Narrative:

Aircraft involved was a falcon 20 with a large cargo door. The aircraft began takeoff on runway 28 at cle. Upon rotation, the cargo door came open. The crew initiated an emergency return to the airport, were unable to make the runway due to flight control problems caused by the open door and subsequent left engine failure from a suitcase that entered the left engine, and landed on a ramp area near the terminal. There were no injuries or aircraft damage except damage to the cargo door itself. Both flight crew members were adamant that the door was closed and locked and the door warning light was out. Subsequent investigation revealed no damage or malfunction of the door locking mechanism. FAA investigators could find no design flaw in the locking mechanism which could possibly allow the door to open by itself. Conclusion: pilot error in failure to properly lock door and monitor warning light system. As a company manager, I intend to retrain all pilots on proper door operation with continual periodic recurrent training, and to install an augmented door open warning system (horn or buzzer). Callback conversation with reporter revealed the following information: callback with captain reporter. FAA investigated, could find no malfunction with the latch and determined it was pilot error in failure to properly lock door and monitor warning light system. FAA first threatened punitive action, but then withdrew it. Captain says that the problem continues to occur and the reason it hasn't been reported in the past is because pilots are fearful of FAA investigations and punitive action, as in this case. Also, flcs concern that the FAA will ground the aircraft in turn affecting their jobs. When the locking mechanism became unlatched reporter was returning to airport for landing when the cargo net webbing tore, allowing the cargo door to open wide enough to suck a crew bag into the engine. With the end failed, captain had difficulty controling the aircraft because, not only was the engine out, but also the 'flapping' cargo door was blanking airflow over the rudder. Thus, the reporter captain thought he also had a hydraulic problem since the rudder control was intermittent. The aircraft was controllable, but by then there were so many unknowns that the captain just wanted to get the aircraft on the ground. Subsequent to the incident their company has modified the latch with added alerts, visual and aural. Reporter says that still doesn't fix the main problem, the latch itself.

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Original NASA ASRS Text

Title: ACFT EQUIP PROB CRITICAL. CARGO DOOR OPENED INFLT, SUCKED BAG INTO ENG WHICH FAILED.

Narrative: ACFT INVOLVED WAS A FALCON 20 WITH A LARGE CARGO DOOR. THE ACFT BEGAN TKOF ON RWY 28 AT CLE. UPON ROTATION, THE CARGO DOOR CAME OPEN. THE CREW INITIATED AN EMER RETURN TO THE ARPT, WERE UNABLE TO MAKE THE RWY DUE TO FLT CTL PROBS CAUSED BY THE OPEN DOOR AND SUBSEQUENT L ENG FAILURE FROM A SUITCASE THAT ENTERED THE L ENG, AND LANDED ON A RAMP AREA NEAR THE TERMINAL. THERE WERE NO INJURIES OR ACFT DAMAGE EXCEPT DAMAGE TO THE CARGO DOOR ITSELF. BOTH FLC MEMBERS WERE ADAMANT THAT THE DOOR WAS CLOSED AND LOCKED AND THE DOOR WARNING LIGHT WAS OUT. SUBSEQUENT INVESTIGATION REVEALED NO DAMAGE OR MALFUNCTION OF THE DOOR LOCKING MECHANISM. FAA INVESTIGATORS COULD FIND NO DESIGN FLAW IN THE LOCKING MECHANISM WHICH COULD POSSIBLY ALLOW THE DOOR TO OPEN BY ITSELF. CONCLUSION: PLT ERROR IN FAILURE TO PROPERLY LOCK DOOR AND MONITOR WARNING LIGHT SYS. AS A COMPANY MGR, I INTEND TO RETRAIN ALL PLTS ON PROPER DOOR OP WITH CONTINUAL PERIODIC RECURRENT TRAINING, AND TO INSTALL AN AUGMENTED DOOR OPEN WARNING SYS (HORN OR BUZZER). CALLBACK CONVERSATION WITH RPTR REVEALED THE FOLLOWING INFO: CALLBACK WITH CAPT RPTR. FAA INVESTIGATED, COULD FIND NO MALFUNCTION WITH THE LATCH AND DETERMINED IT WAS PLT ERROR IN FAILURE TO PROPERLY LOCK DOOR AND MONITOR WARNING LIGHT SYS. FAA FIRST THREATENED PUNITIVE ACTION, BUT THEN WITHDREW IT. CAPT SAYS THAT THE PROB CONTINUES TO OCCUR AND THE REASON IT HASN'T BEEN RPTED IN THE PAST IS BECAUSE PLTS ARE FEARFUL OF FAA INVESTIGATIONS AND PUNITIVE ACTION, AS IN THIS CASE. ALSO, FLCS CONCERN THAT THE FAA WILL GND THE ACFT IN TURN AFFECTING THEIR JOBS. WHEN THE LOCKING MECHANISM BECAME UNLATCHED RPTR WAS RETURNING TO ARPT FOR LNDG WHEN THE CARGO NET WEBBING TORE, ALLOWING THE CARGO DOOR TO OPEN WIDE ENOUGH TO SUCK A CREW BAG INTO THE ENG. WITH THE END FAILED, CAPT HAD DIFFICULTY CTLING THE ACFT BECAUSE, NOT ONLY WAS THE ENG OUT, BUT ALSO THE 'FLAPPING' CARGO DOOR WAS BLANKING AIRFLOW OVER THE RUDDER. THUS, THE RPTR CAPT THOUGHT HE ALSO HAD A HYD PROB SINCE THE RUDDER CTL WAS INTERMITTENT. THE ACFT WAS CONTROLLABLE, BUT BY THEN THERE WERE SO MANY UNKNOWNS THAT THE CAPT JUST WANTED TO GET THE ACFT ON THE GND. SUBSEQUENT TO THE INCIDENT THEIR COMPANY HAS MODIFIED THE LATCH WITH ADDED ALERTS, VISUAL AND AURAL. RPTR SAYS THAT STILL DOESN'T FIX THE MAIN PROB, THE LATCH ITSELF.

Data retrieved from NASA's ASRS site as of July 2007 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.