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|
Attributes | |
ACN | 1756021 |
Time | |
Date | 201909 |
Local Time Of Day | 0001-0600 |
Environment | |
Flight Conditions | VMC |
Light | Night |
Aircraft 1 | |
Make Model Name | EC135 |
Operating Under FAR Part | Part 135 |
Flight Phase | Parked |
Route In Use | Vectors |
Flight Plan | IFR |
Component | |
Aircraft Component | Main Rotor Vibration Monitor Indicator |
Person 1 | |
Function | Pilot Flying Captain |
Qualification | Flight Crew Instrument Flight Crew Commercial |
Events | |
Anomaly | Aircraft Equipment Problem Less Severe Deviation - Procedural Maintenance Deviation - Procedural Published Material / Policy Deviation - Procedural FAR |
Narrative:
Crew was dispatched for [a flight]. An eng chip ct caution precluded launch and flight was cancelled. PIC called on-duty mechanic to inform him of the maintenance issue. The mechanic asked me to pull the eng chip ct circuit breaker to see if it would extinguish the light. Upon returning to acft and turning on the battery; I noticed the light was extinguished. However; I also noticed a red fault light with the letters 'lmt' adjacent to it. I turned the page selector to the maintenance page and saw that the limit exceeded showed a code of 'mmexc 0061'. I called the mechanic back and let him know that the engine chip ct had resolved itself; but now there was a mast moment exceeded fault. He informed me he was enroute to take a look at it. [Later;] mechanic texted me and told me he was at the base. I walked out to the aircraft and noticed the mechanic was sitting in the pilot seat and that the battery was on. As I climbed into the co-pilot seat; the mechanic said he didn't see the red fault light and lmt light on the cds I had told him about earlier. I explained that it was there and asked him when and why he cleared the fault. He mumbled that he didn't clear the fault and he never saw it. I then let him know that I had taken a picture of the fault and showed it to him. He asked me to send him the photo and I did. After researching the fault code; the mechanic explained that he would have to disassemble the rotor head and inspect the bearings; mast and other components and that he'd have to remove the seal. He also explained that the aircraft would be out of service for at least 24hrs because after reassembling everything; the sealant would need 24hrs to cure. I then briefed the medical crew; called operations and apprised them of the situation. A few hours later; the mechanic approached me and told me he spoke with his supervisor and other maintenance personnel and that it was agreed upon that he could just complete an external visual inspection of the mast; blade cuffs and other components and that would be sufficient; since the mechanic believed that it was 'probably moisture' that caused an erroneous fault indication. I respectfully disagreed since this particular aircraft recently had a new second-generation seal installed and there were no subsequent erroneous mast moment indications. The mechanic said he already completed the required suggested visual inspection and it was 'good to go'. Later in the morning; the on-coming pilot approached me and asked to see the fault on the cds. I told him that the mechanic already cleared the fault but he could still see the mmexc 0061 code on the maintenance page. After seeing the exceedance code; the pilot then mentioned that he now probably looks a bit suspicious since he had asked me at shift change the evening prior; 'how does the T1 record exceedances?'; a fact that didn't register with me when I saw the fault code later in my shift. The pilot also mentioned that it was possible that he could have inadvertantly displaced the cyclic while on the ground but honestly didn't recall seeing or hearing anything unusual. I told him if there was an exceedance; that it wasn't a huge issue and that the required inspection had to be done and if nothing is found; we'd back in service. In the middle of this conversation with the on-coming pilot; the mechanic approached us and said that he spoke with the maintenance supervisor and other leadership; and that all were in agreement that it was probably moisture which caused the erroneous exceedance and that he only needed to conduct an external visual inspection of the blade cuffs; and other components. He said that if a 'true exceedance' occurred; that there would be visual damage to the inside portion of the blade cuffs. I respectfully disagreed but told him that if the maintenance supervisors were all in agreement with the plan of action then that was their decision. The mechanic kept asking the other pilot and I; how we 'felt' about the aircraft and the procedure he proposed. I explained that I didn't 'feel' there was anything unsafe with the aircraft; but if a maintenance action was supposed to be completed; then it should be done. He then asserted that the maintenance team all agreed that the visual inspection he performed was appropriate. I then departed the base. On the way home; I contacted the aviation service manager (asm) to inform him of what happened and told him that the mechanic said he agreed with the maintenance plan. The asm denied saying that he was good with any specific plan but that he said to conduct whatever the required inspection was. I sent the on-duty pilot and the mechanic a message letting them know that my official stance is that we don't 'know' if moisture was the culprit for the mast moment exceedance and that I didn't think it wise to not follow maintenance action procedures based on our 'feelings' or beliefs that it could be this or that. I said I felt it best to err on the side of caution and proper maintenance procedures rather than guessing. The mechanic then called me in a very heated tone and asked me what my concerns were. I explained that my concerns were that 1. We don't know if moisture caused an erroneous exceedance. 