The FAA delegated too much of the 737 MAX’s certification oversight to Boeing and it failed to understand the implications of the MCAS autotrim system, according to an international panel that reviewed the troubled aircraft and released its report today.
In the wake of two hull loss accidents that killed 346 people, the Joint Authorities Technical Review examined both the accident data and the FAA’s certification trail and concluded the agency left too many decisions without proper oversight to Boeing. The JTAR, led by NTSB veteran Chris Hart, was formed in April shortly after an Ethiopian Airlines crash in March. It includes safety experts from nine certification agencies, including the FAA and NASA.
“With adequate FAA engagement and oversight, the extent of delegation does not in itself compromise safety. However, in the B737 MAX program, the FAA had inadequate awareness of the MCAS function which, coupled with limited involvement, resulted in an inability of the FAA to provide an independent assessment of the adequacy of the Boeing-proposed certification activities associated with MCAS,” the JTAR report said.
The so-called Maneuvering Characteristics Augmentation System was installed on the MAX by Boeing to mimic the control feel and forces of previous 737 models. Because of the MAX’s larger, more forward-mounted engines, it exhibited light pitch-up forces at high angles of attack with a rearward CG at low weights. MCAS was designed to roll in automatic nose-down stabilizer trim to reproduce the control forces pilots were used to in previous 737s.
However, The Seattle Times and other new organizations reported that Boeing made MCAS—which was capable of applying full nose-down trim—far more aggressive without informing the FAA of design changes. Boeing was also criticized for using a single angle-of-attack vane for the MCAS data input and for failing to notify airlines and pilots of the system’s technical specs.
In the first fatal crash of Lion Air 610 off Jakarta on Oct. 29, 2018, a failed AoA vane caused the MCAS system to activate intermittently, feeding in nose-down trim until the pilots could no longer control the airplane. The crash killed all 181 people aboard. A second crash on March 10, 2019, killed 157 occupants aboard Ethiopian Airlines Flight 302, which impacted near Addis Ababa. Initial data suggests the circumstances were similar to the Lion Air accident, even though the pilots had been briefed on the previous accident.
The JATR report summary also said, “The JATR team found that the MCAS was not evaluated as a complete and integrated function in the certification documents that were submitted to the FAA. The lack of a unified top-down development and evaluation of the system function and its safety analyses, combined with the extensive and fragmented documentation, made it difficult to assess whether compliance was fully demonstrated.”
Late last month, JATR chairman Hart told Reuters that the certification system isn’t broken, but does need improvement. “The U.S. aviation system each day transports millions of people safely, so it’s not like we have to completely overhaul the entire system, it’s not broken. But these incidents have shown us that there are ways to improve the existing system,” Hart told the news agency.
Hindsight is always 20/20. Even though it is obvious that, out of whatever reasons, Beoing did take some shortcuts and did not do their due diligence in regards to one sensor dependability on overriding the other systems, including the pilot.
In addition, not informing the pilots and authorities of the implications was more than an oversight and done, in the intention to save money and time, both for Boeing stock holders as well as by Airlines interests in saving educational cots, which in the end cost all of them way more and in addition cost many innocent people their lives.
The lessons learned meetings though is what will make a difference on both sides of the regulatory and Manufacturers / users sides. This is just the tip of the iceberg and there are a ton of other oversights like this that usually get handled by AD’s and other corrections that usually dripple in over time making at an even safer system.
Usually the last Products from a line of manufacurered vehicles, let it be cars or planes are the safest of their brethren. Without innovation though, there would be no growth in safety and economy, so there is always a “price to pay”. The most precious price, which are lives of people has the aftereffect of a big price to pay in many areas, such as reputation, trustworthiness and the least important is just an aftereffect is money….. which they aimed at saving in the first place. It is ironic that greed paired with overconfidence will continue to have the same effects not only here. (Just look at the Diesel scandal of the european car makers, lol) “Lies have short legs and thed don’t get very far….”
Boggles my mind when I think of how many hours it has & will take for a team of engineers to fix this. In lite of the urgency here, don’t they have “round the clock” input here? Hummm
Much of the problem lies with the arrogance of top management in FAA and The industry in general.
If Engineers and Mechanics are critical they will find themselves out of a job. Workshops find their business going to the lowest bidders.
Actually, the lack of oversight was on Boeing’s part; ODA has delegated it to Boeing. I work under ODA for a jet engine manufacturer; when we went under the program, things got harder, not easier—these guys KNEW their behinds were on the line.
The FAA is a clunky, outdated mess—just look at the delays in medical cert issues.
Since the FAA delegated many certification decisions to Boeing, does the FAA (aka US Fed Govt) share liability for the failure of the 737 MAX’s MCAS? Clearly, the families of those killed in the two crashes are going to get big payouts from Boeing – will the FAA have to share in paying those payouts? Seems the families now have access to the US Treasury’s big, big bag of money. Does “joint and several liability” affect the payouts? In the “old days”, if you let someone else take care of your responsibilities, you were responsible for what that person does.