United finds loose bolts on plug doors during 737 Max 9 inspections
theaircurrent.com
theaircurrent.com
Unfortunately, Boeing did not know they had other issues with the plug door bolts.
Especially since most shops have pretty much tossed professional career QA out the window.
Retraining has its own problems. No matter how well retraining is done, pilots still make mistakes from doing the right thing for the previous plane that is the wrong thing for the one they are currently flying.
Adjusting airplanes to fly the same way is a major safety advantage.
Unreported by the media, there was another MAX incident before the first crash. The crew had no knowledge of MCAS, but did follow the emergency runaway trim procedure, and continued the flight and landed safely.
Turn off the motor, and the trim is manual. There is a crank right there in the cockpit. If it is too hard to turn, change aircraft configuration to reduce the forces required to. Pilot know how to do this. This pilot stuff, they understand the forces on the flight controls and what impacts them.
Boeing made an engineering mistake. The pilots also made an operational mistake. Unfortunately, both mistakes at the same time were fatal.
I pray that pilot training has improved. And that Boeing has made systems level changes to the aircraft that will preclude it happening in the future.
And that is how aviation becomes safer every year; at a significant cost of customers lives.
"Significant" might be inaccurate.
It looks like FAA Part 121 accidents over the last 10 years with fatalities have been... 4. [0]
For a total of 6 fatalities.
[0] https://www.ntsb.gov/Pages/AviationQueryV2.aspx; 2018 (1 passenger fatality) https://www.ntsb.gov/investigations/Pages/DCA18MA142.aspx ; 2019 (3 crew fatalities, cargo flight) https://www.ntsb.gov/investigations/Pages/DCA19MA086.aspx and (1 passenger fatality) https://www.ntsb.gov/investigations/Pages/DCA20MA002.aspx ; 2022 (1 ramp fatality) https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/G...
I'm sure there's been a study somewhere that attempts to untangle all the factors that differ between commercial carriers and GA, to see which safety is most sensitive to -- continuous highly professional maintenance, highly trained and experienced crew, rigorous airliner certification regime, etc.
> The probable cause of this accident was the inappropriate response by the first officer as the pilot flying to an inadvertent activation of the go-around mode, which led to his spatial disorientation and nose-down control inputs that placed the airplane in a steep descent from which the crew did not recover.
Also, overspeeding the airplane makes it much harder to turn the manual trim wheel. The cockpit voice recorder on the EA flight recorded the overspeed warning horn, which the crew did nothing about (they were at full power, should have pulled the throttles back).
The LA crew restored normal trim twenty-five times before crashing. What they never did was turn it off after restoring normal trim.
What Boeing did (and is STILL doing) is expect pilots to know or remember obscure NON-PILOTAGE (and in the case of MCAS, BURIED) trivia to prevent disaster.
Now... what's the more-responsible approach? Expect pilots to pilot, or expect them to recall an ever-growing list of workarounds to incompetent system design?
Is that what you meant by "the problem wasn't the software?" Because the pilots should have been trained to unplug the computer to stop it from crashing the plane?
Afaic, the fault apportionment was Boeing documentation > airlines >> pilots > Boeing technical design.
Edit: Also, how does the fault lie with the airlines? Boeing didn’t document the existence of MCAS in the flight manual or training materials.
>> Because the pilots should have been trained to unplug the computer to stop it from crashing the plane?
Yes.
The fault lies with the airlines because I don't for a second believe they didn't put pressure on Boeing to get the MAX certified without mandating retraining.
And then once that was done, didn't dig into the details too hard about what changes were made.
I have a low tolerance for 'I set up all the conditions and incentives to encourage you to break the law... but you should take all the blame when it explodes.'
At some point, the customer has to take some responsibility for what they asked for.
If you listen to podcasts, these two episodes of Causality are excellent:
https://engineered.network/causality/episode-33-737-max/
https://engineered.network/causality/episode-50-737-max-ethi...
Back when I flew regularly before covid, I was tempted to create a bunch of these and hand them out to the flight crew for the flights I flew on.
They introduced MCAS in the aircraft for to balance by software a hardware issue, a big design negligent issue which can lead to stalling. It is beyond to trim an aircraft, and because of this there is a big difference in the scale of the values that the algorithm manages from a trimming.
It is not my field, but I think it is not a simple factor, and that it should not be put this over the Pilots like if it were a normal aircraft that received a simple update. Every pilot flying that plane should have been warned that it was not a classic plane with a classic update.
If this type of behaviour by aircraft manufacturers becomes the norm, costs over safety, we as passengers will suffer it, as other passengers unfortunately suffered it, while they blame the Pilots. In addition that nowadays the China's aircraft manufacturing industry wants to enter global market. Some days ago I read they want permission (homologations approvals) for to enter in the European Union.
PS: They also cut costs retiring backup sensors, delegating responsibility for a vital system due the MCAS to the buyer as if it was an unimportant feature; disaster was the order of the day. And the spending cuts were not limited to that, as we have seen in recent days.
> They introduced MCAS in the aircraft for to balance by software a hardware issue, a big design negligent issue which can lead to stalling.
> Every pilot flying that plane should have been warned that it was not a classic plane with a classic update.
I was mean,
> They introduced MCAS to use software to attempt to balance an aerodynamically unbalanced aircraft with a high stall tendency, in order to avoid designing a new aircraft.
> Any pilot flying that aircraft should have been warned that it was a plane that didn't want to fly aerodynamically, with software forcing it to fly without backed redundancy. It was not mere trimming.
In the 737 MAX, the only way to disable auto-trim also disables powered trim (the thumb buttons). As grand parent says, at a certain step in the sequence it was not physically possible for a pilot to trim the plain back to stability manually. It simply can't be done.
In the 737 ng, there was a button to do just that. That would have been useful.
And that's even ignoring the fact that all symptoms were very different from those present in a runaway trim situation as described in the manual and learned by the pilots.
The user of the parent comment is remarking about time.
The aircraft can be certified without MCAS?
By what I read, MCAS is there for to avoid entering into an aerodynamic stall when the aircraft is approaching a high angle of attack, due it's using larger motors for what classical 737 was designed for. It's balancing an unbalanced aircraft using software to repeatedly adjust the horizontal stabilizer.
It is not my field, but I'm not even sure if it should be called to trim, it sounds like a euphemism for what's going on.
Software QA when actually practiced is more advanced now than airline QA.
...eh, I think "when actually practiced" is doing a lot of carrying there.
What do you mean by "actually practiced".
Outside of the aerospace and healthcare industries, I'm not sure there are many software shops that are doing QA to a level I would like to trust anyone's life with.
also software is the least likely comparison I would have made; software quality is a shit-show on a general level, and the vast public is quite aware of this every time a subway timeboard blue-screens or gets frozen on an AMI screen, or the POS machine that they're forced to interact with at work does something equally as stupid.
Software QA provides nothing of value to software development; having it as a dedicated function works against the overtly stated goals of the function and counterintuitively acts to degrade quality within software by mandating strict top down process and brittle end-to-end testing.
Although Software QA is intended to be an independent verification body that provides engineering organizations with tools and resources, in practice they function as a moral crumple zone [1] within the complex socio-technical defense industrial system, being one of the groups that the finger will be pointed to when something goes wrong and absorb shock to the business in the event of a failure. As a result they have a strong incentive to highly systematize their work with specific process steps, to shield them from liability, which can be applied generically to all projects.
Good software teams build quality into projects by introducing continuous integration, unit testing, creating feedback, and tightening these feedback loops. This acts to find problems quickly and resolve them quickly. Software QAs need for high level, top down, generic systemization requires them to work against these principles in practice. Bespoke project specific checks, such as unit testing, is not viewed as contributing to the final product and is discouraged by leadership who see it as waste.
To give an example of how these dynamics destroy quality in software. I once found a bug in software on a piece of test equipment where a logarithmic search function was not operating on a strictly sorted list. When I pointed this out to my leadership I was told that if we changed any part of code, it would require a new FQT, which would be too expensive to conduct and was not in the budget. Although the bug would have been trivial to solve, and was clearly wrong and would not provide any benefits by remaining in the test equipment software, the process required for changes prevented solving the issue.
[1] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2757236
This is driven by Pournelle's iron law of bureaucracy [1], which says that people who promote the bureaucracy rather than the mission of the bureaucracy will get promoted within the organization and come to dominate its decision making.
For example, in schools, administrators make more money than teachers. This is despite both groups having similar levels of education and intelligence. The reason for this is that administrators know the laws and regulations of the environment they’re working in and ensure the continuity of the organization. Despite not directly contributing to the organization’s stated mission of education, they are in charge of the organization and take more benefits from it.
Software QA has similar dynamics. A QA department may start out making good faith contributions to the organization. Eventually there are product failures, eventually leadership needs a scapegoat to show they’re doing something, and eventually QA takes the blame. People get moved, demoted, or fired. QA realizes its risk, and takes steps to mitigate it. They create a highly systematized workflow and process, adopt or introduce standards. Then assert that following process equates to good outcomes. When bad outcomes occur, they point to their strict adherence to following process as evidence of innocence.
If the process does not support the work or mission, that is a cost they are happy to impose on other functions to deal with. This is the final state until a system disruption happens.
An equivalent software QA to building planes would be to verify a known process with existing tooling.
Manufacturing process builds identical widgets using standard equipment. Widgets are inspected to confirm they are within spec. Frequentist statistics are used to determine when widgets are consistently out of spec. When this happens, equipment is inspected and repaired as a corrective action. This process is well defined and linear.
Software produces bespoke, non-standard widgets to address domain specific needs. At the end of the day, software developers are defining a process for machines to follow. If you want to control quality in the software development , aside from having perfect domain knowledge for a particular project, the only way to do it do it is to define an arbitrary process for developers to follow and track adherence to it. This may have no impact, or be a hindrance. It will never add value because it will never be abstract enough to be appropriate for every domain.
The case I'm talking about does not have a separate QA department, but QA people as part of every software team. If a product fails, that team is responsible, so software devs are in the same boat as QA. They focus on learning from these failures, so no scapegoat is needed. Process does get followed, but not as a defense mechanism, but because not doing so introduces noise that is an obstacle to improvement. In case of bad outcomes, people do point out that they followed process because then it is clear that the process is involved in the failure and should be improved.
Unfortunately, companies with that kind of culture are rare.
However, there are situations where less QA may be needed, for periods of time, such as when PRs may be low. QA may be seen as overhead by management, and something to reduce. This will lead to QA shared between teams and a push for standardization and top-down process deployment to minimize complexity for these personnel will develop. Complexity to manage the QA personnel will be shifted to development teams.
This situation absolutely is controlled by company culture. A culture that neither values QA nor development will do this. A company under financial strain will do that. Companies wax and wane constantly.
Sure, maybe, but if nobody ever can implement the theoretical utopia, maybe we should talk of things humans can do instead and ditch the unimplementable idea.
QA cannot be done by a separate team the way you dream: it will always be a political buffer zone staffed by the cheapest half-competent people you can find, expulsing good people into dev or management. Or you merge it into dev/solution design.
The reason is simple: just like contract law, you only care about quality once you are in trouble and need to reverse back the source of the issue to give to the client a post mortem. Otherwise, you care first about velocity, or $ input/hr of effort.
Agreed, for good software teams.
I would content that most software teams at most companies are not good.
Which is to ask, with an average to bad software team is it better to have integrated or separate QA?
