What happened
On December 9, 2023, an Embraer 195 operated by TAP Express, registration CS-TAX, was parked at stand 703 in Lisbon Airport (LPPT) following a flight from Porto. During the turnaround process for flight TP1324 to Dublin, the ramp agent removed the passenger stairs. Upon noticing the removal of the stairs, the pilot in command (PIC) consulted the ramp agent, who reported a small dent on the stairs. The crew checked the aircraft's Dent & Buckle Chart (D&BC) and, finding existing records of dents in that area, determined that the flight could proceed safely.
However, after landing in Dublin, the crew received an ACARS message from maintenance requesting an inspection of the area beneath the left-hand cockpit window. This inspection confirmed that the aircraft had sustained a forward fuselage perforation. The aircraft was subsequently withdrawn from service for repairs, which were completed in Lisbon by December 19.
The investigation
The GPIAAF investigation examined the event alongside subsequent damage records found on the same aircraft, including V-shaped marks caused by blunt objects recorded in late December 2023 and January 2024. The investigation reviewed the operator's maintenance records, specifically the D&BC, which contained a high volume of entries (over 200), making rapid comparison of recent damage difficult. The investigation also looked into the ground handling provider's safety management system and equipment maintenance protocols.
Findings
- The pattern of damage indicates a systemic issue with ground handling procedures or equipment when positioning aircraft access equipment.
- The aircraft's high flight cycle ratio (approximately 0.588 cycles per hour) increases its exposure to ground-based risks.
- The high number of active entries in the D&BC complicates the ability of crews to quickly identify new versus existing damage.
- The operator's fleet lacks integrated airstairs, necessitating the use of mobile ground equipment that poses a contact risk.
- The operator's safety department had previously issued alerts regarding the area around door 1L, but the damage persisted.
Safety action
Following the incident, the operator issued a safety alert instructing pilots to visually verify any damage reported by handling agents, regardless of whether it is already recorded in the D&BC. The ground handling provider initiated inspections of all ground equipment to eliminate critical contact points and reinforced "no touch" policies through awareness campaigns.