Another A32x engine cowling ?

[atakacs]

Yesterday in Milano (Milano to Lisbon flight):

http://www.20min.ch/dyim/5a32dc/B.M600,1000/images/content/2/4/6/24685718/3/topelement.jpg

Apparently during takeoff roll ?

[fox niner]

Malpensa or linate?

[atakacs]

Malpensa flight EZY2715

more pics here (http://www.tio.ch/News/749634/I-passeggeri-hanno-iniziato-ad-urlare-c-e-un-ala-rotta/Immagini)

[Mick Stability]

Interesting that it's a CFM this time.

[DaveReidUK]

The Italian report linked above quotes a passenger as saying that part of the cowl was lost on takeoff, with a further piece becoming detached on touchdown.

[Flightmech]

As Mick said. CFM56 this time rather than V2500

[Sky Wave]

Also interesting that it wasn't 1st flight of the day.

[DaveReidUK]

Also interesting that it wasn't 1st flight of the day.Fifth sector of the day, having earlier operated rotations from Malpensa to Lamezia Terme and Corfu, arriving back from CFU a couple of hours before the departure for Lisbon.

[J.O.]

It doesn't have to be prior to the first sector to have maintenance open a cowling before departure.

[TURIN]

Cue screaming headline of lowcost airlines cutting corners nonsense.

Oh well, 34 reported cowl losses and counting.
At least this one won't be a write off.

[superq7]

When I was an a/c inspector we had to do duplicate inspections of flight safety items, does this not happen anymore?

[Dry wretched thunder]

Is the BA aircraft with the double cowling failure back in service ??

[BOAC]

Plenty of time for a 'daily'.........

Are the CFM cowling fasteners the same as the V2500 - ie are they 'Airbus' parts or engine parts?

[Off Stand]

Not yet Dry wretched thunder, still under repair at LHR. Could be in the hangar for another 3-4 weeks I believe.

[DaveReidUK]

Are the CFM cowling fasteners the same as the V2500 - ie are they 'Airbus' parts or engine parts?Both the IAE and CFM cowls are made by Rohr (now part of Goodrich) and are technically airframe parts and therefore Airbus's responsibility.

[Dannyboy39]

Do EZY use CFM56s exclusively or do they also operate IAE V2533s?

[babotika]

CFM56 only.

[champair79]

Is the BA aircraft with the double cowling failure back in service ??

Repairs should be completed on 17th Aug. May have to do a test flight to confirm everything is working properly. May also have to be repainted. Can't confirm the repaint though.

[matkat]

Superq7, yes duplicate inspections are still carried but on what is deemed 'safety critical' items, engine cowlings do not fall into this category.

[Peter G-W]

As told to me by an engineer, the advantage of the CFM cowl is that, unlike the V2500, the latches can only be closed flush when the doors are closed. Therefore an unlocked door must, by design, have its catches protruding. On the V2500, the latches can be closed whatever the position of the door. Indeed it is (was?) common practice to close the latches on opened V2500 doors to avoid walk-by injuries. Thus the CFM should be much easier to check on the pre-flight walk round.

[DaveReidUK]

The other critical difference between the two engine cowls is that, when unlatched, the CFM cowl door sits with a noticeable gap around the forward and aft edges of the door, sufficient to insert your fingers and pull the unlatched door open.

The V2500, on the other hand, has a smaller gap (which you can't get your fingers into) when unlatched, such that it's usually necessary to pull on the bottom edge of the door to open it. The smaller gap, of course, is easier to miss, as events have shown.

See

Airbus A320 (CFM56) Opening and Closing of Engine Cowl Doors - YouTube

and

Airbus A320 (V2500) Opening & Closing of Engine Cowl Doors - YouTube

(around 2:15 on both videos)

[TURIN]

Superq7, yes duplicate inspections are still carried but on what is deemed 'safety critical' items, engine cowlings do not fall into this category.

They do if its a V2500.

[peakcrew]

Having expressed discontent elsewhere about the 787, I can now even things up by saying that it is unacceptable that this keeps happening on Airbuses. It is a known problem that, as I understand it, can and should be checked for prior to moving the plane. There is a lot of worrying negligence being shown.

[BARKINGMAD]

"There is a lot of worrying negligence being shown"........................