2. The on-duty pilot asked how exceedances were recorded at shift change the day prior; and admitted at least there was a possibility one could have occurred. 3. The mechanic stated that there have been no erroneous mast moment 'moisture' issues since the new '2nd generation' seal was recently installed. 4. And finally that he (the mechanic) cleared the fault before I came out to the aircraft and told me he didn't see the fault. At this point; he vehemently denied clearing the fault upon arrival. I told him he cleared it before I climbed in the aircraft. He denied it again and claimed he didn't clear it until he returned to the base from the base. I reminded him that he cleared it prior to that and said he didn't see what I was talking about; at which point I told him I took a picture of the fault and that he had asked me to send him the picture; which occurred at xa:39. He then began yelling; telling me he wasn't going to argue with me about what time he cleared the fault. Additionally; he said he wasn't going to sit there and let me question his work ethic. I then reminded him of the multiple times I've called him while he was on call and he complained that this wasn't his base or his aircraft. He said that he was hired to work at his base and nowhere in his contract does it say he was to work at the other bases and that he's 'tired of fixing (expletive) that the on-duty pilot breaks'. In a hostile tone; he kept asking me what I wanted him to do. Did I want him to take the aircraft out of service or keep it in service? He said he needed an answer from me as soon as possible because he had another aircraft to deal with that was stuck in ZZZ. He said that he was the only mechanic available and that he'd have to complete the required inspection 'taking everything apart' by himself and that if I wanted him to take the aircraft out of service; that he would look like a [expletive] because he already completed the write-up and put the aircraft back in service. I explained that I wasn't worried about how he looked; I was only concerned that the proper maintenance action was completed; the aircraft was in an airworthy state; and the entire crew was safe. He then received an incoming call and our call ended. It was discovered that the mechanic wrote up the fault; and corresponding corrective maintenance action as completed. However; it was found that he did not complete the required correction action per the [maintenance manual]. Four separate flights totally 3.3hrs were completed after the mechanic signed off the maintenance logbook indicating the required inspection was completed. I believe the mechanic knowingly misrepresented the circumstances surrounding the maintenance event in orderto avoid having to complete the required maintenance action per the manual. To reiterate; mechanics and pilots the importance of following maintenance procedures by the book. To not base maintenance actions on feelings or assumptions but to ensure maintenance is done as required.
Original NASA ASRS Text
Title: Helicopter Pilot reported misgivings due to suspected unapproved procedures used to return an aircraft to service.
Narrative: Crew was dispatched for [a flight]. An Eng Chip CT Caution precluded launch and flight was cancelled. PIC called on-duty Mechanic to inform him of the maintenance issue. The Mechanic asked me to pull the Eng Chip CT circuit breaker to see if it would extinguish the light. Upon returning to acft and turning on the battery; I noticed the light was extinguished. However; I also noticed a Red Fault light with the letters 'LMT' adjacent to it. I turned the page selector to the maintenance page and saw that the limit exceeded showed a code of 'MMEXC 0061'. I called the mechanic back and let him know that the ENG CHIP CT had resolved itself; but now there was a Mast Moment Exceeded Fault. He informed me he was enroute to take a look at it. [Later;] Mechanic texted me and told me he was at the base. I walked out to the aircraft and noticed the mechanic was sitting in the pilot seat and that the battery was on. As I climbed into the co-pilot seat; the Mechanic said he didn't see the red fault light and LMT light on the CDS I had told him about earlier. I explained that it was there and asked him when and why he cleared the fault. He mumbled that he didn't clear the fault and he never saw it. I then let him know that I had taken a picture of the fault and showed it to him. He asked me to send him the photo and I did. After researching the fault code; the Mechanic explained that he would have to disassemble the rotor head and inspect the bearings; mast and other components and that he'd have to remove the seal. He also explained that the aircraft would be out of service for at least 24hrs because after reassembling everything; the sealant would need 24hrs to cure. I then briefed the medical crew; called operations and apprised them of the situation. A few hours later; the Mechanic approached me and told me he spoke with his supervisor and other maintenance personnel and that it was agreed upon that he could just complete an external visual inspection of the mast; blade cuffs and other components and that would be sufficient; since the Mechanic believed that it was 'probably moisture' that caused an erroneous fault indication. I respectfully disagreed since this particular aircraft recently had a new second-generation seal installed and there were no subsequent erroneous Mast Moment indications. The Mechanic said he already completed the required suggested visual inspection and it was 'good to go'. Later in the morning; the on-coming pilot approached me and asked to see the