Ideally we’d always have good software teams, but in the real world sometimes you have to build software with bad teams.
Leaders have options, they can do things like reduce scope, increase budget, increase schedule, or full on abandon or cancel the project. These are all options available to leaders, but they require tradeoffs and decisions to be made on a project by project basis.
It is scalable to have a strict process that everyone has to follow, then impose a watchdog to enforce it on a wide scale. It may not be better to have separate QA, but it is easier for those in charge.
If I'm trying to build something with undertrained, demoralized, underpaid engineers... it's not optimal to use methods intended for self-motivated, high-performance teams.
And nothing says there must be company-wide mandates. Maybe this area gets a formal, independent QA team, but this other area doesn't.
My experience just doesn't bear out that collapsing the QA function into development always leads to better outcomes.
I've seen the opposite happen too often, and QA be the sole bulwark between idiocy and customers.
Here's a real, perhaps unexpected counterpoint. Say you have a good software team. How do they build good software with bad management?
Consider the classic statistic "most drivers think they are above average".
I posit that the same is true of software teams, almost every team will self-assess as above average, i.e. good. Those teams will then imagine that, being good, they build quality into the process and very little verification QA is done.
I have worked as a software consultant for 15 years now. I've worked with at least 40 separate software teams in that time. Every single team manager would pep talk with "this is the best team I've ever seen". Some of this is obviously blowing smoke to get people to work harder and feel good. But over the years I've had candid conversations with managers and realized that most of the time the genuinely think their team is really good, truly top 10-20%.
Here's the rub. Being a consultant, I'm almost always brought in by higher level management because something is going horribly wrong. The team can't deliver quickly. The software they deliver is bug ridden. They routinely deliver the wrong software (i.e. incorrect interpretation of requirements.)
Often times these problems are not only the fault of the development team, management has issues too. But in every single case, the development team is in dire straits. They have continuous integration sure, and unit tests, and nightly builds, and lots of green check marks. But the unit tests test that the test works. The stress tests have no reality based basis for expected load. The continuous integration system builds software but it can't be deployed in that form for x, y & z reasons, so production has a special build system, etc...
In 15 years I have never once encountered a team that would not benefit from a QA team doing boring, old school, black box manual testing. And the teams that most adamantly refuse to accept that reality are precisely those that think they are really top tier because they have 90+% unit test coverage, use agile and do nightly builds.
So, my question is, do you (I don't mean the specific "you" here, rather everyone should ask themselves this, all the time) think that most bad software teams know they are bad? Including the one you are part of? Would it really hurt to have some ye olde QA, just in case, you know, you are actually just average? :)
Also, did you run across any orgs where they basically refused to use a process like Agile, and instead just did ad-hoc coding, insisting that this was the best way since it worked just fine for them back when they were a 5-person startup?
You usually had a few personality archetypes:
- The most technical dev on the team, always with a chip on their shoulder and serious personality issues, who had decided to settle for this job for (reasons)
- The vastly undertrained dev who was trying to keep up with the rest of the team, but would eventually be found out and tossed, usually to blame for a major issue
- The earnest and surprisingly competent meek dev, who presumably didn't have enough confidence to apply to a better job, but easily could have made it on merit, work ethic, and skill
- The over-confident dev who read a bit of SDLC practice, and could see every tree while missing the forest
The key is that, aside from the incompetent person, they had all always been working there for awhile. Consequently, there wasn't good or bad health and quality: there was just "the system" (at that company) and dealing with it.
And none of these folks ever worked at 5-person startups. ;) I think it was definitely more an issue of SDLC "unknown unknowns" they should be doing, than willful decisions not to.
Yes, generally I join teams and work as an engineer or sometimes as a team lead, so I'm talking to all the team members.
Most start up teams are composed of junior developers, often pretty smart people. Usually 5 or fewer years of experience. Many times these are people who have already accomplished stuff they didn't think they could do. So that generally means that yes they think pretty highly of themselves. To a degree it is quite justifiable, they tend to be very accomplished but in a narrow domain. Unfortunately they don't realize that their technical accomplishments in a specific field does not mean that they are experts everywhere. Their managers understand that these are smart people and assume again that this is therefore a good team.
Non start ups that I join are usually just plain dysfunctional.
> Also, did you run across any orgs where they basically refused to use a process like Agile, and instead just did ad-hoc coding, insisting that this was the best way since it worked just fine for them back when they were a 5-person startup?
Usually more the opposite. In my experience I come across teams that are sure they must not need any help because they follow all the rules in Scrum and have great code coverage metrics.
It is really common to see this kind of thing. I call it "the proxy endpoint fallacy". It can crop up anywhere that there is something that can be measured. In that example, it would be confusing adherence to Scrum with having a working SDLC or perhaps confusing code coverage metrics with the objective of having bug-free releases.
This isn't a software only fallacy. In politics, GDP is often confused with societal well-being. Always be wary of your metrics and change them as required to keep you tracking your actual goals.
Suppliers (to include software) were expected to manage the quality of the product they provided; the purchaser would focus on how they managed the process, not in the compliance of every part.
This had a chance until software process was tossed in the name of "agile".
"Hey Bob I know you're a competent engineer, but don't worry about specifying a certain type of bolt or loctite, the untrained assembly personnel will figure it out. I'm sure they won't let 200 people die in a plane crash."
Anyhow, the fix for this was created and written. But we never got to put it into production. The reason: the company didn't have a lab test facility that could put a sufficient load on the software to prove it. Even though we were getting field failures because of this issue that were getting a bad rep, we couldn't fix it because even though the old code was known to be buggy, we couldn't prove the new code. So the process said we couldn't ship it.
I don’t work in this industry, but this seems fairly ridiculous on its face: software is not at all like manufacturing.
In manufacturing, there’s a design and a manufacturing process, and a critical function of QA is ensuring that the manufactured produce is manufactured to spec.
With software, the software is written, compiled, and then repeatedly copied. And something should verify that it’s copied correctly, but this is straightforward and boring.
So software QA ought to be much more like the kind of validation that happens when designing hardware, not like the kind of testing and validation that happens as products are manufactured.
You need some level of specification so you know what you’re building, but you have to keep in mind that the final code defines what the behavior truly is. Sometimes, that behavior unintentionally becomes part of the specification because users begin to rely on it.
I do like the fact that you both used hyperbole to succinctly illustrate the dangers of veering too far in either direction though :)
It's asymptotic. By the time you reach a human who is as dumb as an actual computer, the specification _is_ the code.
I think that's why people always tell each other to not take things at face value.
Of course there is a big difference between sw and hw QA, in the thing that they test, and how they test them.
But they are also very similar. Any QA department has to think about ways that things can go wrong, and what things to test for, how to test, which testing methods, which standards to handle, keeping certifications, etc. During testing you also need to keep reevaluating if you actually are catching each problem/bug and how to implement changes in your company that decreases the amount of problems or increase the amount that you catch.
I think in that way there's a lot of overlap in thinking about business processes and how to identify problems with them.
Of course once a specific binary gets tested and approved by QA it shouldn't matter if it gets copied or whatever as long as you make sure its the same binary (by a checksum for example).
But still making sure that errors don't reach the customer, is vital in any QA. If errors does happen, QA is the department that can make sure that it doesn't happen again. And ofc be able to proof in court that you did your due diligence if something does happen.
No. Good software teams are led by competent, technical management. Managers who aren't afraid to get down into the dirty details. Managers who aren't afraid to roll up their sleeves and write code if they need to.
The process doesn't matter. The management of what is or is not important does. Agile is just one process out of many.
Imagine an accounting team led by someone who never did accounting in their life: "Just make the numbers work out! I don't care how you do it! My bonus is at stake!"
Let's say you have a bunch of school children and architects create a skyscraper. I've given both groups the process to design a skyscraper.
So in both cases, I should end up with a safe building?
...or perhaps with no managers at all. I'm less and less convinced of the importance of management in engineering except to give investors an illusion of control.
For some reason, developers seem remarkably blind to the skills other roles and disciplines require. Only a developer can do that, everyone else is basically useless fluff. Maybe it's a form of arrogance or just deep unself-awareness.
Your contention is that the surgeon should be running the hospital.
Although I don't deny it can help to have the background, it is not necessary to be a good manager of something. Also seen plenty of good techies promoted to management and failing badly.
I stand by what I said, although my experience is in the technical domain, not finance or law. Maybe those departments are different, I don't know.
I guess if you have a manager who is making technical decisions, they are really a hybrid manager/contributor role. Maybe that works better in smaller organisations.
He has no experience to lead the team in high pressure situations. Like production being down.
He can't truly have a first person understanding of the work of the people who he manages. He has to rely upon others to tell him who's good and who's bad. That sets up a pecking order.
He can't help or mentor engineers with design decisions, or provide a historical context.
He doesn't understand the technology so there's an immediate communication and knowledge barrier that has to be overcome between him and his directs.
He doesn't feel the pain of a bad decision, because he's not coding it, and he can't emphasize with them since he doesn't code.
He tends to push feature development without fixing technical debt. Again that's pain he personally doesn't feel.
Simply not true however that a good manager can't lead the team in a high pressure situation. I'd say that exactly what a good manager could do well. Obviously they won't be making overtly technical decisions, that's what you are for. They can make business decisions, provide cover, get resources, communicate to other stakeholders... All the bits that need doing but would be a huge hassle for the techies who are trying to fix the issue.
I wouldn't call what I'm describing as product management, although it's possible they could do general management too.
The head of accounting should be an accountant, not a surgeon.
And even at the executive level of a hospital, you would want people who have spent their careers in healthcare, rather than, say, architecture.
"Nah, I don't need to slouch anymore in this moral crumple zone!"
"We need this new feature in our program!"
"If we implement this it means the management fell in a moral crumple zone"
"What seat would you have to have for your flight?"
"Anywhere, but not in the moral crumple zone, please"
Them: “Please review this design.”
Me: “Ok, sure, when do you plan to start coding?”
Them: “Oh, it’s already in beta.”
Me: “So you can’t do anything with my feedback, but you’ll say I reviewed it?”
Them: “Well…”
Me: “You’re putting me in a moral crumple zone here!”
> To give an example of how these dynamics destroy quality in software. I once found a bug in software on a piece of test equipment where a logarithmic search function was not operating on a strictly sorted list. When I pointed this out to my leadership I was told that if we changed any part of code, it would require a new FQT, which would be too expensive to conduct and was not in the budget. Although the bug would have been trivial to solve, and was clearly wrong and would not provide any benefits by remaining in the test equipment software, the process required for changes prevented solving the issue.
I've seen this happen where it was a bad thing, but also where it was a good thing.
It's all about risk.
What risk does the software defect pose to the mission? What risk is inherent in making any change to the software? Noting that even trivial changes can be fat-fingered and thus are a source of risk. I've seen it go wrong this way: a seemingly trivial change was made, but the developer accidentally checked an extra file into source control, causing a further defect.
And then: what is the cost of mitigating these risks? Maybe the software defect is as trivial as its fix. Maybe an acceptable fix would be to write up a workaround in the documentation.
I don't think it's always wrong to say no to fixing issues. I also don't think it's always right that a separate QA department contributes nothing to the organization, even if they act as a handbrake on the software developers (sometimes, precisely because they do that). Human factors are real.
You think that QA is a liability shield, but that is only a side effect of the work that they actually do.