As also there is a lot of worrying fatigue, overstretch, undermanning and 'sweating' of resources being highlighted in CHIRP and elsewhere.

So PLEASE, before the armchair designers start inventing microswitch activated alerting systems, warning flags, completely new latches etc, can we just keep this ever present common cause of incidents and accidents prominently on the table?

Then maybe the xAAs various may be forced to confront their inaction and timidity in NOT facing up to big business as we pay them big bucks to SUPERVISE on our behalf, whether we are taxpayers or licence-holders!

FATIGUE yet again springs to mind reading of the tragic UPS crash in USA, but the word and the existence of the problem appears to be the elephant in the room which nobody wants to discuss.

And still the awful EASA regs bubble away in the EU cauldron, ready to make the likelihood of HF incidents/accidents MORE likely.

[peakcrew]

@Barking: I'm not sure if you are agreeing or disagreeing with me! However, yes, this is what I meant - the people with final responsibility for ensuring that the aircraft are safe are failing. Whatever the reason, it is negligence on the part of all, from the airline CEOs to the people on the ground. What proportion of this collective negligence needs to be allocated where is for discussion, but the fact is unchanged.

Like you, I see fatigue in a lot of recent incidents. A relevant question, though, is whether technology (micro-switches or whatever) could help to reduce the impact of fatigue.

[fenland787]

There is a lot of worrying negligence being shownAs opposed to non-worrying negligence presumably?

But, yes I do think technology can help overcome the effects of under-manning and fatigue but I'm not sure that is necessarily a good thing.
The more people rely on that, the greater the risk of something very bad happening when the technology fails - which it will - and if the human beings are not ready and in a condition to do what human beings are great at, namely look at a bunch of weird and unexpected stuff going on and figure out quickly what to do about it, then some folk are likely to have a bad day.

Unfortunately as more and more companies that rely on technology, and I'm not talking just airlines here, are run by people who don't have a grasp of that fact (or indeed of the technology they are in charge of) the greater the risk of things going bad.

But, hey, I'm an engineer, what would I know?

[BARKINGMAD]

Fenland787 but, hey, I'm just an old pilot, what would I know?

Unless we've got a MBA in Underwater Basket-Weaving, neither of us is qualified nor suitable to manage, or even to advise the current crop of bean-counting whizz-kids, as to desirable ways of achieving the task without endangering lives.

And of course lives are priced, as seen in the projected freighter accident rates quoted in the UAE 747F LI-Ion batteries accident report.

So we'll all carry on like creatures from the film "Metropolis" hoping it wont be our :mad:, or the :mad: of a loved one or colleague which get burnt.

And all the time the mealy-mouthed responses of the CAA and other AAs can be read in the pages of CHIRP and elsewhere.


And we can watch as our elected representatives look on idly whilst EASA FTLs are drafted and enacted without a single qualified aircrew member in the midst of those movers and shakers.


Time to take out and dust off those copies of "The Tombstone Imperative"?


But then we should not have joined if we couldn't take a joke, what??

[Speed of Sound]

A relevant question, though, is whether technology (micro-switches or whatever) could help to reduce the impact of fatigue.

Of course it can, but surely it is better to reduce or eliminate the incidence of fatigue?

When the :mad: hits the fan and the technology lets you down, a fatigued mind is the last thing you need.

[matkat]

Turin, sorry but they don't safety critical items are control rods flight, controls etc. Not engine cowls, it is perhaps a recomendation or a maintenance manual requirement but is NOT a mandated requirement. I have been a line engineer for over 35 years and have never seen a duolicate inspection required for an engine cowl. The main reason that the safety critical item is rarely required is so as not to degrade the check and leave it for items that can affect the aircraft performance/handling.

[vs69]

The cowls falling off the BA A320 seemed to affect its performance so I think its fair to say the long standing Dupes that are called for on V2500 fan cowls are a fair shout.

But yes I hear what you are saying that you do not want to degrade the significance of the check lest you end up needing a dupe on a seat cushion change....

[matkat]

VS, exactly my point.

[TURIN]

At least one UK Airbus operator demands a second inspection, signed off in the log in the same manner as a 'Dupe'.

