Don't Be Afraid to Ask

Lessons Learned

Don't be Afraid to Ask and Don't be Macho

October 2004

I recall my days as an on-the-job-trained mechanic in a certain charter-operations company near the local domestic airport. I was in my third year of college, and it was my first experience of working in the aircraft maintenance field.

It was late afternoon, after refueling a De Havilland Twin Otter with full passengers and their baggage. I installed the fuel cap and closed it; it was the first time that I installed that cap. After signaling our lead mechanic all's OK, we cleared the aircraft, then the engines roared. The aircraft taxied and took off with no incident. Then suddenly after a couple of minutes the aircraft returned to our hangar accompanied with airport fire trucks. The pilot onboard said after takeoff there was a pressure buildup of air in the fuel tanks. He maneuvered the aircraft into a turnaround and landed safely. Then it was found that fuel was also leaking from the fuel cap I stowed!

Assuming is dangerous. It was my mistake. I assumed that I securely installed the fuel cap. And I did not ask our lead mechanic to check it. And the latch which helps you open/close the cap was obviously damaged, a piece had broken off. Even that I did not call to the attention of our lead mechanic.

That was then and this is now. Right now I?m recuperating from an injury in my lower spine that I sustained from my present work in a MRO. I recently fell 20 feet straight down from the aft door of a wide body aircraft we were overhauling. The culprit was a temporary platform (made of laminated wood), screwed onto the fuselage dock, which suddenly broke to pieces after stepping on it.

I was on the late shift working overtime. My co-workers and I were carrying out a galley module we just removed in the cabin. Three of us first stepped out of the LH aft passenger/crew door. Then I suddenly heard a loud snap! I looked down, the platform broke off and fell to the ground. I fell and hit the ground, my lower spine getting most of the impact. When I was falling I immediately protected my head. All my co-workers were alarmed; they put me on a stretcher and carried me off in an ambulance to the nearest hospital. I thank God that my two co-workers who stepped out with me in the LH aft passenger/crew door managed to hold on and were safe. And thankfully I received no serious fractures, I was not paralyzed, and my spine can still recuperate.

I'm not here to scare anybody out of this profession. I just want to promote awareness that safety is and must always be given the top priority before any work is done on the aircraft. All mechanics from foreman to the workman must assess whatever safety concern they may encounter in a particular task they will work on. And we must always follow what is stated in the manual. Always be aware of your surroundings especially when working on fuselage docks, workstands, or on high areas. Don?t be macho, always wear a safety harness attached to a lifeline. Be sure the harness and lifeline are well secured when doing a wing walk, or above the pylon, above the elevators, or around the vertical stabilizer because you never know when an accident is just lurking around when you?re not careful and aware.

Remember God has given us only one life. If we lose it, we may lose it forever.

Safety First
I am not a storyteller so bear with me. It was third shift, chilly, and raining. A 767 aircraft was to be returned to the customer the next morning. The aircraft was parked in the long-term storage area due to no hangar space. In order to save time for the mechanics it was towed nose up to the hangar doors for power, etc. Here?s where it started to go wrong. The aircraft was not positioned properly, the mechanics who placed the entry stand were new or were in a hurry because of the rain. The entry stand could not be placed properly because the power island was in the way. So it was placed at an angle to the entry door. To top it all off, it was the wrong stand for this use. The stand was for working on a 747 APU area built at an angle to fit around the tail cone area.

The workload that night was heavy, so a mechanic from another maintenance line was assigned to help out the regular crew detail and check the aircraft for an early morning departure. He was told to help the mechanics in the interior and at the time he was assigned the entry door was closed to keep the rain out.

To my knowledge he had never been on a 767 aircraft. He was told how to get in the aircraft and away he went. In order to open the door he had to pull the release handle just forward of the door; there was no guard railing to protect him. He reached out and pulled the handle, lost his balance and fell to the apron. His injuries were fatal. The causes are many (1) wrong positioning of the aircraft, (2) wrong stand used, (3) no railing, and (4) no training on the aircraft before working on it. (The handle is spring loaded to the open position which is probably how he lost his balance.)

To prevent this from happening again a few simply things need to be addressed such as proper supervision safety at all times not just during the day shift Monday through Friday, proper usage of equipment, and last but not least training. Knowledge does not kill but aircraft can and will.

Editor?s Note: One way that many of us learn safe maintenance practices is through the lessons learned from someone?s mistakes or oversights. By learning from others mistakes or sharing our own lessons learned with others, everyone is more knowledgeable and safety is enhanced. So send us your story of an incident that happened to you or someone you know.

?Lessons Learned?
1233 Janesville Avenue
Fort Atkinson, WI 53538
or e-mail to