The task of QA is exactly that: an entity that tries to assure that the quality is up to some standard. Even in favourable conditions mistakes happen, so how do you make sure as a company that not 1 in every 100 product are faulty and tarnishes the good reputation that your company has spent so much time and money on to build? You hire a QA to make sure problems get caught before delivery.
But if all humans make mistakes, and QA is human, how do you make sure that the QA doesn't make a mistake? A never ending chain of QAs expecting each other?
No of course not. One thing that helps with reducing errors is to have a rigid protocol that is followed to the letter everytime. Pilots, for example, have a preflight checklist that they have to run every time they operate the plane.
The rigid protocol of QA teams is therefore an essential part of their jobs.
Although from your standpoint as a developer it might seem strange that QA is 'preventing' you from fixing a bug, it is actually very reasonable.
Especially since you work in the defence industry, I hope you understand that it is very important that the software that operates radars, planes, missiles, bombs, etc is working exactly as expected. Understandably there is a great deal of effort made to assure that when those things are needed they work exactly to spec.
So in your example it is probably very reasonable that any change you make needs to go through some rigorous process. The fact that it 'only' was about test equipment, doesn't matter because test equipment is just as, if not more important as the stuff it tests.
The reason why QA has the side-effect of being a 'liability shield' is that it gives companies the ability to argue (and proof) after the fact that the company did their due diligence in making sure that the product was to spec.
Especially certification is basically to get an external organisation to approve your QA. In that case if you get sued you can rightfully claim that you did everything that was legally asked of you, and if there is blame, then it is the certifying company using insufficient standards.
I suspect it's rather a case of parallel evolution between McDonnell Douglas brass and software startup culture, since cost-cutting culture goes back many decades (remember "Chainsaw" Al Dunlap[1] ?) — but I wonder if there's a more direct influence.
It's inherently short-sighted unless forced to do otherwise by legislation. Cutting small corners pays off A LOT until the hammer falls, so there's a massive advantage to doing it / you need to do it if competition is doing it, or you eventually shut down as they take all your business.
It's inherently a race to the bottom. Sometimes that's a net gain, sometimes it isn't.
I'm not carte blanche defending capitalism - its a mixed bag but it sure outpaces the competing systems put forward to date. It does need some stronger safeguards against industry self regulation - that has a bad track record.
What anti-capitalist sympathizers, in my view, don't realize is that this is due to people being in the loop. These economic systems are merely vehicles, some better than others, but the conductors are people, be they communists or capitalists. At least with capitalisms there is a delayed regulator (negative feedback) in communism it's up to the system to decide if it needs to modify itself.
Other systems had incentives such as, get it running by such and such date or have yourself and relatives sent to inhospitable place. So people rushed flawed designs into production.
That said, upper management at Boeing needs a shake-up. People need to get fired. They need to do what Intel is trying and that is to get more engineers in charge, or at least grant them veto power on designs.
It should be a lesson against dogmatic pursuit of absolutes: capitalism comes in a wide range of flavors, and the worst is if it’s completely unrestrained. Communism produced worse and worse results the further it got from any sort of public accountability, etc.
The two problems that I see is that the concept of nuance is somewhat at odds with having a simple concept to teach kids at school, and there’s always a group which is more motivated to game the system than the average person who really just wants to hang out with their friends, raise a family, etc. rather than play political games. Boeing didn’t start it by any means but they’ve benefited enormously from decades of reduced oversight and elevated pay driven by a sort of cartoon libertarianism where letting people get enormously rich will motivate them to build great things unfettered by “red tape”.
They have, but post-Thatcher neoliberal capitalism has taken the existing perverse incentives and made them exponentially worse. We're on a course heading straight to feudalism, just with fancy titles with legal rights replaced by economic might.
Ironically, I believe it was Grace Hopper who said it... Whoops.
"With impressive clarity, Downfall: The Case Against Boeing reveals corporate corruption that's enraging in its callousness and frightening in its scope."
https://en.wikipedia.org/wiki/Downfall:_The_Case_Against_Boe... https://www.netflix.com/hk-en/title/81272421
1% of 10000 is 100.
.01% is 1.
If someone came up to me and said, "Hey I can save you 99% of expected costs with 1% of your profit.", I might go for it.
I’m regularly critical of Boeing Defense (particularly space contracts where I’m a huge Boeing skeptic), but I think people are pretty off base if they think Boeing is just completely incompetent.
Airliner safety is insanely good. Just vast seas of competence, but when there’s a super rare failure, the incorrect impression people get is that Boeing (or Airbus) is just full of incompetency. Almost nothing that humans do is held to the same standard. Not spaceflight, not software, not healthcare, and certainly not automotive.
Flying a 737 Max with a bad door and without the fix to the angle of attack sensor is probably still better per mile than driving. In spite of going at 10 times the speed and miles above the Earth.
You can almost argue it’s held to a higher standard than it should, slowing development of cleaner aviation (and therefore killing more people in the future due to tertiary effects of climate change, etc).
It kind of annoys me when comment sections are filled with people talking about how incompetent Boeing is. It feels like out of shape slobs on their La-Z-boy chairs talking about how incompetent or slow some professional sports players are. Like, airliner safety is just a totally different league than almost anyone else plays in. On the worst day, their better than almost anyone else is on their best.
Because I dug it up for another comment, commercial carriers operating under Part 121 (roughly: scheduled passenger and cargo operation) had 4 fatal incidents in the last 10 years. [0]
Totalling 6 deaths.
In 10 years of US commercial carrier aviation.
One of those was literally 'the engine exploded and threw part of the turbine into the cabin (and also shredded some of the wing)'!!
Which resulted in 1 person dying and a successful landing.
Okay, awesome. But how much of that was luck with the 737 Max that they didn't crash on US soil by US airlines?
The two MAX 8s that fell from the sky were 100% Boeing's fault and could have happened in the US. If 5% of airline traffic is in the US you can renormalize those hundreds of dead and you get dozens dead.
I can't find specific numbers but estimates say about one in three has a military background. That's an awful lot.
Not surprising given that pilot training is really really expensive. Airlines love former military pilots because they are a significantly lower financial risk for them. Put them into type rating and off they go, it's rare that one ends up as a dud.
No matter how good they are and how prescient, that doesn't help them if the aircraft computer decides it's stalling, forces a nose down and they cant fight the controls.
But, even if we assume omnipotence from these American pilot gods, and assume they can fly outside the bird and Superman-style catch it, they are still only 30% of American pilots. Just another population to normalize out.
But that's not what happened. According to every report, it is possible to take back control, it's just very much not intuitive and the situation was confusing.
According to the Seattle Times
> However on both accident flights, the angle-of-attack sensor failure set off multiple alerts causing distraction and confusion from the moment of takeoff, even before MCAS kicked in.
> On the Ethiopian Airlines flight, for example, a “stick shaker” noisily vibrated the pilot’s control column throughout the flight, warning the plane was in danger of a stall, which it wasn’t; a computerized voice repeating a loud “Don’t sink!” warned that the jet was too close to the ground; a “clacker” making a very loud clicking sound signaled the jet was going too fast; and multiple warning lights told the crew that the speed, altitude and other readings on their instruments were unreliable.
You can find some of the US reports complaining about MCAS here https://s3.documentcloud.org/documents/5766398/ASRS-Reports-... and it includes
> I manually positioned the thrust levers ASAP. This resolved the threat
Then there's
> B737 MAX First Officer reported that the aircraft pitched nose down after engaging autopilot on departure. Autopilot was disconnected and flight continued to destination
> I called "descending" just prior to the GPWS sounding "don't sink, don't sink." The Captain immediately disconnected the autopilot and pitched into a climb
Another
> Takeoff and climb in light to moderate turbulence. After flaps 1 to "up" and above clean "MASI up speed" with LNAV engaged I looked at and engaged A Autopilot. As I was returning to my PFD (Primary Flight Display) PM (Pilot Monitoring) called "DESCENDING" followed by almost an immediate: "DONT SINK DONT SINK!" I immediately disconnected AP (Autopilot) (it WAS engaged as we got full horn etc.) and resumed climb
People do this with everything though, and air travel induces a large amount of fear in the populace. Not only are we not generally comfortable flying in the air for obvious reasons, but when it happens almost everyone has to concede control to a few people in the cockpit and on the ground. Driving, even if exponentially more dangerous, affords the illusion of control of one's outcome, given driving or having someone you know driving, and control over the vehicle maintenance, etc, as well as familiarity with the control and mechanism of the vehicle. These things don't exist with airplanes for the vast majority of people.
So, you can see why there is a need to find a human component to air travel problems, because that is something one can fix (fire the incompetent people, fine them, whatever), as opposed to all of the other things which must be accepted or rejected entirely.
It is entirely in line with human nature to do this, regardless of its accuracy or effectiveness.
Flying isn't safer then trains I would assume.
Flying has the advantage of being seperated from almost everything else. Most accidents happen when there is mixed traffic, specially cars operated by people with minimal training.
And there's good reasons for that. Spaceflight actually is regulated pretty strictly (partially, because any spaceworthy rocket is effectively a missile), and space pilots and tourists both sign up for such missions fully knowing that they will have a very significant chance of dying one way or another - there simply hasn't been enough human spaceflight activity to work out and understand all the failure modes, unlike with other forms of transportation.
Humans, unlike birds, aren't naturally wired to travel by air... they need to be able to trust their lives to a significantly higher degree to someone else behaving like they should, because unlike in a car they have zero control (or the illusion of control) in an aircraft.
Additionally, the inherent security risk of an airliner is very high: what is a widebody airplane at its core? Hundreds of tons of weight, a decent portion of which is fuel, propelled at near-supersonic speed, and only two people in control of it. Anything goes bonkers and you can get thousands of people killed and injured (see 9/11).
In contrast, cars, even trucks, have way less capability to cause damage simply because they weigh so much less. The only thing that comes close is railways, and hell I don't get what the US is doing there, there's barely any regulation compared to European standards (see the videos I linked at https://news.ycombinator.com/item?id=38725988).
Think of railway signalling systems, control-by-wire bits of modern cars, medical equipment, etc. Where the design of the software is formally proven, and the implementation verified to ensure it fits the design.
EDIT: I saw the pictures of bolts with pins and bolts without pins. The ones with pins cannot get loose, the others can. Let's see what happened.
Sure, it failed, and it isn't perfect.
But planes have had a long track record of being absurdly safe.
Almost certainly systemic issue though, so that sucks. Sucks real bad.
They need to get a Tiger Team or whatever together to look at everything with a shipment config, and make sure those "ship kits" don't leak into the real actual airplane configuration. This is . . ok, this is really manufacturing 101 stuff, but well, things happen.
I'm in the industry, but haven't touched the MAX, so take this with a grain of salt.
[1] Basically a "shipping" or train configuration
It's not a control surface, but it is a "moving part." That's what's baffling to me, that they spent a lot of effort building this hinge and pin roller system, and designed the door to hinge open up to 15 degrees.
It makes me wonder if there's maintenance procedures that at some point would require the operation of that door to successfully complete. Otherwise, the mechanism itself seems so incredibly overwrought, with lots of additional bolts, castle nuts, retaining pins, and even sprung hinges at the bottom.
Does anyone know why this "plug-type non-plug door" is built this way?
It needs to be usable depending on how many passengers the interior is configured for.
So it has all of the door bits there. Maybe some parts like the emergency escape slide are not installed.
e: I should be clear that it's not usable as an emergency exit, as configured by Alaska. However the operator could choose to activate it later and install a usable exit.