fault on the CDS. I told him that the Mechanic already cleared the fault but he could still see the MMEXC 0061 code on the maintenance page. After seeing the exceedance code; the pilot then mentioned that he now probably looks a bit suspicious since he had asked me at shift change the evening prior; 'how does the T1 record exceedances?'; a fact that didn't register with me when I saw the fault code later in my shift. The pilot also mentioned that it was possible that he could have inadvertantly displaced the cyclic while on the ground but honestly didn't recall seeing or hearing anything unusual. I told him if there was an exceedance; that it wasn't a huge issue and that the required inspection had to be done and if nothing is found; we'd back in service. In the middle of this conversation with the on-coming Pilot; the Mechanic approached us and said that he spoke with the Maintenance supervisor and other leadership; and that all were in agreement that it was probably moisture which caused the erroneous exceedance and that he only needed to conduct an external visual inspection of the blade cuffs; and other components. He said that if a 'true exceedance' occurred; that there would be visual damage to the inside portion of the blade cuffs. I respectfully disagreed but told him that if the Maintenance supervisors were all in agreement with the plan of action then that was their decision. The Mechanic kept asking the other Pilot and I; how we 'felt' about the aircraft and the procedure he proposed. I explained that I didn't 'feel' there was anything unsafe with the aircraft; but if a maintenance action was supposed to be completed; then it should be done. He then asserted that the maintenance team all agreed that the visual inspection he performed was appropriate. I then departed the base. On the way home; I contacted the Aviation Service Manager (ASM) to inform him of what happened and told him that the Mechanic said he agreed with the maintenance plan. The ASM denied saying that he was good with any specific plan but that he said to conduct whatever the required inspection was. I sent the on-duty Pilot and the Mechanic a message letting them know that my official stance is that we don't 'know' if moisture was the culprit for the Mast Moment exceedance and that I didn't think it wise to not follow maintenance action procedures based on our 'feelings' or beliefs that it could be this or that. I said I felt it best to err on the side of caution and proper maintenance procedures rather than guessing. The Mechanic then called me in a very heated tone and asked me what my concerns were. I explained that my concerns were that 1. We don't know if moisture caused an erroneous exceedance. 2. The on-duty Pilot asked how exceedances were recorded at shift change the day prior; and admitted at least there was a possibility one could have occurred. 3. The Mechanic stated that there have been no erroneous Mast Moment 'moisture' issues since the new '2nd generation' seal was recently installed. 4. And finally that he (the Mechanic) cleared the fault before I came out to the aircraft and told me he didn't see the fault. At this point; he vehemently denied clearing the fault upon arrival. I told him he cleared it before I climbed in the aircraft. He denied it again and claimed he didn't clear it until he returned to the base from the Base. I reminded him that he cleared it prior to that and said he didn't see what I was talking about; at which point I told him I took a picture of the fault and that he had asked me to send him the picture; which occurred at XA:39. He then began yelling; telling me he wasn't going to argue with me about what time he cleared the fault. Additionally; he said he wasn't going to sit there and let me question his work ethic. I then reminded him of the multiple times I've called him while he was on call and he complained that this wasn't his base or his aircraft. He said that he was hired to work at his base and nowhere in his contract does it say he was to work at the other bases and that he's 'tired of fixing (expletive) that the on-duty Pilot breaks'. In a hostile tone; he kept asking me what I wanted him to do. Did I want him to take the aircraft out of service or keep it in service? He said he needed an answer from me ASAP because he had another aircraft to deal with that was stuck in ZZZ. He said that he was the only mechanic available and that he'd have to complete the required inspection 'taking everything apart' by himself and that if I wanted him to take the aircraft out of service; that he would look like a [expletive] because he already completed the write-up and put the aircraft back in service. I explained that I wasn't worried about how he looked; I was only concerned that the proper maintenance action was completed; the aircraft was in an airworthy state; and the entire crew was safe. He then received an incoming call and our call ended. It was discovered that the Mechanic wrote up the fault; and corresponding corrective maintenance action as completed. However; it was found that he did not complete the required correction action per the [maintenance manual]. Four separate flights totally 3.3hrs were completed after the Mechanic signed off the Maintenance Logbook indicating the required inspection was completed. I believe the Mechanic knowingly misrepresented the circumstances surrounding the maintenance event in orderto avoid having to complete the required maintenance action per the manual. To reiterate; Mechanics and Pilots the importance of following maintenance procedures by the book. To not base maintenance actions on feelings or assumptions but to ensure maintenance is done as required.
Data retrieved from NASA's ASRS site and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.