They call it a Verification Check as it can be certified by two 'A' Licenced Technicians as opposed to a Duplicate (or Secondary) Inspection which, as far as I know, requires two 'B' Licenced Engineers.


This was introduced on the V2500 Airbus fleets after a number of operators had reported cowl losses.

[Epsomdog]

My own employer has mandated "Dual" inspection of all engine cowlings, for security and closure. On all company types, ie. A330 (CF6) A320 (CFM) & B737. This procedure has been in place for at least the last 10 years.

Surely, this is just good engineering practice!

[matkat]

ED I agree with you it is indeed good engineering practice however where does it stop? Dual inspections are there for a certain purpose and not just for anything, surely it is enough that a licensed type rated engineer should reasonably be expected to carry out this task without the need for duplicates?
When I worked the line (QA office now:=) we always closed and latched the cowls as soon as the task was finished that required you to open them in the first place. The cowls on the JT9 were the worst design you could imagine and frequently were lost in flight even though they were closed properly:ugh:

Turin, what an Operator demands is entirely up to them but that is not what we are talking about we are talking about mandatory duplicate inspections.

[Speed of Sound]

But yes I hear what you are saying that you do not want to degrade the significance of the check lest you end up needing a dupe on a seat cushion change....

Yes, but a check list doesn't exist in a vacuum, it exists for a real-world purpose.

Changing how the cowlings are checked in response to a known, ongoing problem with certain aircraft/engine combinations would lead to an overall improvement in safety.

Surely that outweighs any 'degrading of significance' of the check?

surely it is enough that a licensed type rated engineer should reasonably be expected to carry out this task without the need for duplicates?

But recent events show that this isn't happening. :(

[TURIN]

matkat

Superq's original post..

When I was an a/c inspector we had to do duplicate inspections of flight safety items, does this not happen anymore?

No mention of 'mandatory'.

Your response...

Superq7, yes duplicate inspections are still carried but on what is deemed 'safety critical' items, engine cowlings do not fall into this category.

Still no mention of a mandate.

The point is this, engine cowlings are a safety critical item....now. They may not have been but experience has shown that they are. My understanding of the BA a/c, for example, is that it was very nearly an insurance write off due to the effect the fire had on adjacent structure. An annealed wing is not what we want now is it?

Just to avoid any confusion. This is not a personal attack on matkat, just healthy debate. :ok:

[matkat]

Turin I do not take it personally as I do not make the rules only enforce and adhere. Until an applicable NAA MANDATE the cowl latching duplicate inspection it is at least in the eyes of the authority not a safety critical item, it is the NAA that mandates not an individual operator, however see my previous post in which I state that if the operator wants to include cowl checks on their pre-departure checklist then it is entirely up to them but nevertheless it is an 'over and above' requirement.

[bugg smasher]

FWIW, at my airline an additional layer of safety is achieved by the pilot preflight inspection, cowl latch security is considered a significant item on the walk around, for all the reasons mentioned above.

[rmm]

Add another to the list.

Florida-Bound Plane Returns To O?Hare After Engine Cover Falls Off « CBS Chicago (http://chicago.cbslocal.com/2013/11/09/plane-returnsto-ohare-after-engine-falls-off/)

[LiveryMan]

Oops!
I think MX crews need to be re-educated in the importance of closing those pesky latches!

[Max Angle]

And flight crews re-educated as to the importance of checking they are locked before going flying.

[Cows getting bigger]

... and manufacturers need to be re-educated as to the design of systems and human fallibility. :)

[Cough]

Hopefully in time we will see a microswitch retrofitted to cowl latch and a nice ECAM 'ENG 1/2 cowl open' when the engineer helps you out...

[jossurf]

Cough:
Hopefully in time we will see a microswitch retrofitted to cowl latch and a nice ECAM 'ENG 1/2 cowl open' when the engineer helps you out...

I should like to think engine cowlings can be aerodynamically designed in such a way as not to be able to open during flight.
Moreover what is wrong with a REMOVE BEFORE FLIGHT tag on the latches?

[Basset hound]

The number of this type of incidents cause me to be embarrased for Maintenance staff world-wide. These cowls are opened ONLY by Maintenance staff; and it is the responsibility of an Engineer to ensure those cowls get closed & latched after said opening.