If there was a reconfiguration to a seating standard that required the extra exit, the plug would be removed and a proper door would be installed, with the associated interior pieces.
This is true.
However there's still common hardware in there to allow the plug to be installed and maintained. This is why it's a complicated set of kit vs just bolting in a permanent fixture.
Alaskan airlines chose a 178 passenger configuration for their 737-9, and so are not required to have a mid-cabin exit door.
Lion Air's chosen to go with a 221 passenger configuration, and so are required to have an operating door.
Obviously changing up the number of seats isn't done on-demand, you'd need to go for a refit/maintenance cycles.
But if Alaskan decided to change density, or sold the aircraft to someone else who decided to change density - then they could go and do this.
[1] https://youtu.be/nw4eQGAmXQ0?t=305 "The Boeing 737 Technical Channel"
If you are correct, then the implication is that the concern extends beyond door plugs for MAX-9 737s to all emergency exit doors on all models of aircraft sharing this design. This is somewhat reminiscent of the huge problem with the 688 (Los Angeles) class submarines, where the discovery of a faulty weld that had passed inspections raised doubts about all welds.
Those bolts being loose (and they are BIG bolts) would mean multiple people in the installation process didn’t do their jobs, and signed their life on the line saying they did.
When I did maintenance, there was someone (QA) there to witness every torqued bolt, inspect every safety wire and installed part.
There is something rotten in Boeing.
The same management that drove it to ground?
The fish rots from the head. And these constant problems sure do sound like a new company culture of cutting corners instead engineering first.
Alternative is wrong bolts, or sabotage.
But more possible - one lazy QA ghosting.
In my experience, no one puts their job on the line over silly reasons like this, unless there is intense pressure (unrealistic deadlines, heavy workload and poor working conditions) that makes mistakes like this inevitable. I wouldn't be surprised if an honest independent review of either company found ridiculous cost-cutting measures and/or emotional overload.
Boeing should be held liable for hiring based on skin colour and orientation instead of merit, this risking lives.
In fact, this is one pattern I've seen with such racist dog whistles - blame the marginalized groups and target DEI measures without any good justification to save the image of the privileged. It propagates the sinister implication that an employee is definitely bad if they are a DEI hire.
We're talking about a dangerous situation again with the potential to cause loss of life. It warrants serious contemplation as it might affect us some day. The fact that some people will hijack the discussion to advance their racist agenda is beyond disgusting.
The argument so far has shown how fallacious and unsubstantiated this claim is. The irony in this case is that the exact opposite applies.
> It should be discarded for a merit based approach that ignores race, religion etc.
This so called 'merit' is a distraction meant to hide 'privilege'. There is no merit unless privilege gap is addressed first. If you think DEI hiring counts as privilege, then you haven't seen or recognized systematic discrimination, racist mistreatment and outright kakistocracy. It's like a trained and well-armed soldier asking a farmer for a fair duel over who gets to keep the harvests- there is nothing fair about it.
My original reply had nothing do with race, but you managed to drag it into it for no good reason. The only reason I responded is because I didn't want to lend credence to such crude ideas with my silence. Unless you have any reasonable evidence to suggest that DEI hires are in any way responsible for these mishaps, I'm going to assume that have nothing more to say other than a one-sided diatribe against the challenge to your privileges.
Once you get out of the wacky humanities courses and into the real world this argument falls apart. Look at the aforementioned UA incident.
> This so called 'merit' is a distraction meant to hide 'privilege'
We'll have to agree to disagree on that one.
> My original reply had nothing do with race, but you managed to drag it into it for no good reason
Race is but one component of DEI and the easiest to reach for.
> I'm going to assume that have nothing more to say other than a one-sided diatribe against the challenge to your privileges.
Yes safe landings and safe air travel is a privilege and DEI is a challenge to that. What's more it is but a single industry where public safety and product quality is being sacrificed for the religious dogma of DEI. Its a funny coincidence DEI is Latin for god, but fitting none the less.
I've heard this since they killed hundreds of people in the two crashes. Why are they being protected? They have names.
It's more a question of culture (oversimplifying, sales vs engineering) and this is harder to change most of the time. Apparently, even the Max debacle was not enough.
That was a funny one. They replaced him with his chairman... hence, more of the same.
> But the nearest Boeing commercial-airplane assembly facility would be 1,700 miles away. The isolation was deliberate. “When the headquarters is located in proximity to a principal business—as ours was in Seattle—the corporate center is inevitably drawn into day-to-day business operations,” Condit explained at the time.
Oh man, wouldn't want that to happen.
> With ethics now front and center, Condit was forced out and replaced with Stonecipher, who promptly affirmed: “When people say I changed the culture of Boeing, that was the intent, so that it’s run like a business rather than a great engineering firm.”
Indeed.
The NTSB is staffed with people familiar with the industry - it has to be. Thus, a significant portion of these people are former Boeing employees. And historically, many NTSB staff have gone to work for Boeing (and other industry giants) after their stint at the NTSB as well. It's not that large of an industry after all. This is known as the Revolving Door.
Regulatory capture
> that was initially a regional airplane but is now being used for transatlantic flights.
And had its engines moved to an unstable location 50 years after the type first flew, necessitating software controls to compensate for which, paradoxically, are there so that the pilots do not need to train on the new aircraft's inherent flight characteristics yet should be disabled by the pilots under some emergency situations.Rushing to judgement merely obscures the true responsibilities.
Or did anyone decided to cut corners by using an old batch/skipping degreasing/not putting glue because they were late on delivery?
With a seperate follow through by another party to check the work.
That's SOP for US | AU | UK | EU military air mechanical crews.
This thing is obviously not just an interior part, look at the meat in those castings, and it’s obviously safety critical, look at the cotter pins on other bolts. Sounds like it was going to be installed behind interior paneling and not inspected every day. For something like that, every important bolt should be secured by secondary methods, torqued and witnessed installed correctly. This looks like a failure in engineering (not having wire on this bolts), then a profound failure in assembly with multiple people not doing their jobs (not torquing, not witnessing, faking logs), risking the lives of passengers.
If this happened at cruising altitude and speed, people would have died. I can’t find the flight number but I believe 9 people died when a jet lost cabin pressure and a piece of the plane while decompressing during cruising altitude over water.
Clearly this is hyperbole.
Though it should be!
It sounds counterintuitive but without grease a bolt (or machine screw) will bind early with a high torque well before it is correctly tensioned lengthways. The torque is just a proxy for the tension and it is this tension which is needed to fasten your components together as intended.
The grease means that when the torque to turn the bolt reaches the correct value then the bolt is also under the correct tension instead of being because it got stuck in the thread half way.
It’s also a magnetic one so I can stick it to stuff and it stays put.
Speaking from personal experience, this is also useful for brushing a robot's teeth.
It's like they think I'm going to take this thing apart and put it back together every year.
j/k, finding torque specs for a decades old steel bike is a lost cause
mine is much older than linked version, but i doubt they'd revise that whole section out of it.
[0]: https://www.amazon.com/Machinerys-Handbook-Toolbox-Erik-Ober...
There's another reason to grease them - the grease keeps the water out which prevents corrosion.
In working on my cars, I always use a bit of grease when assembling fasteners. I've never had one come loose, nor have any rusted themselves on.
And it's very important to understand that in most mechanical design with fasteners, the fasteners provide tension, and friction between 2 faces actually carries the load. Too little tension then fasteners can be sheared off. Too much, then the fasteners may not have remaining strength available for loads that act to add tension to the fasteners.
Using a torque wrench to reach target tension is normally only about +/-30% accurate. Usually design margin allows for this but in very critical applications where margin is not feasible, calibration is done on a sample of the same materials, etc, or a more direct measurement done. More direct measurement can mean hollow fasteners that allow you to measure the amount of stretch, use of ultrasonic measurement to measure stretch, washers with integrated strain gauges, or cleverly designed "tension indicating" washers or fasteners. There are many types so I just those keywords for anyone interested.
I am not saying that this design required such complex methods and sizing these fasteners should not be difficult. There is probably a mistake or lack of control in the assembly process.
Is there something I am missing here?
After manufacturing tension tends to drop over time so starting off with a '+' may not be entirely bad assuming it isn't extreme and that it doesn't cause the materials to deform more than permitted. The way I understand it: you apply a certain torque to a fastener in order to get to minimum levels of tension and friction (which still have an engineering reserve) on the fastener itself to guarantee a seal and to stop the fastener from coming loose, so under-tension is far worse than over-tension as long as the over-tension does not result in damage to fastener or the materials, and the allowed tolerances for over-tension are quite large (up to +150% or so normally before any permanent deformation would occur).
Unless you are using 'stretch' bolts which tend to elongate to accommodate any over-tension to end up with something quite close to the intended value. This stretching tends to be non-elastic so you'd have to replace a stretch bolt every time you unfasten it or there is a pretty good chance that it will break and/or that the threads under the ending position of the nut will have deformed so that they end up being stripped if you refasten them because the nut will travel a bit further on every refastening.
You pay attention to the size of the bolt, the material it's going into, and it's overall job. Yes you'll mess it up a few times a long the way. Hopefully you're a lot more careful when you see that the cost of making a mistake is a difficult extraction or alteration of some sort. Personally, I think you'll run into bolt/thread failure 10x more from improper insertion, dirty threads, corrosion, and overall entropy than you will from over torquing once you learn a few early lessons.
I've done countless brake jobs, tire rotations, oil changes, spark plugs, valve cover gaskets, shock and bushing changes, without a torque wrench. I've yet to ever had a problem from it after going a little too hard when I was 16 yrs old and learning what bolts and materials can hold what.
Then another, different technician comes by and checks all the nuts again with his own torque wrench.
When all is done and I get the sign off paperwork, they strongly encourage me to stop by next time I'm there so they can quickly check the wheel nuts again with a torque wrench.
So please, don't "do it by feel". That's how you Boeing. I know I would never patronize your shop again if I saw you being so callous.
A true craftsman double and triple checks his work objectively with other craftsmen, not be proud he can do it blindfolded with one arm behind his back.
Costco prior to probably 15 years ago used to just throw wheels on and hit them with air guns without a torque wrench in sight.
Mechanics shops snapping wheel studs was a common problem for years. A decent mechanic would know to never use a high torque impact gun on something with decently low torque threshold, as I said in my OP about experience. But that shows you how many years and millions of cars were/are on the road without caring about exact torque.
The reason Costco does this, and does it twice, is to make sure the lig nuts at tight on the first place... So you don't leave with one loose. The fact that they use a torque wrench is just because they got tired of replacing wheels studs.
Threads that are this way do not get stuck half-way.
If the threads are already boogered up for whatever reason, then the torque specification is already wrong: The threads aren't clean, clear, and free of corrosion and grease. This can result in under-tensioned fasteners when using a torque wrench as a guide, since boogered threads (rather obviously) can present an impingement that allows a torque wrench to click off before proper tension is reached.
However, grease is not a magical antidote to this condition.
If the threads (boogered or not) are greased, then the torque spec is also wrong: Greased threads are also not clean and clear, and free of corrosion and grease. This can result in over-tensioned fasteners when using a torque wrench as a guide, since grease is (rather obviously) a lubricant -- allowing things to slide more-freely in a way that doesn't allow a torque wrench to click off until somewhere beyond ideal tension.
---
So what do, then, as a home-gamer with a bicycle or maybe a car in the rust belt (but never an aircraft) full of dissimilar metals that are constantly rotting?
