American Airlines, one of the world’s largest commercial air carriers, has not experienced a fatal accident in nearly two decades. Despite this safety record, reports of potentially unsafe maintenance practices have raised concerns about the Federal Aviation Administration’s (FAA) oversight of the carrier’s maintenance programs.
The Office of Inspector General (OIG) has examined whether FAA ensures that American Airlines implemented effective corrective actions to address the root causes of maintenance problems and has assessed FAA’s oversight of American Airlines’ safety management systems (SMS).
OIG found that FAA lacks effective oversight controls to ensure American Airlines’ corrective actions for maintenance non-compliances addressed root causes. According to FAA guidance, FAA inspectors should collaborate with the air carrier to correctly identify and fix the root cause(s) of deviations or non-compliances. However, in 171 of 185 (92 percent) of cases OIG sampled, FAA inspectors accepted root cause analyses by the air carrier that did not identify the true root cause of the problem. Furthermore, FAA closed compliance actions before the air carrier implemented its corrective actions.
OIG determined that FAA’s oversight controls are not effective for evaluating if American Airlines’ SMS sufficiently assesses and mitigates risk. FAA requires American Airlines to use its SMS to determine the level of risk associated with maintenance non-compliances. However, OIG found that FAA inspectors did not routinely or consistently evaluate whether the carrier adequately and effectively assessed and rated risks. This is in part because FAA did not provide its inspectors with comprehensive training and tools for overseeing and evaluating the carrier’s SMS, OIG says.
OIG has made seven recommendations to address the shortcomings:
- Develop and implement root cause analysis training for inspectors more in line with training in the aviation industry.
- Develop and implement a management control to ensure that inspectors maintain the link between the compliance action and the corrective action validation inspection within its inspection databases.
- Develop and implement a management control to ensure inspectors require air carriers to provide written root cause analyses and that these analyses do not specifically identify human factors issues as root causes.
- Develop and implement a management control to ensure that inspectors do not send compliance action close out letters until the corrective actions have been completed and validated.
- Develop and implement a team inspection approach in order to periodically assess the air carrier’s Safety Management System.
- Develop and implement Safety Management System training for inspectors that is specifically designed to aid inspectors in evaluating air carrier risk assessments.
- Revise the Safety Management Systems data collection tool to allow inspectors to perform more detailed reviews and accurately document the results of these reviews.
FAA concurred or partially concurred with OIG’s recommendations. For example, the Agency agreed that additional guidance is needed to address root cause analysis, but states it cannot statutorily require an air carrier to provide written root cause analyses. Alternatively, FAA stated it will publish a policy that provides clear expectations when requesting outputs and performing analyses of an air carrier’s SMS processes.