37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 692023 |
Time | |
Date | 200603 |
Place | |
Locale Reference | airport : zzz.airport |
State Reference | US |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | SF 340B |
Operating Under FAR Part | Part 121 |
Flight Phase | ground : parked ground : maintenance |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | maintenance : technician |
ASRS Report | 692023 |
Person 2 | |
Affiliation | company : air carrier |
Function | oversight : coordinator |
Events | |
Anomaly | aircraft equipment problem : critical maintenance problem : improper documentation maintenance problem : improper maintenance non adherence : published procedure non adherence : far |
Independent Detector | aircraft equipment other aircraft equipment : crew oxygen indicator other flight crewa other flight crewb |
Resolutory Action | none taken : detected after the fact |
Consequence | other other |
Factors | |
Maintenance | contributing factor : schedule pressure performance deficiency : repair performance deficiency : logbook entry performance deficiency : non compliance with legal requirements |
Supplementary | |
Problem Areas | Maintenance Human Performance Aircraft Chart Or Publication Environmental Factor |
Primary Problem | Maintenance Human Performance |
Narrative:
Saab 340B arrived at gate with a PIREP for oxygen system needing to be serviced. During the process of servicing; another mechanic reminded me to review the logbook for prior repeat items. After the servicing was complete; I made a logbook review and found that on the duty day prior a work scope from maintenance control was worked for oxygen system leakage. Now alerted to the fact that this was a repeat; maintenance control was contacted directly and I was initially told that the problem was known and that it is to overnight in ZZZ1 that night and was acceptable to sign the logbook as serviced the oxygen system and allow the aircraft to continue in service. Questioning this course of action due to the nature of the reoccurring item I was then given a name and payroll number of mr X in maintenance control to include in the corrective action. Verbiage given to include in the corrective action block was: 'under the direction of maintenance control; work scope is in progress and aircraft is ok for service per mr X maintenance control repeat control.' further questioning this procedure; the maintenance controller xferred the call to mr X directly. In talking with mr X; he assured me that this was a valid procedure according to the gpm and if any problems had arisen he was responsible; and not myself. Not wanting to delay a now loaded aircraft any longer; I relented and did as instructed and released the aircraft with given verbiage and amm reference. Returning from my days off; I notice that a mechanic is preparing to service the oxygen system on aircraft. I then performed a logbook review and found that on a subsequent page; a discrepancy for oxygen system needing servicing and very similar corrective action to the one I made. The corrective action contained a different name and payroll number from my previous encounter. In a discussion with my crew chief about this ongoing item he had contacted maintenance control and they assured him that the aircraft in question was to overnight in ZZZ1 that night and the work scope was being compiled. Maintenance control again instructed the return to service of the aircraft.callback conversation with reporter revealed the following information: the reporter was assured the airplane was routed for an overnight repair. The reporter stated two days later on returning from days off; the same airplane arrived with a logbook on crew oxygen service required. The logbook was reviewed and the same identical signoffs were in the book for servicing with endorsements from maintenance operations with different names and payroll numbers. The airplane was in service for 2 to 3 days with no leak correction.
Original NASA ASRS Text
Title: AN SF340 WAS DISPATCHED WITH SEVERAL DAYS OF LOGBOOK ENTRIES LISTING CREW OXYGEN BEING SERVICED AND AUTHORITY FROM MAINT OPS TO CONTINUE IN SVC FOR OVERNIGHT LEAK CORRECTION.
