1999-10 · NASA ASRS report 453547
A B767-300 INCURRED HYD SYS DAMAGE WHEN THE L SYS WAS OPERATED TO TEST A REPLACEMENT ENG DRIVEN PUMP WITH NO FILTERS INSTALLED.
ON OCT/XA/99; I WAS PULLED OFF LIVE FLT GATES TO TRY TO RETURN TO SVC A B767 THAT HAD A DISINTEGRATED L ENG HYD PUMP. I WAS TOLD TO GO HELP 2 OTHER TECHNICIANS FINISH UP TIGHTENING UP A FEW HOSES; FILTER HOUSINGS; AND THE ACTUAL PUMP. UPON ARR TO THE ACFT; THE TECHNICIANS WERE ALMOST DONE AND WAS DIRECTED TO THE COCKPIT TO GET READY FOR AN ENG RUN. I PROCEEDED TO MOTOR AND THEN RUN THE L ENG PER THE TAXI/START-UP CHKLIST EXCEPT OMITTED TO CHK THE LOGBOOK. AT THE TIME; I FOUND IT NOT OF GREAT CONCERN BUT LATER FOUND OUT THAT THIS JOB WAS A PRIOR SHIFT TURNOVER. THE JOB WAS TURNED OVER TO 4 DIFFERENT PEOPLE BEFORE WE STARTED WORKING ON IT. PER THE MAINT MANUAL WE WERE TO CHK THE HYD FILTER FOR CONTAMINATION. UPON REMOVING THE HOUSING WE FOUND OUT THERE WERE NO FILTERS INSTALLED. NOBODY HAD SAID ANYTHING TO US. AFTER THE INCIDENT I LOOKED THROUGH THE LOGBOOK AND SAW AN ITEM THAT READ 'CASE DRAIN AND PRESSURE FILTERS REMOVED; HOUSING INSTALLED LOOSELY.' THIS IS A PERFECT EXAMPLE OF COM BREAKDOWN. ALTHOUGH THE ITEM WAS IN THE LOGBOOK; IT SHOULD HAVE BEEN REITERATED THAT THE FILTERS WERE NOT INSTALLED. ALL OF THE MECHS INVOLVED ARE OF GOOD MAINT JUDGEMENT. THIS INCIDENT IS JUST A NATURAL HUMAN ERROR.
More incidents for this aircraft family
Source: NASA Aviation Safety Reporting System (public domain). Reports are voluntary submissions and are not verified by NASA.
Loading the flight search…
Pick an aircraft model — Boeing 737, Airbus A320, A380, Boeing 787 Dreamliner and more — enter your origin airport, and FlightFinder shows every route that plane flies from there with live fares.
We support Boeing 737/747/757/767/777/787, the full Airbus A220/A319/A320/A321/A330/A340/A350/A380 family, Embraer E170/E175/E190/E195, Bombardier CRJ and Dash 8, and the ATR 42/72 turboprops.
Search and schedules are free. Pro ($4.99/month, $39/year, or $99 one-time lifetime) unlocks the enriched flight card — on-time stats, CO₂ per passenger, amenities, live gate & weather — plus My Trips with push alerts.
Live schedules come from Amadeus, AeroDataBox and Travelpayouts. Observed routes (which aircraft actually flew a given city pair) are crowdsourced from adsb.lol ADS-B data under the Open Database License.