You could perhaps kit up to do the Junker test such as in DIN 65151, and make a study of how different greases affects things. You can even make a career out of publishing your studies.
Or: Just make sure the threads are clean, clear, and dry, and then assemble with an anti-seize paste which does not have lubricating qualities that affect final tension yield. (Permatex makes some, as do others.)
---
(And in aircraft, always do what the engineers say. If the engineers are wrong, then: Stop doing whatever it is that you're doing, and consult them.)
Some of the bolts that would be loosened when the plug is opened during maintenance have a pin to prevent them from turning. That pin is present in this photo: https://x.com/byerussell/status/1744460136855294106?s=46&t=s...
However, the same photo shows other critical bolts that hold the whole hinge on the door are loose, and there’s not meant to be a pin on those.
I’m curious how the decision is made whether to include that pin in the design. Did they idiot-proof the maintenance of the plug, but not the initial installation?
Some quotes from this article: https://www.reuters.com/business/aerospace-defense/spirit-ae...
> As part of the production process, Spirit builds fuselages for 737s and sends them by train with the special door assembly “semi-rigged,” one of the people said.
> “They are fitted but not completed," the person said.
> At its Renton, Washington, plant, Boeing typically removes the pop-out, or non-functioning, door and uses the gap to load interiors. Then, the part is put back and the installation in completed. Finally, the hull is pressurized to 150% to make sure everything is working correctly, the person said.
I can imagine a diffusion of responsibility as to whose job it is supposed to be to tighten those hinge bolts. Spirit is installing the plug in a “semi-rigged” state. Boeing is removing the plug to load the interior, then reinstalling it. I’d hazard a guess that Boeing is not removing the hinges, because the plug can be removed without doing so. What if, when reinstalling the plug, Boeing workers just redo the stuff they removed? They tighten the vertical movement arrestor bolt, put the pin through it, and believe they have done their job? If they never messed with those other hinge bolts, they don’t bother tightening them?
Bolts can be loosened by the physical and thermal stresses of use if there is a design flaw. So it’s not evidently an assembly QA problem.
Maybe, unless it required really specific conditions that have only occurred for this one or also required some maintenance snafu that also had nothing to do with Boeing assembly QA. We don’t have enough data to establish anything as the most probable explanation yet.
The discussion about snowman hole issues and other problems is really alarming.
Customers get to decide which engine to fit and negotiate for them separately from the aircraft.
Sometimes there's only one choice, but other times gives you a chance to have the same (or similar) engine to maintain across your fleet (or avoid that to avoid a total grounding) and whatever other reasons to choose one over the other.
At least that's what the A380 tour in Toulouse said. Kinda makes sense to at least keep the big aircraft builders from throwing too much of their weight around.
Yes, and to lower compensation because Boeing’s benefits are probably better than Spirits, and so if Boeing wants to pay the people that make the fuselage less, then having them be employed by someone else helps them pass non discrimination testing for pre tax benefits offered to Boeing’s higher compensated employees.
Also, lower unemployment insurance premiums if they want to reduce the amount of labor they buy, since Spirit would be the one laying people off.
I'm having a hard time imagining how this failure could occur from just those bolts "needing tightening". They are lock bolts with pins and appear to take shear forces and provide no clamping functionality. Even if the bolts were "loose", or not torqued to spec, how would they come all the way undone? Then the bolts, under shear, work their way out completely? And isn't the lift spring forcing the top pins into the upper part of the track? On top of that the curve of the track appears to be such that outward force on the door would actually cause the pins to go into the upper part of the track.
IDK, seems like there is something else going on. Different bolts maybe.
It means people were careless and sloppy during assembly.
Think of it like seeing "one cockroach in your kitchen." It's not one cockroach. You just haven't opened up the rest of the walls.
Lots of stuff is assembled consistently and carefully “wrong”, but as specified.
Cost cutting could have been a factor. Or the root cause might have been something entirely different.
It's quite possible to choose to spend more money on a process or method you believe is higher quality, but still discover it has some specific problem that the previous cheaper version didn't.
https://nitter.net/ByERussell/status/1744460136855294106
I think this should stick out to an assembly person as not quite right.
Complicates the issue of who is at fault; where/when were they loosened?
The center one doesn't concern me. The two that aren't even finger tight do.
Those are much more problematic as the remaining tight bolts could fail leading to a cascade. Though, would expect the flange to still be connected to the post in the aftermath images and the upper pins .. how did they get out of the track?
I wish we had close up pics of all the bits in the airframe opening.
Maybe. Could also be incorrect torque specs, bad parts, unexpected vibration in that area, etc.
Edit: Yes, none of these are good either. Just saying there are many possibilities.
If you make 10 or 500 planes in a year, you have to rely on multiple people to use multiple torque wrenches, with multiple attachments, to follow multiple procedures to assemble multiple planes using fasteners of multiple lengths, nearby multiple other processes and people. There is a big emphasis on procedures and traceability but there are still so many potential failure points that can go undiscovered for a long time.
An ex worked on a QA-type project related to production for them. It makes me wonder if some of the issues were more fundamental than that project could ever have addressed.
https://www.nytimes.com/2019/06/28/business/boeing-787-dream...
In aerospace this is dead people.
Hospital system failing to parse patient's allergies can kill.
MCAS
Therac-25
That said, the stuffs I normally work in (or rather what I allow myself to work in) fall in to the reboot and apologize category.
I don’t like how the sentence in this parent comment blames individuals for process problems.
Boeing has a responsibility to make sure its workers do their jobs as needed.
>> "Initial reports from our technicians indicate some loose hardware was visible on some aircraft."
Friendly reminder that 'some' can also mean most or all.
https://www.travelweekly.com/Travel-News/Airline-News/Omnibu...
I believe someone at Boeing actually was criminally prosecuted in connection with the earlier MAX 8 problems, but, as in all these situations, it is seriously unlikely that that fixed any actual problems. Most likely, somebody felt they needed a neck to wring and found a convenient scapegoat.
The presenter is a 777 pilot and A&P mechanic. Released 2hrs ago.
I first started watching his channel during the Oroville dam crisis in 2017 and he had some excellent coverage of that event. He seems to cover "things which interest him" the venn diagram of which which overlaps with mine quite a lot.
"I’ve been an aircraft technician for 23 years and we operate the Max9. I’ve opened and closed one of these plugs as well. Keep in mind that other 737 NG’s have these plugs installed in the longer fuselage models, not just the Max. They all work the same way and there’s never been an incident like this. I’m not saying this is what happened, but I can’t see how this could lug could come loose unless the two upper capture bolts, and the two lower bolts through the spring hinges weren’t installed. Even if a set of bolts, either uppers or lowers were missing with the opposites installed, I can’t see how the plug could come loose and depart the airframe. Just my ten cents. " - @jeffropenn
https://www.bloomberg.com/opinion/articles/2024-01-08/alaska...
Fortunately, most airlines in my country use Airbus planes.
My armchair speculative guess: there are only 4 bolts effectively holding the door onto the roller pins and lower hinges. Somehow I don't think it's a simple case of someone forgetting to tighten the bolts; since they're using castle nuts, forgetting to torque them down would leave behind extra cotter pins. Those bolts look positively tiny, probably no more than M12 diameter, and are subject to intense shearing forces. In the case of the upper roller pin with locking bolt, they are effectively two cylinders perpendicular and on top of each other, which causes extreme compressive forces to be concentrated on one tiny spot on the bolt. My guess is they cheaped out and switched to an inappropriate/softer bolt, which sheared and/or corroded. If one shears, the load quickly spreads to the remaining 3 bolts which all also shear off. This theory would still jive with OPs article about UA; "loose bolts" may not necessarily mean "untightened nuts and bad QA", but rather, signs that the locking bolts are all beginning to bend or shear.
Longitudinal forces on the bolts there, not shear. A change during construction doubled the force on the nuts and the bolts went through weak weld joints in beams. (Also not a PE.)
Wow
or if some other mechanism like the springs on hinges below grew weaker over time .. would that in turn put too much weight on the bolts?
what if the springs on the lower hinges (that are supposed to keep an upward pressure on the door, supporting its weight) are weaker than necessary or somehow failed and went unnoticed... would that put too much burden on the bolts and other fastening mechanisms and cause them to fail in turn over time?
On paper all 6 degrees of freedom may be constrained with the plug but in principle compliant pads may allow shear forces and/or rattling on the fasteners and they eventually fail.
I will eat my hat if the eventual required solution doesn't involve some kind of mating cup/cone or wedge shaped parts to more positively constrain the plug.
It appears that the latter is what happened.
Perhaps those who did the assembly of the doors at Boeing did not use the right kind of washers that are needed to prevent the unscrewing of the bolts, or they did not apply the correct torque to the bolts.
It is extremely surprising if such trivial errors can happen during the assembly of an aircraft.
The latter seems more likely.
- "bad parts from vendor" - "bad programming on torque wrench from MRP" - "insufficient training on process" - "tooling was programmed correctly but bad sensors" - "lube mislabeled for 3 days"
This is absolutely not some simple thing. This is why people don't take us seriously as engineers.
It can be a design problem if the bolts and associated parts like washers have been substituted recently or if the assembly instructions have been changed recently, e.g. by specifying a different torque. If any such engineering change has happened recently, then that would be the likely culprit.
A resonance problem of the aircraft body as supposed by another poster seems extremely unlikely as that would have required significant recent changes to the aircraft body, which did not happen.
I wouldn't be so certain it's installation error or mfr defect of the fasteners...
Or the ‘correct’ assembly instructions weren’t actually correct, or the design isn’t good enough (e.g. it uses too few bolts, or didn’t check the strength of the bolts when they get cold), or the bolts were of the correct material, but designed too thin, etc.
It's really unlikely that washers are a root cause (spring/split washers are useless and are definitely not used for this type of apllication). "Correct torque" is not trivial to determine and maybe it was calculated right or wrong based on right or wrong materials/conditions or maybe conditions were changed or maybe...
I am 99.9% sure a procedure was followed and a torque or other measurement applied and was documented. This is probably not a trivial error but a cascading failure in design and/or documention and/or integration.
can be reassuring if it removed the doubt that he was making a senseless decision. while still being the opposite about flying the thing.
The decision OP took might have been extreme and costly (time wise and effort mostly). People around him might have lightly whispered to him to be reasonable, or "trust the experts". This wears on you eventually and you start to doubt your own reasonableness.
Boeing starts leaving bolts unfastened and all of a sudden you remember the almost weekly stream of pre-pandemic HN articles with new material on Boeing's fall from excellence.
Boeing's marketing dept. was capitalizing that everyone had forgotten about the MAX. The few of us who remembered it maybe weirdos, but we're nut nuts!
Humans make mistakes. The whole point of modern manufacturing is to make products better than any human can make them, by layering processes and procedures to catch those mistakes before they get out the door, and continually improve the processes to catch ever more.
I think it's much worse than a design flaw.
Even very carefully-engineered systems can have flaws. Engineering flaws, once identified, can be engineered around, managed, or corrected.
I'm much less comfortable with the idea that the assembly plant for these planes could be a random-critical-failure generator based on how the employees handle a torque wrench.
If they got this wrong, what other bolts didn't they tighten properly? This question is especially relevant since just a few weeks ago, Boeing issued an airworthiness directive about loose bolts in the rudder system.
In any reasonable aerospace organization, the discovery of a systematic problem with the rudder system assembly should have prompted an audit of other processes. Why did that audit not uncover this issue with the plug door?
