Final report on Alaska Airlines Flight 1282 in-flight exit door plug separation

long story short:

1. boeing and spirit both work on planes

2. damaged rivets discovered and lots of back and forth to get them repaired. boeing does the doors and spirit does the rivets.

3. rework on rivets needed door plug to be removed, someone at boeing (who is not onsite) sees that the door plug needs to be removed, escalates this request but notes that work must wait for the next week because the only door person who is qualified to remove plugs is on leave.

4. door manager - on the day of the plug removal - de-escalates the door plug removal request. later that day the door manager, door master and three door crew enter area near the fuselage & door plug - correct documentation of removal not generated and none of them were trained to remove door plug. No one knows who removed the plug.

5. a boeing technician moves a stand that has what he believed to be a door plug bolt on top of it. he "strapped it and let it hang" to the fuselage.

6. Spirit indicates plug was removed and reworks rivets

7. No one checks the door plug was reinstalled correctly

Boeing also had a rivet problem on Japan Air Lines Flight 123 in 1985 and 520 people died.

https://en.wikipedia.org/wiki/Japan_Air_Lines_Flight_123

Damn son, thanks

Also, Boeing spun off Spirit in 2005 to juice its own profit margins, so the poor coordination between these two entities is ultimately Boeing's poor judgment. And more specifically that of Harry Stonecipher, perhaps the worst American CEO this side of Jack Welch.

I really love reading NTSB and Coast Guard break-downs... a lot of very interesting engineering!

Full NTSB report https://www.ntsb.gov/investigations/AccidentReports/Reports/...

> The crash is the deadliest single-aircraft accident in aviation history…caused by a faulty repair by Boeing technicians

Extremely sad to learn this. It could have been prevented.

A benefit of being a golden child business to the US government is you don’t have to worry about economic consequences like a normal business. They’ll still make money off gov contracts and the “local jobs” monopoly system that congress protects like the mob.

4. Someone knows who removed the plug, but they're not about to fess up to it because they totally fucked up.

Pretty neat how you’ve become so good at summarizing what looks stupendously opaque to me.

Yep. And it's all fruit of the MD management takeover in '94.

https://www.economist.com/news/2014/11/17/the-trouble-with-m...

Yep. A "strategic defense contractor" can do whatever it wants[0], and get away with even more[1] than the United Fruit Company (UFC).[2]

0. https://www.seattletimes.com/business/boeing-lawsuit-alleges...

1. https://thehill.com/newsletters/business-economy/4793579-boe...

2. https://en.wikipedia.org/wiki/Banana_Wars

The Air Force and Navy aviation also usually release public reports outside of internal investigations and/or court-martials on their mishaps.