37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 459363 |
Time | |
Date | 200001 |
Day | Sat |
Local Time Of Day | 0601 To 1200 |
Place | |
Locale Reference | airport : zzz.airport |
State Reference | US |
Altitude | agl single value : 0 |
Environment | |
Light | Daylight |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | MD-83 |
Operating Under FAR Part | Part 121 |
Flight Phase | ground : parked ground : maintenance |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | maintenance : inspector |
Qualification | technician : powerplant technician : airframe technician : inspection authority |
ASRS Report | 459363 |
Person 2 | |
Affiliation | company : air carrier |
Function | maintenance : technician |
Qualification | technician : powerplant technician : airframe |
ASRS Report | 459362 |
Events | |
Anomaly | aircraft equipment problem : critical maintenance problem : improper maintenance non adherence : far non adherence : published procedure other anomaly other |
Independent Detector | aircraft equipment other aircraft equipment : #2 engine indication |
Resolutory Action | none taken : detected after the fact |
Consequence | other other |
Factors | |
Maintenance | contributing factor : schedule pressure contributing factor : work cards performance deficiency : testing performance deficiency : inspection performance deficiency : installation |
Supplementary | |
Problem Areas | Aircraft Maintenance Human Performance |
Primary Problem | Maintenance Human Performance |
Narrative:
On jan/mon/00 at XA30, I was informed of an incident where the throttle 'bolt' fell out of an engine we changed on the jan/sat/00. The bolt in question was installed on the engine from the overhead shop. There was not a tag stating that this bolt was not safetied. (The nut is on the inboard side of the engine and not readily visible.)
Original NASA ASRS Text
Title: AN MD83 EXPERIENCED LOSS OF #2 ENG CTL DUE TO THE THRUST LEVER INPUT TO THE FUEL CTL DISCONNECTED WHEN A NOT SAFETIED BOLT FELL OUT.
Narrative: ON JAN/MON/00 AT XA30, I WAS INFORMED OF AN INCIDENT WHERE THE THROTTLE 'BOLT' FELL OUT OF AN ENG WE CHANGED ON THE JAN/SAT/00. THE BOLT IN QUESTION WAS INSTALLED ON THE ENG FROM THE OVERHEAD SHOP. THERE WAS NOT A TAG STATING THAT THIS BOLT WAS NOT SAFETIED. (THE NUT IS ON THE INBOARD SIDE OF THE ENG AND NOT READILY VISIBLE.)
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.