Narrative: SAAB 340B ARRIVED AT GATE WITH A PIREP FOR OXYGEN SYSTEM NEEDING TO BE SERVICED. DURING THE PROCESS OF SERVICING; ANOTHER MECHANIC REMINDED ME TO REVIEW THE LOGBOOK FOR PRIOR REPEAT ITEMS. AFTER THE SERVICING WAS COMPLETE; I MADE A LOGBOOK REVIEW AND FOUND THAT ON THE DUTY DAY PRIOR A WORK SCOPE FROM MAINT CTL WAS WORKED FOR OXYGEN SYSTEM LEAKAGE. NOW ALERTED TO THE FACT THAT THIS WAS A REPEAT; MAINT CTL WAS CONTACTED DIRECTLY AND I WAS INITIALLY TOLD THAT THE PROB WAS KNOWN AND THAT IT IS TO OVERNIGHT IN ZZZ1 THAT NIGHT AND WAS ACCEPTABLE TO SIGN THE LOGBOOK AS SERVICED THE OXYGEN SYSTEM AND ALLOW THE ACFT TO CONTINUE IN SVC. QUESTIONING THIS COURSE OF ACTION DUE TO THE NATURE OF THE REOCCURRING ITEM I WAS THEN GIVEN A NAME AND PAYROLL NUMBER OF MR X IN MAINT CTL TO INCLUDE IN THE CORRECTIVE ACTION. VERBIAGE GIVEN TO INCLUDE IN THE CORRECTIVE ACTION BLOCK WAS: 'UNDER THE DIRECTION OF MAINT CTL; WORK SCOPE IS IN PROGRESS AND ACFT IS OK FOR SVC PER MR X MAINT CTL REPEAT CTL.' FURTHER QUESTIONING THIS PROC; THE MAINT CTLR XFERRED THE CALL TO MR X DIRECTLY. IN TALKING WITH MR X; HE ASSURED ME THAT THIS WAS A VALID PROC ACCORDING TO THE GPM AND IF ANY PROBS HAD ARISEN HE WAS RESPONSIBLE; AND NOT MYSELF. NOT WANTING TO DELAY A NOW LOADED ACFT ANY LONGER; I RELENTED AND DID AS INSTRUCTED AND RELEASED THE ACFT WITH GIVEN VERBIAGE AND AMM REFERENCE. RETURNING FROM MY DAYS OFF; I NOTICE THAT A MECHANIC IS PREPARING TO SVC THE OXYGEN SYSTEM ON ACFT. I THEN PERFORMED A LOGBOOK REVIEW AND FOUND THAT ON A SUBSEQUENT PAGE; A DISCREPANCY FOR OXYGEN SYSTEM NEEDING SERVICING AND VERY SIMILAR CORRECTIVE ACTION TO THE ONE I MADE. THE CORRECTIVE ACTION CONTAINED A DIFFERENT NAME AND PAYROLL NUMBER FROM MY PREVIOUS ENCOUNTER. IN A DISCUSSION WITH MY CREW CHIEF ABOUT THIS ONGOING ITEM HE HAD CONTACTED MAINT CTL AND THEY ASSURED HIM THAT THE ACFT IN QUESTION WAS TO OVERNIGHT IN ZZZ1 THAT NIGHT AND THE WORK SCOPE WAS BEING COMPILED. MAINT CTL AGAIN INSTRUCTED THE RETURN TO SVC OF THE ACFT.CALLBACK CONVERSATION WITH RPTR REVEALED THE FOLLOWING INFO: THE RPTR WAS ASSURED THE AIRPLANE WAS ROUTED FOR AN OVERNIGHT REPAIR. THE RPTR STATED TWO DAYS LATER ON RETURNING FROM DAYS OFF; THE SAME AIRPLANE ARRIVED WITH A LOGBOOK ON CREW OXYGEN SVC REQUIRED. THE LOGBOOK WAS REVIEWED AND THE SAME IDENTICAL SIGNOFFS WERE IN THE BOOK FOR SERVICING WITH ENDORSEMENTS FROM MAINT OPS WITH DIFFERENT NAMES AND PAYROLL NUMBERS. THE AIRPLANE WAS IN SVC FOR 2 TO 3 DAYS WITH NO LEAK CORRECTION.
Data retrieved from NASA's ASRS site as of January 2009 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.