6.2 Case Study Analysis: Accident Research – Aircraft Maintenance/Repair/Alteration Issues

In this activity, you may choose one of the following three accidents related to aircraft maintenance/repair/alteration issues as your Case Study Analysis:

• Japan Airlines Flight 123, Boeing 747-SR100, JA8119/FAALinks to an external site.
• https://www.faa.gov/lessons_learned/transport_airplane/accidents/JA8119
  
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• China Airlines Flight CI611, Boeing Model 747, B-18255/FAALinks to an external site.
• https://www.faa.gov/lessons_learned/transport_airplane/accidents/B-18255
  
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• American Airlines Flight 191, McDonnell Douglas DC-10-10, N110AA/FAALinks to an external site.
• https://www.faa.gov/lessons_learned/transport_airplane/accidents/N110AA
  

This case study explores aircraft maintenance, inspection, repair, or alteration flaws, often involving errors or faulty assumptions during the maintenance process. Feel free to explore each of the accident descriptions to help you decide if there is a particular accident you wish to study over the other two. As you study and research the accident you chose, be sensitive to discover what the flaws, errors, and faulty assumptions were.

These resources hold a wealth of data and useful information pertaining to the case study analyses of this course. Use this case study to become acquainted with the information and resource layout on this excellent website. Graphics, actual documents, and final accident reports are all included in the accidents provided in this database, which makes it a great starting point. Try to be as specific as you can while expressing your analysis in your own words, so try to limit your use of jargon.

Note: The links provided herein should serve as a starting point for your research and are not intended to be the only stop to your detailed analysis. You are encouraged to review the final accident report and other records and other sources, too (i.e., the Hunt Library).

You will analyze this case study in terms of mechanical and structural factors and provide a technical report that analyzes this accident case study (usually six or more pages, including a title page and reference page). This written assignment will be formatted as a research paper using Times New Roman, 12-point font, and double-spacing between lines of text. All sources should be cited using the American Psychological Association (APA) current edition style and format. Papers must be grammatically sound and free of spelling errors. See the Case Study Guidance tab for additional information on how to format your Case Study Analysis. 

Save your assignment using a naming convention that includes your first and last name and the activity number (or description). Do not add punctuation or special characters.

Your paper will automatically be evaluated through Turnitin when you submit your assignment in this activity. Turnitin is a service that checks your work for improper citation or potential plagiarism by comparing it against a database of web pages, student papers, and articles from academic books and publications. Ensure that your work is entirely your own and that you have not plagiarized any material!

It is best to include section headers to delineate one section from another clearly. Most of your research should be authoritative websites and databases, NO wikis. Use any resources you wish to complete this activity. Ensure you do a thorough Web search and check the vast database resources available from ERAU’s Hunt Library.

Your case study analysis must include the following sections sequentially:

1. Title or Cover Page – Include title, activity number, course number, and your name at a minimum.
2. Introduction or Executive Summary – Include a brief paragraph to introduce your reader to your approach to this analysis and what to expect.
3. Primary Causal Factor(s) of the Accident – Include one to two paragraphs identifying the probable cause(s) of the accident. Were these mechanical, structural, or both? Usually, it is hard to narrow an accident event down to a single cause, especially if two related or intertwined systems or system components are involved simultaneously, referred to as “coupling” in the context of safety analysis. This content must be evidence-based and factual in nature.
4. Contributing Factors to the Accident – Include two to four paragraphs identifying what the contributing factors were causal to the accident. These factors contributed to the accident, even though they weren’t primary. These factors could be links in the accident chain of events leading up to the mishap. These factors may reduce or exacerbate the accident conditions and resulting severity. A thorough analysis in this section should aid you in formulating potential risk mitigation or reduction strategies in a subsequent section. Infer flaws, errors, and faulty assumptions as part of the accident failure sequence. This content must be evidence-based and factual in nature.
5. Structural and Mechanical Factors Related to the Accident – Include two to four paragraphs identifying the structural and mechanical factors involved in this accident. This portion should entail the bulk of your analysis. Use this section to detail any strengths and weaknesses of the applicable aviation system(s), whether aircraft design, construction, maintenance, component reliability, etc. This content must be evidence-based and factual in nature.
6. Relevant Human Factors and/or Organizational Factors Related to the Accident – Include two to four paragraphs identifying what the relevant human/organizational factors were involved in this accident. Be sure to include how these deficiencies led to or exacerbated the situation. This content must be evidence-based and factual in nature.
7. Outcomes of the Accident – Include two to four paragraphs stating what happened subsequent to the accident (this may be months or years later). Although a bulleted list of outcome items may be provided, there should be sufficient explanations to describe any disparities between the investigation board’s proposed solutions (i.e., recommendations) versus “real-world” eventual actions by the various governmental and industry groups. Examples may include possible airworthiness directives (ADs) issued, new regulations or rules adopted or amended, redesign standards, etc. Consider which recommendations were suggested by the investigation board. Were these recommendations followed or complied with? What recommendations were left unheeded? If so, why? This content must be evidence-based and factual in nature.
8. Risk Mitigation or Reduction Strategies – Include two to four paragraphs explaining, from your analysis, any risk mitigation or reduction strategies or methods that you believe may have either prevented this accident or lessened its severity. This is your opportunity to demonstrate and integrate your knowledge learned up to this point of the course and apply learned facets in analyzing this accident. This is where you can interject your opinions, suggestions, any differences you may have regarding investigation board results, and any differences toward eventual outcomes related to this accident. Point out primary and secondary failures associated with assumptions and errors in an aviation accident.
9. Conclusion or Summary – Include one or two paragraphs to explain your main takeaways from this case study. This is your opportunity to demonstrate and integrate your knowledge learned up to this point of the course and apply learned facets in analyzing this accident. This is also where you can interject your opinions, suggestions, or differences regarding investigation board results related to this accident. 
10. Reference Page – Include all references cited in the paper of information sources in current APA 7th edition format.