Maintenance oversight fails
Similarities Cited in Emery and Air Midwest crashes
Dayton Daily News Op-Ed
Friday, February 21, 2003
Fred Chesbro / Other Voices
The recent Air Midwest crash is reason to question, yet again, FAA and airline oversight of commercial airline maintenance.
This week marks the three-year anniversary of the deadly crash of Emery Worldwide Airlines Flight 17. Although the National Transportation Safety Board has not yet provided its own probable cause finding, many believe a maintenance mistake on the horizontal stabilizer caused that crash. This is important because investigators are reportedly looking at a maintenance mistake as the most likely cause of the Jan. 8 fatal crash of an Air Midwest twin-turboprop at Charlotte, N.C.
Recall Emery 17: The DC-8 freighter took off from Sacramento en route to Emery's global hub in Dayton. Two minutes later, the large jet, full of fuel, crashed into an auto auction yard, killing all aboard. Engulfed in a massive inferno, the auction yard literally looked like hell on earth.
More than two years later, on May 9 and 10, 2002, the NTSB convened a public hearing. Dubbed "historic" by the media, it was, in fact, the NTSB's first-ever public hearing for an air-cargo accident.
One reason for the hearing, according to the safety board, was to focus on issues of "contract maintenance and the associated oversight." The hearing showcased a technical panel of investigators who exposed intolerable safety lapses, while the presiding officer sternly criticized inadequate airline maintenance practices. At one point, the presiding officer said, "I think we've found cancer."
Now, as in the past, the effectiveness of FAA and carrier oversight of third- party airline maintenance continue to be criticized by industry observers as well as government officials.
The airline industry today remains substantially reliant on third parties to perform maintenance and repair. Nearly half of all work conducted on U.S. airlines is done by thousands of independent repair stations, constituting a $3 billion per year industry.
According to a Government Accounting Office report, airlines find it "more economical to contract out much of their maintenance work rather than hiring their own staffs and building extensive facilities." And oversight of third- party maintenance has become a matter of concern in recent years, in part, because "work performed by repair stations has been identified as a factor in several aircraft accidents."
According to an NTSB investigation update, an exam of the Emery wreckage found indications that part of the DC-8's mechanical flight control components may not have been connected prior to the flight (a push rod connecting to an elevator control tab).
A contract maintenance repair station, just three months before the crash, had overhauled key components of the plane. According to media reports, the NTSB subsequently asked the airline to inspect its remaining fleet of DC-8s for similar problems. They reportedly found 11 planes with their push rod bolts installed backward; five planes had problems in both elevators; and one plane had the push rod itself installed backward.
A recent Air Safety Week article identified several curious similarities between Emery 17 and the Air Midwest flight that took the lives of all 21 aboard at Charlotte, N.C. Although it's far too early to identify probable causation, the article stated that the "crash has all the earmarks of maintenance error as the precipitating event."
The parallels between the two fatal flights are striking. Among the similarities cited: third-party maintenance and repair work issues; loading/weight and balance questions; suspected catastrophic malfunction of the horizontal stabilizers; possible pre-accident data recorder indicators showing the crash airplanes' elevators moved in ways "inconsistent" with what might be expected; and both airplanes were destroyed in fireballs. Clearly, oversight of contract maintenance affects both passenger and cargo airlines.
Published safety statistics reveal that aviation maintenance errors account for more than 3,000 deaths during the last three decades. These statistics take on special meaning in light of the GAO's characterization of FAA oversight of third-party maintenance as "comparatively limited."
Given the notable increases in industry outsourcing, oversight of commercial airline maintenance is plainly daunting. But the FAA is not expected to face this challenge alone. Federal Aviation regulations clearly provide for a shared approach: Carriers must ensure that "repair stations are conducting work that conforms with the air carriers' manuals and the applicable FAA regulations."
The burden is, by design, required to be assumed both by the airline regulator and regulated airline. A shared obligation exists as a matter of law.
Fred Chesbro is a professional pilot and member of the National Air Disaster Alliance & Foundation. Write him at Fred.Chesbro@att.net.