and following through with inspections of jet-engine repair shops in addition to inspecting other critical airline services.
Testimony in the hearing shows that the regional FAA office in Miami was allowed to set its own inspection agenda. Aerothrust was considered a ``low priority.''
Though inspectors apparently visited AeroThrust several times -- perhaps even frequently over the years -- there are no records to show any inspections over a 2-year period.
There was also a failure to enforce such regulations requiring written training certification.
Anthony J. Broderick, associate administrator for aviation standards in Washington, says the FAA has taken positive action to ensure that jet-engine repair facilities comply with regulations.
``The process has changed,'' he says. ``We have a national work program that establishes guidance for minimum inspection frequency for all aviation businesses of any size.''
Mr. Broderick says he believes Bailliff's comments were positive, in that they pointed up the rigorous nature of the FAA code's many volumes of closely written regulations.
``If one seeks to, one can find, using those regulations, almost any aviation professional in some minor technical violation of the regulations,'' he said. ``If I'm ticketed once for speeding in my car, that doesn't necessarily make me an unsafe driver.''
Broderick admits, however, that ``training regulations are one of the areas we find frequently not complied with. . . We do not condone that. But there is a difference between undocumented people and unqualified people.''
The FAA recently launched a major inspection drive to check airlines and jet-engine repair facilities. And inspections of all 19 jet-engine repair facilities were just completed. A report should be out soon, Broderick says.
Still, it seems important to critics that such efforts not be just temporary or spasmodic attempts to deal with merely obvious violations of FAA regulations. What is needed, they say, is long-term committment to inspections deep enough to catch even lesser violations that could result in major accidents.
``Airlines are making much more use than in the past of contract maintenance,'' says David Balderston, an evaluator for the General Accounting Office, which recently criticized FAA inspection practices.
``The concern was that the FAA hadn't reacted fast enough [under deregulation] to develop good inspection procedures. That's because previously a lot of the repair was done in-house. But more and more air carriers are contracting outside for heavy maintenance.''
An FAA maintenance inspector concurs: ``Like NASA [the airline industry] would let quality control slip if there wasn't someone to keep an eye on them. But nobody's out there trying to do a bad job.'' `Bombshell' testimony raises questions about engine repairs
National Transportation Safety Board (NTSB) hearings into the crash of the Midwest Express DC-9 also probed engine inspection procedures.
The questioning of Pratt & Whitney inspector Bruce N. Bailliff was conducted by John Drake, who headed the crash investigation for the safety board. AeroThrust is an independent jet-engine overhauler. The following are excerpts from the testimony.
Mr. Drake: How typical of the industry was this AeroThrust shop review, the results of it.
Mr. Bailliff: I would categorize AeroThrust as at least average, or better.
Drake: I believe you indicated then from our previous discussion that although there was a long list of items [needed improvements] cited and recommendations related to these, that you didn't consider that there were . . . serious safety problems anywhere on the list?
Bailliff: That's correct. . . .
Drake: I believe you also indicated to me that if FAA had made such findings, the shop probably wouldn't have passed the inspection.
Bailliff: I think -- I think when I made that statement I specifically excluded AeroThrust. What I said to you was in general, for all shops. I don't believe that in the past five years I've looked at a single shop that would survive close scrutiny by the FAA to their requirements, particularly in the area of calibration of instruments. I don't go into a single shop that I can't walk around the shop and pick up an instrument that's not out of calibration, or I should say not out of calibration date.
Drake: Are you saying that a detailed examination such as Pratt & Whitney does would result in a failure at any shop, any JT8 overhaul shop?
Bailliff: I'm saying this is a general observation. . . . This is my impression without knowing how the FAA goes about and audits and in fact what their regs really do say.
What I'm saying is that there are repeated cases throughout the industry, both domestic and foreign, both 8D and 9D engines . . . where the instruments being used either cannot be traced back to National Bureau of Standards standards or have not been tagged or are not under some kind of a control system or have been calibrated within a reasonable period of time. That is a general observation, essentially without exception.
Drake: How would you rate the AeroThrust response to the shop review that you were involved in?
Bailliff: It was the best of any of the shop reviews that I participated in. . . .
Drake: No other questions. Thank you.
NTSB chairman Burnett: AeroThrust?
[AeroThrust representative] Mr. McMillen: No questions, Mr. chairman.
[FAA representative] Mr. Del Gandio: No questions, Mr. chairman.
Burnett: I can't believe a bombshell like that doesn't draw any questions. Second of three articles.