[Volume]

...and there are 4 of them. I can understand if you forget to lock one, or miss to check one during walkaround. But to completely forget to lock any of them or to completely miss to check all of them is just another indicator for where we are heading for, if cost is our highest priority.

[Non-Driver]

...and there are 4 of them. I can understand if you forget to lock one, or miss to check one during walkaround. But to completely forget to lock any of them or to completely miss to check all of them is just another indicator for where we are heading for, if cost is our highest priority.

Since the cowls lock together as a pair, it is not possible leave an odd number unlocked. I was also under the impression this was 2 cowls not 4 this time.

Believe me, Maintenance folks don't deliberately fail to follow procedures, it is a repetitive mundane / easily distracted function performed thousands of times per day all over the world and the error is always classic Human Factors. There is nothing to do with cost saving. It is down to the authorities and Airbus's sadly lacking will to correct the design with any great urgency. Airbus's standard response is always "didn't follow procedures".

[tdracer]

Are they failing to actually latch the latches? Or are the latches not being latched "properly"?

I was under the impression it was the later....:confused:

[DaveReidUK]

They are either latched or not. There is no "latched, but not latched properly" configuration.

Yes, the handles can be pressed flush without the hooks being engaged at all, but that's not the same thing.

[Dannyboy39]

Correct me if I'm wrong, but didn't Rohr (or indeed Airbus?) release a VSB, so it was easier to determine whether the latch was insecure? Paint the latch in orange or another high contrast colour?

[DaveReidUK]

The latch design, mods, etc (on both CFM and IAE engines) were extensively discussed in this thread following the BA A319 cowl separation:

http://www.pprune.org/rumours-news/515531-incident-heathrow.html

[fenland787]

so it was easier to determine whether the latch was insecure? Paint the latch in orange or another high contrast colour? Not sure that helps, I seem to recall a post on a much earlier thread about this issue that the problem was that when the cowls were open the dangling latch was a nuisance and was sometimes pushed flush to get it out of the way. Then the cowls get closed but unless someone immediately opens the latch, engages and re-latches them it can appear to a quick glance that all is closed and latched whereas they aint.

Have to say it sounds to me like the latch design is the problem here, classic Human Factors issue?

[PAXboy]

This Spirit 319, do we know which engines?

[west lakes]

do we know which engines?

V2524 according to Av Herald

[Wirelock]

Maintenance companies need to do more to prevent these events. Saying that this is down to human factors is really only relevant if the company involved analyze where the break down happened and resolve the issue.
In my opinion this is down to poor maintenance standards and a failure of the organisation to prevent a well publicized and preventable event.
I would think that in the majority of similar cases the same would apply.

[fenland787]

Saying that this is down to human factors is really only relevant if the company involved analyze where the break down happened and resolve the issue. Generally, for an isolated incident I would agree. However in this case with this frequency of the issue, across several different organizations, I feel the 'once is happenstance, twice is coincidence but three times is enemy action' rule applies! The 'enemy action' in this case is poor latch design.

[Volume]

Since the cowls lock together as a pair, it is not possible leave an odd number unlocked. I was also under the impression this was 2 cowls not 4 this time. Yes it is 2 cowls locked against each other by 4 locks. Probably locking and latching just one (the forward one) would be enough to fly safely...
The 'enemy action' in this case is poor latch design.Not too sure about that. If a design is known to be poor, it should normally get special attention by the mechanics. However, it looks more like it gets no attention at all.
Anyway I agree that a latch in a dirty location where you have to knee down to get to it is poor. But it is hard to design it any other way, if you want gravity to close the doors so that the latching can be done by a single person, then this is the only possible design. You may move the handles to the side of the cowling where it can easily be reached and checked and actuate the locks by bowden cable, but that would just create new failure causes. (at the moment these are KISS latches...)

I think the key here is knowledge and attention.

[PAX_Britannica]

Whoopsie. Here we go again.

Certain historical aircraft designs have succeeded in both eliminating the risk of loose cowlings damaging control surfaces, stabilisers, and/or engine subsystems, and reducing maintenance workloads. We should learn from the lessons of the past.

A careful comparison of the foreground and background aircraft in the picture linked below perhaps illustrates my point.
http://www.trimotors.awiggins.com/images/Ford414Hand707atSFO.jpg

In the automotive industry, it has long been recognised that uncommanded opening of engine cowlings can lead to an sudden and disorienting loss of visual references - often abruptly followed by uncontrolled impact with terrain.

