37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 736474 |
Time | |
Date | 200704 |
Local Time Of Day | 0001 To 0600 |
Place | |
Locale Reference | airport : zzz.airport |
State Reference | US |
Altitude | agl single value : 0 |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | B767-300 and 300 ER |
Operating Under FAR Part | Part 121 |
Person 1 | |
Affiliation | company : air carrier |
Function | maintenance : technician |
Qualification | technician : airframe technician : powerplant |
Experience | maintenance lead technician : 17 maintenance technician : 22 |
ASRS Report | 736474 |
Events | |
Anomaly | aircraft equipment problem : critical maintenance problem : improper documentation maintenance problem : improper maintenance non adherence : published procedure non adherence : far |
Independent Detector | other other : 1 |
Resolutory Action | none taken : detected after the fact |
Consequence | other |
Factors | |
Maintenance | contributing factor : schedule pressure contributing factor : briefing performance deficiency : inspection performance deficiency : testing performance deficiency : repair performance deficiency : non compliance with legal requirements performance deficiency : logbook entry performance deficiency : installation |
Supplementary | |
Problem Areas | Aircraft Maintenance Human Performance |
Primary Problem | Maintenance Human Performance |
Narrative:
On apr/mon/07 I stayed at work for a 4-HR holdover to install a slide pack on door 1R of aircraft X. I worked this slide installation with another mechanic. The slide had been ordered and was already on the flatbed at the aircraft for installation. I do not know who ordered the slide pack and the slide to be replaced was already removed from the aircraft due to deployment. I remember the other mechanic and the inspector discussing the part number for the slide. I assumed that the part number was correct as this was the topic of the conversation I overheard. I don't recall checking the part number myself. I was informed at a later date that the slide pack installed on door 1R on aircraft X was the wrong part number. I will never again trust others checking any part numbers. Also; whoever ordered the slide was not cognizant of the proper effectivity of the slide. The wrong slide was sent planeside for me to install and I installed it. I will not be so trusting in the future.
Original NASA ASRS Text
Title: A B767-300 ACFT DOOR 1R ESCAPE SLIDE WAS REMOVED DUE TO A DEPLOYMENT AND REPLACED WITH AN INCORRECT SLIDE.
Narrative: ON APR/MON/07 I STAYED AT WORK FOR A 4-HR HOLDOVER TO INSTALL A SLIDE PACK ON DOOR 1R OF ACFT X. I WORKED THIS SLIDE INSTALLATION WITH ANOTHER MECH. THE SLIDE HAD BEEN ORDERED AND WAS ALREADY ON THE FLATBED AT THE ACFT FOR INSTALLATION. I DO NOT KNOW WHO ORDERED THE SLIDE PACK AND THE SLIDE TO BE REPLACED WAS ALREADY REMOVED FROM THE ACFT DUE TO DEPLOYMENT. I REMEMBER THE OTHER MECH AND THE INSPECTOR DISCUSSING THE PART NUMBER FOR THE SLIDE. I ASSUMED THAT THE PART NUMBER WAS CORRECT AS THIS WAS THE TOPIC OF THE CONVERSATION I OVERHEARD. I DON'T RECALL CHKING THE PART NUMBER MYSELF. I WAS INFORMED AT A LATER DATE THAT THE SLIDE PACK INSTALLED ON DOOR 1R ON ACFT X WAS THE WRONG PART NUMBER. I WILL NEVER AGAIN TRUST OTHERS CHKING ANY PART NUMBERS. ALSO; WHOEVER ORDERED THE SLIDE WAS NOT COGNIZANT OF THE PROPER EFFECTIVITY OF THE SLIDE. THE WRONG SLIDE WAS SENT PLANESIDE FOR ME TO INSTALL AND I INSTALLED IT. I WILL NOT BE SO TRUSTING IN THE FUTURE.
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.