The fuselage panel that blew off an Alaska Airlines jet earlier this month was removed for repair then reinstalled improperly by Boeing mechanics on the Renton final assembly line, a person familiar with the details of the work told The Seattle Times.
If verified by the National Transportation Safety Board investigation, this would leave Boeing primarily at fault for the accident, rather than its supplier Spirit AeroSystems, which originally installed the panel into the 737 MAX 9 fuselage in Wichita, Kan.
That panel, a door plug used to seal a hole in the fuselage sometimes used to accommodate an emergency exit, blew out of Alaska Airlines Flight 1282 as it climbed out of Portland on Jan. 5. The hair-raising incident drew fresh and sharp criticism of Boeing’s quality control systems and safety culture, which has been under the microscope since two fatal 737 MAX crashes five years ago.
Last week, a different person — an anonymous whistleblower who appears to have access to Boeing’s manufacturing records of the work done assembling the specific Alaska Airlines jet that suffered the blowout — on an aviation website separately provided many additional details about how the door plug came to be removed and then mis-installed.
“The reason the door blew off is stated in black and white in Boeing’s own records,” the whistleblower wrote. “It is also very, very stupid and speaks volumes about the quality culture at certain portions of the business.”
The self-described Boeing insider said company records show four bolts that prevent the door plug from sliding up off the door frame stop pads that take the pressurization loads in flight, “were not installed when Boeing delivered the airplane.” the whistleblower stated. “Our own records reflect this.”
NTSB investigators already publicly raised the possibility that the bolts had not been installed.
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The account goes on to describe shocking lapses in Boeing’s quality control process in Renton.
The work of the mechanics on the door plug should have been formally inspected and signed off by a Boeing quality inspector.
It wasn’t, the whistleblower wrote, because of a process failure and the use of two separate systems to record what work was accomplished.
Boeing’s 737 production system is described as “a rambling, shambling, disaster waiting to happen.”
If that account of what happened is indeed fully documented in Boeing’s system it should be readily verified by the investigation.
The Seattle Times offered Boeing the opportunity to dispute the details in this story. Citing the ongoing investigation, Boeing declined to comment. Likewise, so did Spirit, the FAA, the Machinists union and the NTSB.
A convincing account
Passengers on Flight 1282 were traumatized when a door-sized section of the 737 MAX 9 fuselage exploded out 16,000 feet over Portland.
The door plug that blew out is a panel used to seal a fuselage cutout for an optional emergency exit door that is installed only by a few airlines with high-density seating. To a passenger seated at that location, it looks like just another cabin window.
The incident has proved a monumental setback for Boeing, drawing outrage and mockery across the world.
With large fleets of MAX 9 aircraft still grounded almost three weeks later, the chief executives of both Alaska and United on Tuesday sharply criticized Boeing.
“I’m more than frustrated and disappointed,” Alaska CEO Ben Minicucci told NBC News. “I am angry.”
It was clear soon after the incident that the plug must have been mis-installed.
When the cabin is pressurized, six small stop fittings on either side of the plug press against corresponding stop pads on the door frame.
The only way for the plug to have blown out is if it moved up, so that the stop fittings were no longer aligned with the stop pads — which is how the plug is opened for maintenance.
Four key bolts that prevent such upward movement in flight could not have been in place.
The anonymous whistleblower posted his account online, in the comments appended to an article about the door plug incident on the Leeham.net aviation website.
Before explaining what happened, the person states the motivation for posting it. Doing so, the whistleblower repeated complaints frequently offered by Boeing longtimers who contend the company’s 1997 acquisition of competitor McDonnell Douglas undercut Boeing’s focus on quality.
“There are many cultures at Boeing, and while the executive culture may be thoroughly compromised since we were bought by [McDonnell Douglas], there are many other people who still push for a quality product with cutting edge design,” the whistleblower wrote. “My hope is that this is the wake up call that finally forces the Board to take decisive action, and remove the executives that are resisting the necessary cultural changes.”
The Seattle Times does not know the identity of the whistleblower.
However, the details provided about the manufacturing process failures that led to the door plug blowout appear authentic and authoritative. The Seattle Times confirmed with a Renton mechanic and a former 737 MAX production line manager that the whistleblower’s description of how this kind of rework is performed and by whom is accurate.
The Times also confirmed that the whistleblower accurately described the computer systems Boeing uses to record and track 737 assembly work, systems that mechanics and engineers sign into every day when they begin work.
The whistleblower outlines how, because of a mistake, the removal and re-installation of the door plug in Renton was never entered in the computer system where every detail of the build process on each individual aircraft is recorded. As a result, no quality inspection was triggered.
Ed Pierson, a former manager of the MAX production line and himself a whistleblower who raised concerns about quality control in Renton before the first MAX crash in Indonesia in 2018, said in an interview Monday the new account of the door plug mis-installation and the error in the recording of the work “is very consistent with what I saw in the factory personally.”
After reading the whistleblower account, he said “I think there is a very high probability this is accurate.”
“People, when they’re pressured and rushed, they think, well, I’ll catch up on the paperwork later,” Pierson said. “Then it goes from shift to shift and you don’t know if the next shift got it or not.”