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A B737-700 was released for service in non compliance with the right engine hydraulic pump case drain quick disconnect not reconnected after the filter change.
| Attributes | |
| ACN | 623986 |
| Time | |
| Date | 200407 |
| Day | Wed |
| Local Time Of Day | 1801 To 2400 |
| Place | |
| Locale Reference | airport : zzz.airport |
| State Reference | US |
| Altitude | agl single value : 0 |
| Aircraft 1 | |
| Operator | common carrier : air carrier |
| Make Model Name | B737-700 |
| Operating Under FAR Part | Part 121 |
| Flight Phase | ground : maintenance |
| Flight Plan | IFR |
| Person 1 | |
| Affiliation | company : air carrier |
| Function | maintenance : technician |
| Qualification | technician : airframe technician : powerplant |
| ASRS Report | 623986 |
| Person 2 | |
| Affiliation | company : air carrier |
| Function | maintenance : inspector |
| Events | |
| Anomaly | aircraft equipment problem : critical maintenance problem : improper documentation maintenance problem : improper maintenance non adherence : company policies non adherence : far non adherence : published procedure |
| Independent Detector | aircraft equipment other aircraft equipment : right hyd temp indic other other : 987 |
| Resolutory Action | none taken : detected after the fact |
| Factors | |
| Maintenance | contributing factor : schedule pressure performance deficiency : scheduled maintenance performance deficiency : logbook entry performance deficiency : installation performance deficiency : inspection performance deficiency : non compliance with legal requirements |
| Supplementary | |
| Problem Areas | Maintenance Human Performance Environmental Factor Chart Or Publication Aircraft |
| Primary Problem | Maintenance Human Performance |
Narrative:
On back course check, #2 heavy engine, I changed engine driven case drain filter. Disconnected hydraulic quick disconnect at firewall. Went to empty fluid and filter from container. Came back, safetied bowl. Excessive fluid draining from bowl. Pressure trapped between hydraulic shutoff valve to engine. Forgot to reconnect quick disconnect at firewall. Callback conversation with reporter revealed the following information: the reporter stated the case drain filter was replaced but the case drain hydraulic quick disconnect which was disconnected to prevent loss of hydraulic fluid during the filter change was not reconnected. When the analyst asked when was the disconnected case drain line discovered the reporter said 'he didn't know.' the reporter stated the engines were run after release from the 'B' check and may have had right hydraulic temperature warning.
Original NASA ASRS Text
Title: A B737-700 WAS RELEASED FOR SVC IN NON COMPLIANCE WITH THE R ENG HYD PUMP CASE DRAIN QUICK DISCONNECT NOT RECONNECTED AFTER THE FILTER CHANGE.
Narrative: ON BACK COURSE CHK, #2 HVY ENG, I CHANGED ENG DRIVEN CASE DRAIN FILTER. DISCONNECTED HYD QUICK DISCONNECT AT FIREWALL. WENT TO EMPTY FLUID AND FILTER FROM CONTAINER. CAME BACK, SAFETIED BOWL. EXCESSIVE FLUID DRAINING FROM BOWL. PRESSURE TRAPPED BTWN HYD SHUTOFF VALVE TO ENG. FORGOT TO RECONNECT QUICK DISCONNECT AT FIREWALL. CALLBACK CONVERSATION WITH RPTR REVEALED THE FOLLOWING INFO: THE RPTR STATED THE CASE DRAIN FILTER WAS REPLACED BUT THE CASE DRAIN HYD QUICK DISCONNECT WHICH WAS DISCONNECTED TO PREVENT LOSS OF HYD FLUID DURING THE FILTER CHANGE WAS NOT RECONNECTED. WHEN THE ANALYST ASKED WHEN WAS THE DISCONNECTED CASE DRAIN LINE DISCOVERED THE RPTR SAID 'HE DIDN'T KNOW.' THE RPTR STATED THE ENGS WERE RUN AFTER RELEASE FROM THE 'B' CHK AND MAY HAVE HAD R HYD TEMP WARNING.
Data retrieved from NASA's ASRS site as of July 2007 and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.