What happened
The FAA’s narrative, in sentence case. The FAA writes it in capitals and removes private details.
Event:
? UAL2429 was being pushed off the gate when it struck a stationary "stair truck?. This took place on the non movement area. Newark ATCT was not speaking to any of the operators involved in this situation.
? N37273 (B737-800) left scimitar winglet came into contact with delta airlines ground equipment, causing damage to the scimitar
Root cause:
? Assumption that delta airline?s ongoing operation of mainline aircraft of the same gauge at this gate implied compliance with FAA and corporate standards.
? Station leadership?s improper assumption that gates reviewed by aero systems engineering meet FAA and corporate gate design standards by default
? Acceptance of a gate design which left little margin of error as result of an AD hoc assessment of gate functionality vs. completion of a documented risk assessment and thorough review of company and FAA guidelines (FAA ac 150/5300)
? The gate lead?s failure to alert his chain of command when he found the wireless headsets inoperable as a result of becoming un-paired
? The gate lead?s failure to maintain alignment on the j-line
Corrective action:
? The ramp servicemen who was driving push tractor file a asap report regarding the incident. The report has been accepted and the employee has been retrained.
? Gate B40 and B41 are closed for further assessment and safety evaluation with engineering design firm aero systems and ao safety.
? Risk assessment will be completed for each gate with ao safety, cre, engineering design firm (aero), and rs dsts
? In conjunction with ao safety, safety briefing charts will be developed for each gate that will identify gate restrictions and safety hazards (see example). Will be developed into a laminated book for issue to each rss and tl as a reference document.
? Consider implementation of a qualification standard for pushback operators
? Rss has been assigned immediate responsibility to train rses and equipment room personnel how to pair wireless headsets
As the FAA filed it
EVENT:
? UAL2429 WAS BEING PUSHED OFF THE GATE WHEN IT STRUCK A STATIONARY "STAIR TRUCK?. THIS TOOK PLACE ON THE NON MOVEMENT AREA. NEWARK ATCT WAS NOT SPEAKING TO ANY OF THE OPERATORS INVOLVED IN THIS SITUATION.
? N37273 (B737-800) LEFT SCIMITAR WINGLET CAME INTO CONTACT WITH DELTA AIRLINES GROUND EQUIPMENT, CAUSING DAMAGE TO THE SCIMITAR
ROOT CAUSE:
? ASSUMPTION THAT DELTA AIRLINE?S ONGOING OPERATION OF MAINLINE AIRCRAFT OF THE SAME GAUGE AT THIS GATE IMPLIED COMPLIANCE WITH FAA AND CORPORATE STANDARDS.
? STATION LEADERSHIP?S IMPROPER ASSUMPTION THAT GATES REVIEWED BY AERO SYSTEMS ENGINEERING MEET FAA AND CORPORATE GATE DESIGN STANDARDS BY DEFAULT
? ACCEPTANCE OF A GATE DESIGN WHICH LEFT LITTLE MARGIN OF ERROR AS RESULT OF AN AD HOC ASSESSMENT OF GATE FUNCTIONALITY VS. COMPLETION OF A DOCUMENTED RISK ASSESSMENT AND THOROUGH REVIEW OF COMPANY AND FAA GUIDELINES (FAA AC 150/5300)
? THE GATE LEAD?S FAILURE TO ALERT HIS CHAIN OF COMMAND WHEN HE FOUND THE WIRELESS HEADSETS INOPERABLE AS A RESULT OF BECOMING UN-PAIRED
? THE GATE LEAD?S FAILURE TO MAINTAIN ALIGNMENT ON THE J-LINE
CORRECTIVE ACTION:
? THE RAMP SERVICEMEN WHO WAS DRIVING PUSH TRACTOR FILE A ASAP REPORT REGARDING THE INCIDENT. THE REPORT HAS BEEN ACCEPTED AND THE EMPLOYEE HAS BEEN RETRAINED.
? GATE B40 AND B41 ARE CLOSED FOR FURTHER ASSESSMENT AND SAFETY EVALUATION WITH ENGINEERING DESIGN FIRM AERO SYSTEMS AND AO SAFETY.
? RISK ASSESSMENT WILL BE COMPLETED FOR EACH GATE WITH AO SAFETY, CRE, ENGINEERING DESIGN FIRM (AERO), AND RS DSTS
? IN CONJUNCTION WITH AO SAFETY, SAFETY BRIEFING CHARTS WILL BE DEVELOPED FOR EACH GATE THAT WILL IDENTIFY GATE RESTRICTIONS AND SAFETY HAZARDS (SEE EXAMPLE). WILL BE DEVELOPED INTO A LAMINATED BOOK FOR ISSUE TO EACH RSS AND TL AS A REFERENCE DOCUMENT.
? CONSIDER IMPLEMENTATION OF A QUALIFICATION STANDARD FOR PUSHBACK OPERATORS
? RSS HAS BEEN ASSIGNED IMMEDIATE RESPONSIBILITY TO TRAIN RSES AND EQUIPMENT ROOM PERSONNEL HOW TO PAIR WIRELESS HEADSETS