Presumably, the answer is that Boeing's processes are so incomplete or and/or unreliable so that, even when being given a hint at what kind of a problem to look for, they can't find other instances of the same problem themselves.
It raises the question of what other systems on the plane have problems, and whether Boeing is even capable of confidently answering this question at this point, or whether we just have to wait and see what other parts start falling off.
Their manufacturing process is just kaput. And there is no force that will make them fix it until their planes start falling mid flight in pieces.
I find it unfathomable that the FAA is basically sitting watching with their arms crossed. They should fine the heck out of Boeing and ground all their planes. But american protectionism is strong in this one.
Grounding every plane Boeing has ever built would be quite an overreaction and would be disastrous for both passenger and cargo transportation.
It's also worth noting that other ex-employees of Boeing have also raised concerns about substandard structural components made by Ducommun and Boeing's own manufacturing processes for the 737 NG (737-600 to -900). There is no way to know which ones are defective because an unknown number of these critical parts were manufactured inconsistently and haphazardly by hand when they were supposed to be CNC'ed and Boeing just slapped them in without much care. The net result is an average Boeing 737 NG is variably structurally weaker than previous models, and prone to fuselage breakup on hard landings, runway overruns, and possibly in-flight during extreme turbulence. Level 2 corrosion on structural components only 8 years old is what happens when nonconforming, trash parts are passed off as "conforming".
Around 2009, the DOJ made a false statement that the NTSB said the NTSB concluded structural components were "not responsible" for AA 331. These were absolute lies drafted by Boeing's lawyer, Mr. Cole, as no conclusion had been yet reached. In a subsequent sworn video statement, the DOJ official admits they spoke Boeing's words largely verbatim.
This is what happens when publicly-traded corporations are run by MBAs who gut a company's core competencies for short-term profits and are allowed to largely regulate themselves as a consequent of regulatory capture and the corrosive influence of elected officials who accept "campaign support" and gold bars.
"most scrutinized world leader in history"
> Boeing Co. (BA.N) directors authorized a record US$20 billion share buyback program and boosted the company’s dividend 20 per cent -- a sign the planemaker doesn’t intend to stop showering cash on investors any time soon.[1]
[1] https://www.bnnbloomberg.ca/boeing-sets-new-20-billion-buyba...
The seating configurations for United and Alaska, the 2 major customers for this aircraft, don't require this plug-door feature. Structurally, for these large carriers, the plug door serves only as a fuselage weakness and failure point.
Why don't they just rivet it permanently to the fuselage and make it non-functional? Per the diagrams shown, it's a complex assembly that serves no purpose at all for these carriers.
(Apparently it was used as a cargo door to furnish the interiors, which seems like a trivial use case.)
It just seems like a lot of complexity and moving parts, for a feature that's not in use.
That's exactly how it's engineered right now, though.
This same design has been used for decades and apparently without problem, so it's probably just a case of someone designed it this way originally, and nobody thought to fix what wasn't (at the time) broken.
[1] This can still be swung out for inspection / maintenance, but has no normal latching mechanism, and should be bolted in place.
That's a bit of a leap. If the bolts are e.g. too soft and have worn out in use, that would be a design issue that would only show up after a period of use.
So how did this happen if they we checked so recently?
A bolt is either fastened or it isn’t. If the wire is all that’s left to hold it, then it isn’t fastened and your parts are being held together with a very weak piece of wire.
https://fastenerengineering.com/what-is-a-castellated-nut-an...
You're much better off with a loose bolt, than a missing one. It'll hopefully make itself known somehow (maybe even just visual inspection) while still remaining somewhat attached, which is better than nothing.
When I searched for images of wired bolts just now I saw many examples where the wire is done up quite tightly, which doesn’t seem right.
If the painted seal is broken or misaligned, you know the nut has moved.
There's different kinds of bolts that get wired, with different kinds of goals and results.
My only experience is wiring bolts according to the rules for club racing motorcycles.
Some things, like oil sump drain bolts for example, wiring them will stop them backing out so far as to fall our, and while it will probably weep oil if it loosened enough to take ups the writing slack, it wouldn't dump all the oil out quickly.
Other things, like axle bolts, if it backs out enough to take up the wire slack, it'll have lost its clamping pressure and that's bad, but not immediately catastrophic. The major axle loads are all in shear so the wheel won't fall off, it'll just get more floppy than it's supposed to be. Long term it'd be bad and cause wear to the point that something would eventually fail, but it'd get you to the end of the race most likely, and hopefully the rider will have felt something odd and gone looking or a post race inspection would have caught it.
Most likely weren't checked since the planes left the factory yes.
To quote from: https://theaircurrent.com/feed/dispatches/united-finds-loose...
"The five aircraft were delivered to United between November 2022 and September 2023, according to ch-aviation, and would likely not have been through a heavy maintenance C check that occurs every 4,000 to 6,000 hours or two to three years."
Are airliners marked in this way? Is checking the bolts simply a visual inspection, or do the inspectors need to get out a torque wrench?
No idea how this can happen, Boeing really has to get its shit together.
This is also standard procedure for electrical maintenance inside distribution equipment. Every lug/termination is torqued to spec and then marked to indicate it has been torqued down. This should be done regularly to prevent any loose terminations from causing an arc flash.
The 787 and 757 seem to have been stable platforms.
[1] https://en.wikipedia.org/wiki/2013_Boeing_787_Dreamliner_gro...
[2] https://aviationweek.com/air-transport/new-boeing-787-fix-de...
IOW, it's far too early to be speculating about blame.
In any case the aircraft is only a couple of months old, so it probably hasn't undergone any major work by the airline yet.
Arguably it should have, if the reports of pressurization warning lights are accurate and meaningful. But sadly, I can imagine them looking for a problem, not finding this one due to the need to take the whole plane apart ("Unable to replicate"), and concluding that the warnings were spurious.
(CNN) In a blistering attack on Boeing, the Air Force's top acquisition official said the company has a "severe situation" with flawed inspections of its new KC-46 air refueling tanker aircraft, after trash and industrial tools were found in some planes after they were delivered to the Air Force.
Edit, remove: What is going on in Everett?
It's only the Max 9s that have the option of the door plug, if the installed seat count is below the threshold where an additional exit is required.
A few years ago, I had read that certain airlines demanded planes manufacturered in Washington rather than South Carolina, and I wonder if that information actually ends up being a useful signal for better quality planes.
https://www.postandcourier.com/business/airline-surveys-poin...
https://www.wsj.com/articles/production-problems-prompt-broa...
The one with the blown door plug supposedly came off the Renton assembly line. No one is safe.
And frankly this time we're talking about the worst of the worst, the basic first step of making airplanes : being able to ensure parts of it doesn't fall off for no reason. This is not a design issue, not a cost cutting "they didn't put enough sensors" reason, this is straight up "their manufacturing is bad and their QA is not able to catch it", ... These things have barely started flying and 5 of those are already affected (well, 6 ...), this is absurd.
Sure MBA taking over tends to kill engineering companies ability to make great product, but even Hewlett Packard is still able to make printers that print (they suck, but that's by choice from them)...
I've seen a lot of confusion that its a systemic problem
United found loose fasteners in a different locations on each of the five aircraft they found loose fasteners on. This is right on the heels of another emergency AD for the MAX about loose fasteners in a completely different location. That definitely hints at a systemic problem.If you expand the scope a bit, Boeing's had nasty assembly and manufacturing problems across its whole model lineup. I highly doubt this is a one off problem.
It was total bedlam at the airport when I got in this morning however. With almost no flights available to replace the grounded ones.
Another red eye special for me tonight but at least no connections.
The safety margins on flying machines is really high, so while Boeing really should figure out what the hell is going on, the plane didn't fall out of the sky after a depressurization incident. It failed to a known state (ideally by design!)
Given the MCAS thing and other shenanigans Boeing is trying with the MAX certification my bet is on luck.
Those in the FAA and other oversight agencies who failed to properly oversee them should also be prosecuted.
Failing the above, perhaps it's time to revive an apocryphal custom of the Romans. The engineer of a bridge was required to have his home below it, as a means of enticing them to make sure it was well constructed. We should require that Boeing board members, and their immediate family, only fly in Boeing planes of same variety sold to carry paying passengers.
I don’t disagree that it appears that Boeing has acted badly here. And I’m frustrated with golden parachutes, out of court settlements, and other ways of evading corporate responsibility. But this is a moment in time, and I think Boeing could redeem itself.
Serving the public good should be one of the responsibilities of a corporate charter. If we're not collectively better because a corporation exists, it needs to go.
If we grant Corporations rights, they should also have commensurate responsibilities.
* Lazy production line worker hand-tightens bolts and forgets to torque them, faking the results on the electronic torque wrench (which records the tightening of every bolt).
* A design flaw causes vibrations which cause these bolts to loosen.
* Improper bolt tensioning process where bolt tension is later unintentionally reduced due to tensioning order.
* Design or material failure where bolt tension post-installation drops more than design allows.
* Miscalibrated or otherwise defective equipment.
* Other failure in manufacturing not caused by the worker, e.g. missed a necessary second or third tensioning pass (different torque or rotation angle) without appropriate failsafes or final validation to discover it.
Bolt tension validation is normally done with an ultra-sonic scan. Torque only provides a rough approximation of the tension at time of installation, and is only suitable where precision is not a requirement.
I suggest https://www.youtube.com/watch?v=XLzTB4KLCxU for those curious about bolts - a very specific, but interesting video.
Because of your inclusion of the assumed 'lazyness' of the first I assume that you think it's the first?
why do you think it's more likely that the line worker is lazy and the one that screwed up? why not the 'lazy' designer who thought it would be strong enough, or 'lazy' supervisors that forget to supervise, or the lazy quality-assurer that forgets to assure quality?
Everyone makes mistakes. If your whole organisation relies on nobody ever making a mistake, then your organisation isn't at risk of failing, but is certain to fail. Or alternatively the organisation has already failed in its duties, but the consequences of that failure just haven't popped up yet.
But regardless, not looking good for Boeing
(*door but of course it's more a plug than a real door, just using the term for ease of understanding)
Edit: https://twitter.com/ByERussell/status/1744460136855294106?t=...
Completely shocked they haven’t ditched this plane and owned up that cutting safety for fuel savings wasn’t worth it.
ie one of the reasons it's not out of business due to the multiple failures over the Max is it's just too important to the US economy?
The Europeans would, if it truly came down to the wire, pay quite a lot to keep Boeing afloat, even though they own its main competitor, such is the danger of a monopoly on large commercial aircraft.
EDIT: Maybe the bolts have a really high shearing tolerance, but not as good of a tensile pull?
Look at causes of explosive decompression - look at the mass increase to add windows' struct infra to weight and mass to a plane, look at explosive bolts for emergencies
* Explosive decompression is the most dangerous, and can cause severe injuries or death. It is caused by a sudden and catastrophic failure of the pressure vessel, such as a window blowing out or a structural failure.
* Rapid decompression is less dangerous than explosive decompression, but can still cause serious injuries. It is caused by a more gradual loss of pressure, such as a door being left open or a seal failing.he cowling on the window failed. It was due to poor quality control for the extra mass around the window housings on plugs - the extra mass due to the pull and (IN ADDITION) the patsy ois on bolts.
They dont use explosive bolts in aircraft plugs, apparently, but yeah - this wasnt just bolts. Its a procedural impact, installation impact AND faulty materials QA in componentry.
My bet is on faulty adhesives or faulty QA on bolts.
