What happened
On 15 November 2006, an Airbus A320-214, registration G-BXKD, operated by Thomas Cook Airlines UK Ltd, performed a landing at Bristol Airport during significant turbulence and strong crosswinds. The landing was classified as a hard landing because specific parameters were exceeded upon touchdown.
Following this event, the flight crew recorded the exceedance in the Technical Log. An engineer at Bristol inspected the aircraft using the operator's computer-based maintenance system, AirN@V. After completing the inspection, the engineer released the aircraft for service. However, on a subsequent flight after takeoff from Bristol, the crew experienced difficulties raising the landing gear alongside several ECAM warnings. This necessitated a diversion to Manchester Airport. Upon arrival at Manchester, further troubleshooting revealed that the right main landing gear had suffered an internal rupture of the upper diaphragm tube, a result of the initial heavy landing at Bristol.
The investigation
The investigation examined the maintenance procedures and the use of the AirN@V system. It was established that the engineer at Bristol had not previously used the AirN@V system and had not received formal training on it. The investigation found that the engineer relied on a flow chart in the aircraft maintenance manual (AMM) which directed him to perform a heavy landing check.
Crucially, the inspection performed did not require or lead to the jacking of the aircraft. The investigation determined that a more recent task, AMM 05-51-200-004A, would have required the aircraft to be jacked, which would have likely revealed the internal damage. The investigation also noted that the engineer was unaware of this later task and that the maintenance software made it difficult to navigate or search for updated instructions.
Findings
- The initial landing at Bristol occurred in a strong crosswind and significant turbulence, which prevented adequate control during the flare.
- The internal damage to the landing gear was not visible during the external inspection performed at Bristol.
- The engineer's use of the AirN@V system was limited by a lack of training and the difficulty of navigating the software's menus.
- The maintenance documentation lacked clear differentiation in effectivity coding regarding whether certain sections applied to aircraft before or after specific Service Bulletins.
- There was no established link made between the sensor failure (20GA) and the previous LOAD <15> report during the troubleshooting process in Manchester.
Safety action
- Airbus is to amend maintenance documentation effectivity coding to clearly distinguish between 'PRE SB' and 'POST SB' aircraft.
- Airbus is to amend the AMM to highlight the possibility of internal landing gear damage following a 20GA or 21GA sensor fault and recommend aircraft jacking.
- Airbus is to amend the AMM ATA 31-37-00 to align landing classifications with the more comprehensive check procedures.
- Airbus is to amend the LOAD <15> report to clearly describe the event type and reference the appropriate check procedures.