REG NASA-LLIS-0884-2000 Lessons Learned Lack of Communication Leading to Aircraft Tow Incident.pdf

1、Lessons Learned Entry: 0884Lesson Info:a71 Lesson Number: 0884a71 Lesson Date: 2000-05-22a71 Submitting Organization: ARCa71 Submitted by: Anthony BricenoSubject: Lack of Communication Leading to Aircraft Tow Incident Description of Driving Event: A ground crew was towing the NASA owned B747SP to th

2、e nose docks at Raytheon E-Systems Waco facility. Damage to the aircraft was sustained when the crew was trying to position the aircraft in the nose dock. The aircraft was slightly off center and while it was being moved, it struck one side of the nose dock. The extent of the damage was about 30 squ

3、are inches located on the left hand side of the aircraft just aft of the flight deck, close to the emergency escape area. Ground handling personnel did not have whistles or any other means to properly communicate with the tug driver. An alignment centering line had been painted on the hangar floor b

4、ut the scaffolding had since been moved off-center without notifying all ground tow personnel.Lesson(s) Learned: 1. Inadequate means for communication during towing can lead to damage to aircraft.2. Pre-briefing wilth all tow personnel prior to each tow will assist in planning each tow and avoiding

5、potential towing incidents. For this incident, a pre-briefing would have brought to everyones attention that the scaffolding had been moved off-center and that potential collision with the scaffolding would be likely. Painting of a new alignment centerline would have likely avoided collision of the

6、aircraft with the scaffolding.Recommendation(s): A detailed review of the towing incident revealed that the procedures were adequate, all personnel were certified to participate in the towing of the aircraft, and that whistles are provided for use during towing operations. For this particular incide

7、nt, personnel did not following the towing procedures. Disciplinary actions were taken by company management and emphasis was placed on correctly following towing procedures.Provided by IHSNot for ResaleNo reproduction or networking permitted without license from IHS-,-,-Evidence of Recurrence Contr

8、ol Effectiveness: An audit was successfully performed to verify compliance with establish procedures.Documents Related to Lesson: N/AMission Directorate(s): a71 Exploration Systemsa71 Aeronautics ResearchAdditional Key Phrase(s): a71 Aircrafta71 Communication Systemsa71 Flight Operationsa71 Ground O

9、perationsa71 Ground Equipmenta71 Human Factorsa71 TransportationAdditional Info: Approval Info: a71 Approval Date: 2000-06-14a71 Approval Name: Eric Raynora71 Approval Organization: QSa71 Approval Phone Number: 202-358-4738Provided by IHSNot for ResaleNo reproduction or networking permitted without license from IHS-,-,-