I am pretty sure BOLTS in a plug door are a ruse UNLESS one can prove that window assembly procedures are either by the same company, the same process, or the same QA from multi-vendors.
Rule that out first.
An explosive decompression will not happen unless a single core seal will break....
Look T THE PASSENGER MANIFEST FOR THIS FLIGHT... look at MH370...
And if you want a mind F - look at Facebooks Husband who died in that flight to mexico....
If you look at the similarities, large numbers of high-tech company execs were taken out when those two crashed....
Who was on this manifest?
AI execs? Who lived.... So just give a list of professions of the passenger manifest. (Yes, aware no deaths - who could have? Who were to folks that missed that flight?)
If a singular bolt was faulty - it wouldnt have been an explosive decomp
It would have been a leak.
Explosive at 10K feet is FF attack level "first priority"
(PS they already ruled IN that they use differing contractors to produce certain parts such as plug doors.
How secure are those?
You are a MORON of Aerial-Assassination, as it isnt your thing. Hope you dont get in a small plane anytime soon - why do you think billionaires dont employ you to watch over their planes, Helios, etc...you not-minion.
You dont know this about me. My Grandfather was the primary nuke designer behind Hanford.
Handed me my first engineering design book before I was 6 years old.
I drew every single design in that book before I was 7.
When I went into HighSchool (I am smoothing over a bunch of details) I had already drawn that book left-to-right.) (ABC's Of Autocad} and I went back and forth.
I am 2nd in the nation of the Cad Olympympics.
Might sound stupid - but imagine that in 1992.
3 Hour test finished in 35 minutes;
I designed the datacenters you feed off you dorks.
I was the principle designer for so many you touched.
I fucking hate how much so many people dont get cred.
Just look at Tiny. - We couldnt ever jump out of a plane without Tiny. A 5' woman fearless who invented the parachute....
Look at Kent (the mips designer) - youll never know about him - but why we use the word "fabric" on networking... (that you may never know... It was he and me on ... (he had a sexual deviency proclivity that was bad for computing vcs) - but when he was at MIPS we designed slot level rack computing in 1996
(If anyone wants to refute this, they can refute my claims of being aware of googles early mother board designs,etc...
We will go with your over-valuated opinion on [who gives a shit]
Opening outward is mechanically riskier, but more likely to be useful in an emergency. The drill for plug-style over-wing exits: Remove cover from upper handle, grab upper and lower handle, yank upper handle, pull door inside, have 15Kg or more of door land on your lap, turn big clunky door sideways, pitch through hole so it's outside and out of the way, climb through hole. Training video.[1] Few passengers are likely to get that drill right in an emergency, and the flight attendants are in the wrong place to do it.
Looking at how the plug is configured, you'd have to really screw up for the panel to fall off.
> Safety and quality were taking a second seat to schedule and cost.
However longer term if Boeing's reputation keeps getting worse that can motivate buying decisions by the airlines. That change will be a very slow one, because fleet changes cost a lot of money in training crews, changing maintenance etc.
For example KLM is changing their short-haul fleet from the 737 NG to the A320neo family, that will take many years to completely roll out.
So if it's really that big of an issue for a person, then just fly Delta for the time being.
Still impressive.
The more likely scenario is that the Chinese or Europeans will ground the new 737s until some very expensive fix is put into place and not accept any workarounds. That would probably make a difference.
FYI: https://qz.com/1569865/china-grounds-737-max-8-after-ethiopi...
I’m assuming that the US is less likely to demand costly changes to aircraft produced by Boeing because of the implications it would have for their own economy. I wouldn’t trust France to preemptive ground a series of Airbus planes either.
"The European Union Aviation Safety Agency (EASA) said it had also adopted the FAA’s Emergency Airworthiness Directive (EAD) to ground this particular. ...
configuration of Boeing 737-9. “EASA took the decision to adopt the FAA’s EAD despite the fact that - to the agency's knowledge and also on the basis of statements from the FAA and Boeing - no airline in an EASA member state currently operates an aircraft in the relevant configuration,” said EASA in a statement"
* Ryanair (124 planes out of 575)
* TUI (40 planes out of 134)
* Turkish (25 planes out of 400)
* Norwegian (18 planes out of 81)
* Icelandair (3 planes out of 47)
and aside 787s, they haven't ordered any more Boeings
[1] https://injuryfacts.nsc.org/home-and-community/safety-topics...
[2] https://www.census.gov/newsroom/press-releases/2023/populati...
Those statistics don't really work out at all. They take number of miles and deaths, and nothing else. Let's say flown miles and driven miles are exactly the same for arguments sake. If the number of miles flown on planes were traveled by 4 million people, whereas the number of miles traveled by car were from 4 billion people, your likelihood of dying in a plane crash is FAR higher than by car if you're one of the 4 million who fly on a plane.
Miles and deaths alone are pretty poor metrics. There's also the part where I may only drive once or twice a week vs. the average which takes into account people who commute daily. So my odds of dying in a car crash are still lower. The frequency of travel seems just as pertinent as the miles traveled.
It's passenger miles, so the number of passengers is already factored in.
Even when people have a direct ability to change what vehicle they travel on, like with car sales, safety incidents/features/records/etc have little impact to no on sales.
This is one of the reasons why transportation safety is regulated rather than being left up to market forces. Market forces don't really have an impact until the safety risk reaches some extreme levels.
It wasn't, it was an A320 as I expected.
Obviously that doesn't excuse Boeing, I'm just saying, by the numbers.
[edit] The US has 1.5 deaths per 100M passenger-miles driven. [1]
The 737 NG has hit 10,000,000 flight hours 5 year into operating. That should be around 500,000,000 miles flown. About 180 seats per plane makes that ~90B seat-miles. That's 0.0038 deaths per 100M seat-miles flown.
So the 737-NG models are about 400X safer per mile than a car.
The median American lives 17mi from an airport, so the safety break-even point is 13,600mi flown on a 737-NG, assuming your destination is also a median 17mi away from the airport. If you're flying less than 13,600mi on a given 737 one-way trip, you're more likely to die getting to and from the airport.
Unless my math is off. This is just napkin math.
[1] https://injuryfacts.nsc.org/motor-vehicle/historical-fatalit...
The very first A320 demonstration flight crashed, killing 3 people, allegedly due to software issues in the new fly-by-wire system, and then involved allegations that Airbus had tampered with the investigation. The demonstration flight was mostly journalists on the plane. [0]
The A330 crashed on one of its certification flights due to an issue with the autopilot, killing all 7 onboard. [1]
Both went on to be some of the all-time best selling aircraft, and meanwhile today in this thread you have people touting Airbus as a paragon of safety. Humans have a short memory.
0: https://en.wikipedia.org/wiki/Air_France_Flight_296Q
1: https://en.wikipedia.org/wiki/Airbus_Industrie_Flight_129
I mention these two specifically because they're examples of high-profile failures attributed due to issues with the aircraft early in their lifecycle, but basically every single popular aircraft type (except the B777 and A350) have had serious issues and loss of life due to manufacturing defects, but still went on to be overall successes. Hell, people still flew on the DC-10 even after its _numerous_ issues like AA 191..
https://en.wikipedia.org/wiki/Airbus_A320neo_family
A320neo is the direct competitor to the MAX. So yeah, they're doing pretty well.
Crew and passengers were unharmed after a collision with a firetruck crossing the runway while the aircraft was doing its take-off roll.
edit: 235 Kph!
https://www.youtube.com/watch?v=FBEE7bzatKk&t=47s
two 10ths of a second later and it would have been an entirely different story. Ugh.
> You'll hear more about Boeing than the rest of the industry put together because this is HN...
That's not it.
I mean, it is. The Pratt & Whitney engine issue which is going to ground half the MAX's rival's aircraft for a year because a manufacturing fault makes the engine turbine blades liable to crack garnered two threads and zero comments (Boeing got more for a fun story about paper planes!). Airbus being found at fault but acquitted of involuntary manslaughter by a Paris court last year for the AF447 crash (a 2009 mid air stall with a few MCAS parallels) passed without comment. HN is not a place for aviation news
“Company isn’t found criminally negligent in case where it pretty clearly wasn’t being criminally negligent” isn’t.. news.
I’d be _really_ curious to hear what you think the MCAS parallels are (besides both cases involving a sensor malfunction) if you think that’s news.
The parallels are fairly obvious: AoA sensors malfunctioned, the situation was recoverable but the pilots were confused by conflicting and absent cockpit feedback and lack of relevant training, the OEM initially placed the blame entirely on the pilot but the problem was resolved with a tech remedy. Plus a whole lot of scope for speculation about Airbus regulatory capture of EASA and whether a first incident should have lead to grounding etc. Sure, with AF447 the issue was sensors having a (known) proneness to systematic failure rather than lack of redundancy and the plane plummeted because a stabilisation system disengaged at the worst possible time. They're obviously also not exactly the same, and the Qantas Flight 72 (different software subsystem input conflict automatically pitches nose down) near miss was a closer analogue, but they're all related to critical software handling edge cases and how guidance and UX might have mitigated issues. But as I said, you won't get much of a picture of the aviation industry from HN.
Hopefully they can track down the cause.
I do hope they can track down the cause, whatever it might be.
Flying Blind: The 737 MAX Tragedy and the Fall of Boeing
Also, the rot didn't start with the 737 MAX. The 737 NG has critical problems that went unaddressed that has contributed to multiple fatalities and equipment damage. Here's a documentary about it:
People & Power - On a wing and a prayer (2010) Al Jazeera
https://www.aljazeera.com/program/people-power/2010/12/15/on...
Break them up and it's easier for both the market and the government to punish bad behavior.
They all have the rights to the existing designs, and can create derivatives, but they don't automatically get the rights to the others' derivatives, so they have the incentive to specialize or develop new designs to find a niche, for the same reason the Boeing 737 isn't an exact clone of the Airbus A320 or vice versa.
If there were more competitors, they'd lobby to change how the regulations work so they didn't effectively destroy the market for new aircraft types.
Car platforms change a lot more, a lot more often, IMHO.
I don't know if such a state of affairs is possible with the aircraft or airline industries. Those industries are too rational, whereas the expense of safety features in the consumer automobile market is in part quietly covered by arguably irrational consumer spending habits.
It was a beautiful aircraft, destroyed by years of management comittees.
Boeing needs to be broken up and reorganized, full stop. Congress has to act. It is simply too important and vital of a company to US strategic interests to be left in this state.
SV has tried and failed time and again to realize the enormity of undertaking that is commercial aviation. There are less than 10 countries in the world capable of producing and marketing a competitive modern civil airliner. And of those, a vast majority are state nationalized conglomerates, or in the case of Airbus multi-country efforts. It takes almost the entirety of a country's aviation workforce and industrial capacity to maintain just one of these companies. Boeing cannot be replaced. It has to be fixed.
That's more like Microsoft's kind of market, but uh... don't give them any ideas.
The MD merger that led to the shift of Boeing management culture was due to the government intervening and forcing a marriage between the two companies because MD was too important for vital defense interests.
The fact that people would share this and it didn't curb the amount of business and referrals he got just proved to me what you've said for the longest time.
People don't like to be troubled with details and they'd rather be ignorant of them.
If you are a professional mechanic, it's your responsibility to obtain the specifications and follow them. This is especially true when it comes to a licensed and certified A&P mechanic and not your neighborhood shadetree mechanic.
It's still doable to get the full manual off, just not easy anymore.
