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A B777 in heavy maintenance has an engineering change order to repair and return the right engine air oil heat exchanger dependent on data plate number. Unit not replaced due to technician checked wrong data plate.
| Attributes | |
| ACN | 633145 |
| Time | |
| Date | 200410 |
| Day | Wed |
| Local Time Of Day | 1201 To 1800 |
| Place | |
| Locale Reference | airport : zzz.airport |
| State Reference | US |
| Altitude | agl single value : 0 |
| Environment | |
| Light | Daylight |
| Aircraft 1 | |
| Operator | common carrier : air carrier |
| Make Model Name | B777 Undifferentiated or Other Model |
| Operating Under FAR Part | Part 121 |
| Flight Phase | ground : maintenance |
| Person 1 | |
| Affiliation | company : air carrier |
| Function | maintenance : lead technician |
| ASRS Report | 633145 |
| Person 2 | |
| Affiliation | company : air carrier |
| Function | other personnel other |
| Events | |
| Anomaly | aircraft equipment problem : critical maintenance problem : improper maintenance non adherence : published procedure non adherence : far |
| Independent Detector | other other : 1 |
| Resolutory Action | none taken : detected after the fact |
| Consequence | other other |
| Factors | |
| Maintenance | contributing factor : engineering procedure performance deficiency : repair performance deficiency : inspection performance deficiency : scheduled maintenance |
| Supplementary | |
| Problem Areas | Aircraft Chart Or Publication Maintenance Human Performance |
| Primary Problem | Maintenance Human Performance |
Narrative:
During the MBV2 (maintenance base visit 2) for aircraft X, I was performing an eco (engineering change order) for the ahoe (air oil heat exchanger), to determine if it needed to be right&right (repair and return). As it turned out, I got my information from the wrong data plate on the component and decided the ahoe was ok to leave on the aircraft, when in fact it should have been changed.
Original NASA ASRS Text
Title: A B777 IN HVY MAINT HAS AN ENGINEERING CHANGE ORDER TO REPAIR AND RETURN THE R ENG AIR OIL HEAT EXCHANGER DEPENDENT ON DATA PLATE NUMBER. UNIT NOT REPLACED DUE TO TECHNICIAN CHKED WRONG DATA PLATE.
Narrative: DURING THE MBV2 (MAINT BASE VISIT 2) FOR ACFT X, I WAS PERFORMING AN ECO (ENGINEERING CHANGE ORDER) FOR THE AHOE (AIR OIL HEAT EXCHANGER), TO DETERMINE IF IT NEEDED TO BE R&R (REPAIR AND RETURN). AS IT TURNED OUT, I GOT MY INFO FROM THE WRONG DATA PLATE ON THE COMPONENT AND DECIDED THE AHOE WAS OK TO LEAVE ON THE ACFT, WHEN IN FACT IT SHOULD HAVE BEEN CHANGED.
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.