To this end, automotive designers have created double cowling locking mechanisms, combined with sprung cowlings, such that if at least one locking mechanism is not engaged, the cowling springs open, and the absence of locking is immediately apparent, except perhaps in conditions of extremely poor visibility.

[fenland787]

It would not be difficult to arrange the latch such that it cannot be moved to the 'latched' position unless it was correctly mated with the other half.. That way even a quick glance would show the thing was not latched.

[Epsomdog]

All of these issues would be of no consequence if the engineer closing the cowls did so correctly! The latches have not been proven to be faulty, ie. open, having been closed correctly.

Cowls should be either open on stays, or fully closed and latched!

It is madness to drop the cowls off the stays and say to yourself ill latch those later!

It requires a discipline and mindset that I'm afraid is not, nowadays, brow beaten into you during the modern abbreviated apprenticeships.

I'm not sure even Human Factors can be used as an excuse. Allowing yourself to be distracted during a critical task borders on negligence! Pilots don't go for a p on finals do they?

[fenland787]

Pilots don't go for a p on finals do they?Unless it's going really badly?

[slip and turn]

Pilots don't go for a p on finals do they?Who would know? Is there even evidence they have legs or get out much anymore? Discipline and mindsets - now there's an idea.

[Volume]

Well discipline might be a concept of the past. Forcing somebody to do the right thing may be replace by the more human approach of educating and motivating him.
on second thought discipline might be the cheaper way...

[TURIN]

It's all about the mindset of the engineer!
All of these issues would be of no consequence if the engineer closing the cowls did so correctly! The latches have not been proven to be faulty, ie. open, having been closed correctly.

Cowls should be either open on stays, or fully closed and latched!


The a/c operator demands an on time departure, its quicker to open them, have a quick look, drop them back down, besides, you're on your own and its tricky/dangerous to try and put the stays in on your own. You need to open them again in a minute anyway so you just leave them like that for now.

It's all about the mindset of the engineer!


It is madness to drop the cowls off the stays and say to yourself ill latch those later!


You've just dropped the cowls down and are about to latch them....

Enter dispatcher,
"Eng? The captain wants you and we are holding boarding until he speaks to you, by the way we have a slot and the crew go out of hours in 30 mins. "

Enter refueller..

"Eng? The total fuel has stopped short by about 500 kilos and I've got a dash 8 on a quick turn round screaming for fuel!"

Enter loading supervisor...
"Eng? The aft cargo door won't close"

Ring ring..
"Allo, MCC here, the xyz123 will be with you in five minutes with a bev maker leaking all over the fwd galley, it will need a zonal inspection in the avionics bay"

That is not an exaggeration.

It's all about the mindset of the engineer!


It requires a discipline and mindset that I'm afraid is not, nowadays, brow beaten into you during the modern abbreviated apprenticeships.



Perhaps, but it can also be brow beaten out of you by non technical aviation "professionals" who have no concept of the consequences when interrupting any maintenance task (or even a flight deck briefing).

When driven by performance related pay and an on time departure is a must, some just really do not care.

I make no excuses, just trying to offer a more realistic point of view.

There for the grace of... etc.

[DaveReidUK]

besides, you're on your own and its tricky/dangerous to try and put the stays in on your ownOn an A320/737 ?

How so ?

[Ian W]

You've just dropped the cowls down and are about to latch them....

Enter dispatcher,
"Eng? The captain wants you and we are holding boarding until he speaks to you, by the way we have a slot and the crew go out of hours in 30 mins. "

Enter refueller..

"Eng? The total fuel has stopped short by about 500 kilos and I've got a dash 8 on a quick turn round screaming for fuel!"

Enter loading supervisor...
"Eng? The aft cargo door won't close"

Ring ring..
"Allo, MCC here, the xyz123 will be with you in five minutes with a bev maker leaking all over the fwd galley, it will need a zonal inspection in the avionics bay"

That is not an exaggeration.



Interrupted checks are always dangerous. So it is not the engineer that is causing the problem it is the people repeatedly interrupting that are doing so.