It gets worse when bolts and part are of different materials (say: steel bolt in aluminum part), that's a very nice recipe for trouble (also in the long run, not just during assembly because oxidization will almost certainly occur on the interface and oxidized metal takes up more room than clean metal so unless you very explicitly protect against it the fasteners won't come out without massive damage to the part).
WAGO clamp terminals are a godsend here - no need to take care about wire nuts going loose, screw terminals being too loose or too tight (leading to fracture), ferrules being properly crimped... just insert the cable, lower the lever, and off you go. Unfortunately, standard DIN fuses still come with only screw terminals.
You would definitely hope aerospace assembly would be immune to this widespread phenomenon though.
Given the amount of (soft) aluminum on aircraft, (737 is 80% aluminum), it would be insane to not precisely consider torque.
Steel on steel is more forgiving.
Much easier to strip aluminum threading if you over torque. Steel tends to just bend (and bend back better).
Aluminum also fractures while steel bends/stretch back and forth better.
(This is mainly from my experience working on bicycles, and a little auto)
e.g. any slight boogering of the threads of a used fastener could translate into rotational torque that doesn't end up being converted to a clamping force.
(or in more extreme instances, some fasteners are torque to yield, and change shape after their first use, and must be replaced. But I'll presume that's not what they were talking about here)
Most service manuals require new bolts, fasteners and washers for torque-critical parts.
[1] which makes an ass (out of) u (and) me
That obviously isn't the problem with airplane manufacturing, and maybe not for car mechanics either. But it's totally endemic in the consumer world.
"Do not operate while driving" on car HUDs. "Do not consume if pregnant" on perfectly safe OTC medications. "Do not continue to ride after a crash" on bike frames.
It's not surprising most of this is just ignored now -- there's no information content. The documentation is nothing more than a list of things for which the manufacturer would like not to be liable, and the marginal cost of adding to that list is ~0. It will grow until we run out of room in the manual / space on the packaging.
"Store between 68 and 75 F." Or what? Is that a "must follow or else death", or a "it may reduce efficacy 0.5%" or a "we've never run a sufficiently powerful study under any other conditions, but there's no theoretical reason it should matter"? It matters quite a bit to me which!
I don't see how we can hope to have good-faith communication under such a heavy threat of litigation. I would not be surprised if /that/ turns out to be relevant to the Boeing issue, even if the rest is unrelated.
Leadership from a more environmentally-conscious and empathetic Gen Z would definitely have safer products that last longer.
For example a company of 400 people laying off vital talent is literally shooting themselves in the foot. If I was a CEO I would take a cut till I could course correct. Losing talent with a layoff is way more expensive.
You end up paying three to six months for that talent to not work. This is a huge problem.
It may have not been operator error with the torque wrench. Maybe the torque wrench itself was miscalibrated. Maybe the bolt had a flaw in the metal. It seems too early to make conclusions.
An example of flawed bolts on aircraft in an excerpt from https://www.sciencedirect.com/science/article/pii/S136970210...:
A bolt from an aircraft flap control unit fractured in the threaded region of the shank near the shoulder with the head upon installation after a major service. A metallurgical investigation was carried out to identify the cause of failure. The bolt was manufactured from cadmium-plated, high-strength steel. Material checks carried out on the bolt showed that it conformed to the required specification and was found to have an approximate ultimate tensile strength of 1380 MPa.
The fracture surface of the failed bolt was examined using SEM to identify the mode of fracture and determine if pre-existing defects were present that could account for the unexpected failure. The fracture surface exhibited two distinct modes of failure. [...]
The embrittlement in this case was attributed to the cadmium plating, which is applied to the bolts to provide corrosion protection to the steel. Hydrogen is evolved during the plating process, which becomes absorbed by the steel. The cadmium plating acts as a barrier to hydrogen diffusion at ambient temperature so that the hydrogen becomes ‘trapped’ in the steel. In high strength steels (>1100 MPa) this leads to embrittlement. To overcome this problem, high strength steel fasteners, which have been cadmium-plated, are baked at 175–205°C for 24 hours to allow hydrogen to diffuse through the cadmium. In this case, failure of the bolts was caused by insufficient baking after plating, which gave rise to hydrogen embrittlement.
In this specific case, I would agree.
I share much of the sentiment of the OP, but I wonder if it is simply my perspective changing as I take on more and more responsibilities. Maybe things have always kind of been this way.
I would be hesitant to say it's all going to hell in a handbasket because that tends to be one of those self-fulfiling prophecies. I prefer to look at things as "challenging, but workable".
People care deeply about a lot of things, just not this. And why should they? When you have every business decision made either by private equity or public companies with a focus only on the next 90 days it turns out everything goes to shit. Wages are stagnant. Wealth inequality is massive. Our society is sick. Issues like this will only increase. Our rail ecosystem is experiencing the same issues for the same reason.
$1000 for a first class ticket from DC to BOS. 6.5 hours.
Same flight first class with Delta this week is $850. Also 6 hours with layover.
Blows my mind first class rail travel is as much as first class air travel.
In my experience, in the UK, taking a train is more expensive than taking a flight (or driving, for that matter).
The train cost more, but you enter the train in the city centre, sit down and relax, go to the restaurant car and eat a nice dinner, relax som more and you arrive in the destination city.
This works better in continental Europe, where you have shorter distances and high speed trains between the capitols, often making the train faster from city centre to city centre than air travel. Traveling from Chicago to SF by train is pleasant, but take a couple days, not a couple of hours.
I took the Amtrak a couple times from DC through WVA and have had several delays trying to get from VA to KY due to priority being given to the freight trains. I remember one trip having a one or two hour delay in the middle of no where while we were side tracked.
It is much, much more comfortable than a plane though.
Also IME Amtrak's prices are surprisingly reasonable. More like a place around the corner than like an airport food court.
I haven't ridden Amtrak in a long time, but I would be absolutely shocked if the first class experience on the Acella is as nice, much less worth a premium compared to flying. Regardless, there's pretty much nothing they could offer to make it worth the price premium.
I guess it has to do with planes replacing plane, hence plane must be better, hence more expensive.
But the reality is that the plane won because of two things: speed and cost. Air is free. Miles of miles of railroad is very expensive to build and maintain.
Trains are a bit cheaper than planes. But they travel slowly. So cost per mile per passenger is lower for a plane.
Even when subsidized, the cost of rail travel is often more expensive per mile than air travel.
So when Europe and Asia now are building a lot of high speed rail, it's not to make it cheaper, but to lower carbon footprint and to make a more pleasant experience.
American air travel is safer than it's ever been. Going years without a single fatality is now the norm, not an exception. The airlines are well run and do care deeply about safety. The regulators aren't perfect but generally do a good job. The NTSB is world-class.
Boeing will continue to lose marketshare to Airbus and feel some pain which is appropriate. Eventually they'll get their act together or they will continue to suffer real consequences.
There are only so many checks and balances you can build in until this situation will catch up with you.
Doesn't amazon have such a huge turn over that they are running out of possible candidate to replace those workers?
Being pushed to deliver more and more packages in shorter time or inspect train cars in less time then required why would one care if a packages gets tossed or a rail car is not properly inspected?
In most jobs the only consequence is to be fired which is already possible for no reason what so ever in many states.
You definitely have enough time to work at leisurely pace and assemble every part right. There's not much rushing going on there. If workers get away with doing dodgy work you have a QA issue.
So conditions at the plant in North Charleston haven't looked very good for almost 10 years...
[1] https://www.aljazeera.com/program/investigations/2014/7/20/t...
Let's not pretend layoffs are new.
If not you've got things like a reduction in manufacture of ICBMs to consider.
> My theory is that this is not limited to Boeing or even aircraft design, it's a much deeper and systemic problem affecting all kinds of fields. We've had a lot of industrial accidents lately.
> When aircraft manufacturing was an emerging industry there were tons of undocumented safety margins and "slack" in the design and production pipeline. Over time, the beancounters start optimizing stuff, so these undocumented safety margins are eroded in the name of efficiency/profit (and sometimes even documented safety margins too).
> Furthermore, workers back in the day had a much better life when it comes to purchasing power (especially when it comes to property), and so could actually "give more fucks" about the job than they do now which is a compounding factor. You used to get a lot of implicit quality assurance back then which you don't get now.
> We've now reached a stage where these undocumented safety margins have been eroded enough that it actually starts to cause issues, and the safeguards that are supposed to catch them aren't good enough, either due to 1) they've never been good enough but just weren't really needed before or 2) they too have been eroded in the same way for the same reason.
Privately-owned companies or worker-owned companies are more resilient to this problem because the nature of their existence means a stronger focus on long term goals. Though there are still issues with publicly owned companies exerting enough influence to acquire and subsequently destroy private companies. For example, Rite-Aid acquiring Bartell Drugs then going bankrupt and proceeding to shutter most Bartell Drug stores leaving Seattle with a deficit of pharmacies.
Welcome to the outcome. When companies look at employees and employee training as an expense, and when the only way to improve your salary is to go to a new company, expect to see these companies to be hollowed out shells of untrained people.
After 9/11 a friend who I’m close with was laid off as well as many other maintenance people. United began the process of moving their plane maintenance people to southeast Asian locations to cut down on labor.
Race to the bottom to save money and now loose bolts?
Why couldn't you use something a camera on eyeglasses while doing the work correctly to fine tune a multimodal model, and then infer to a user wearing the same glasses? Audio reply saying "nope, try again."
You would need multiple frames per second, so not today, but not that far into the future, right?
edit: Zero-shot, I just took photos of me "fixing things" around the house, and here is what ChatGPT told me. It does not suck. Do this with fine tuning, many frames per second, and what am I missing?
If a missing some major required component aside from finetuning and frames per sec, which will require a few years for everything to be fast enough... please let me know what it is.
Wait, oh it will be understanding of time... the sequencing of the frames. That is missing for now, right?
Given that the discussion in this post is around torquing to the right specifications, I don't know if just fine tuning is enough. It might need more serious training on videos of assembly. Even then, can it distinguish between the right torque or not from video?
I think it's interesting, but you should deliberately try to make it fail to see where the edges are. Like hold a wrench of the obviously wrong size next to a nut and ask if that will work. Force perspective so they look the same size. See if it will prevent you from mixing potentially dangerous chemical combinations. Will it warn you to wear protective eyewear when using a circular saw?
But in a manufacturing environment, if one labelled wrench sizes with different colors, then things like noticing wrench size would be easier. Also, I imagined that the camera would of known (same) geometry during training and inference in a Boeing implementation.
I also wonder if multimodal LLMs are blowing my mind unnecessarily. It really feels like a huge leap to me though.
I think there are digital wrenches that will record the torque they applied, you don't need to mess around with colors. But at that point, it's sort of like, why bother teaching the AI to notice if people are doing it right, stick a camera on the wrench and QR sticker on the bolt. Make a more formal verification process that can be guaranteed to match specifications.
So back in the day, Expert Systems were a big thing at Boeing. Searching Boeing's job openings today, it's a still a word used in hiring, but I don't understand what they mean by it in terms of manufacturing. Do you have any idea what they mean by that today?
I can't tell you about what Boeing does with expert systems. I've never been employed by them and I never really looked into it or where they use them. It's especially unclear because Boeing does a lot more than just pure manufacturing.
Maybe something like a camera monitoring that they are using the correct tool at various parts of assembly? But I'm not sure how feasible this would be at airplane levels of volume.
I bet it'll be common in car assembly at some point, though.