A PLANE carrying 70 flight crew and passengers left Perth Airport without full stopping power after maintenance was performed incorrectly.
An Australian Transportation Safety Bureau (ATSB) investigation found a wrong part used during work on an engine was left in when the Fokker F100 took off.
The incorrect part rendered one of the two engine thrust reversers – which help airplanes slow down on landing – inoperative. The Fokker was able to decelerate using normal braking when it landed at Karratha on December 27, 2017.
The ATSB found that during an inspection of the aircraft engines’ emergency fuel shut-off cables, a maintenance engineer installed the incorrect lockout bolt to safely isolate the thrust reverser mechanism and then did not remove it once the job was done.
Its investigation found the engineer used a more conveniently located part from the aircraft’s flight deck for the task, instead of the appropriate part, which had a large red warning flag and had to be checked out of the tool store.
As a result, the lock-out bolt did not show as missing during an inventory check.
There were no warning labels in the cockpit to warn the flight crew that the bolt may be installed.
“This investigation highlights the risks of varying from procedures when performing maintenance tasks,” ATSB transport director Stuart Macleod said.
“It is important that in all parts of the maintenance system, there is an awareness of human factors. “
The maintenance organisation has highlighted to its staff at the Airport the importance of following safety instructions and warnings in the aircraft maintenance manual.
It has also reinforced procedures for maintenance activities, including task assessments.
This is the third incident in three years where maintenance engineers have inadvertently left lockout bolts installed in passenger aircraft engines after maintenance.
An ATSB diagram showing the location of the lockout bolt.