This is a management issue (not as in 'the management' but as in managing the jobs)

Each of those interrupts has differing levels of priority. Rather then the meanest or most friendly obtaining priority the jobs should be added to the engineer job list. Any direct tasking access to the engineer should be avoided, he should finish the job and associated checks then access his job-list to find the next highest priority job. Emergency interrupts to a job should be treated as the job being marked not-started so that there is no 'half finished' job.

Forcing this level of management discipline actually forces 'The Management' to realize when they are overtasking. Managing job allocation is simple with the current information systems and the engineer does not take random inputs just says to the captain, the loading supervisor, the refueller - "put the task on the list with maintenance and they might allocate someone else who is not in the middle of a job."

[TURIN]

Ian W
Managing job allocation is simple with the current information systems and the engineer does not take random inputs just says to the captain, the loading supervisor, the refueller - "put the task on the list with maintenance and they might allocate someone else who is not in the middle of a job."

In an ideal world Ian I would agree with you. However, on a line station, at night when there's perhaps only one or two on shift its a different story.

DaveReid

Quote:
besides, you're on your own and its tricky/dangerous to try and put the stays in on your own
On an A320/737 ?

How so ?

It's windy? You may have a chronic back injury. It may be -10c and you've lost all feeling in your fingers. who knows?

[Ian W]

Ian W


In an ideal world Ian I would agree with you. However, on a line station, at night when there's perhaps only one or two on shift its a different story.



Then the 'management' have to accept the responsibility for putting place a flight safety hazard and the occasional incident caused by interruption of engineering checks. The problem being the 'only one or two on shift' and no organized method of 'tasking'.

[sb_sfo]

Yeah, good luck with that. Something similar is happening in medicine--to reduce errors, nurses that are doing meds are now wearing a "don't talk to me" button while they are doing meds so they don't get sidetracked. Don't know how well it's working.

[Chris Scott]

TURIN's scenario rings very true to me. Yet, until I retired from A320s years ago, I led a comparitively sheltered existence - enjoying longer scheduled turnrounds than the budget carriers, and a mangement that tolerated safety as a higher priority than punctuality.

In the early days, we had only CFMs. As a specialist line-checker, one of my concerns when observing external checks was to confirm that the cowling latches were properly observed as being flush with the nacelle. This can only be done by stooping low, and using a torch at night. my reports often reminded crews that the unlatched fan cowlings hang very low and close.

However short the turnround, the flight crew should check them after any engineering work - even if it's just a routine change of the chip-detectors. If that involves a pilot leaving the cockpit after the last of the pax have boarded, it's not going to delay departure more than 5 minutes at the most on an A319. And no engineer worth his salt would be offended by the flight crew completing a check that is one of its listed responsibilities.

[Epsomdog]

The a/c operator demands an on time departure, its quicker to open them, have a quick look, drop them back down, besides, you're on your own and its tricky/dangerous to try and put the stays in on your own. You need to open them again in a minute anyway so you just leave them like that for now.

Exactly the kind of thing you need to avoid! That "for now" moment. Is the moment when you may be distracted. Best to not let that moment occur in the first place. It only takes 30sec to latch the cowls!

Each of those interrupts has differing levels of priority. Rather then the meanest or most friendly obtaining priority the jobs should be added to the engineer job list. Any direct tasking access to the engineer should be avoided, he should finish the job and associated checks then access his job-list to find the next highest priority job. Emergency interrupts to a job should be treated as the job being marked not-started so that there is no 'half finished' job.

I agree Ian

I recently had a dispatcher carry a tech log across from another aircraft, whilst I was changing a brake unit.

"I only need a quick signature"! He said.
":mad:"
He soon went off with his tail between his legs!:)

[DaveReidUK]

Without wishing to be a killjoy, I haven't seen anything in this thread that hasn't already been covered in the 1000+ posts following the BA A319 incident.

[Chris Scott]

Dave,

Does that include your own contributions? ;)

[md80fanatic]

Put the hinges on the bottom and the latches on top. :}

[DaveReidUK]

Does that include your own contributions?I was waiting for someone to ask that. :O

But yes, I'm as guilty as anyone else of simply rehashing what has already been discussed at length following the BA event.

[Ron Herb]

With the fan cowl doors formerly, if not still, subcontracted to Bombardier Belfast.