Despite Boeing’s stated commitment to safety, significant problems continue to arise. Will the new CEO walk the talk?  ‍

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Industry sources continue to reach out to the Foundation with information related to Boeing aircraft unsafe conditions and airplane system failures. Despite the company’s claim they have improved their safety culture, and their products comply with all safety standards, recent accidents, incidents, and airworthiness directives show this is untrue. In addition, Boeing continues to petition for exemptions and exceptions from engineering safety standards^[1]. The data shows manufacturing and engineering defects, coupled with a failure to allocate resources to fix known safety deficits, is exposing the flying public to airplanes with reduced safety and the potential for future accidents. New leadership at Boeing must admit the safety deficit exists and systematically expend resources to fix known problems.

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On June 18, 2024, then Boeing CEO David Calhoun and Boeing’s Chief Engineer Howard McKenzie testified before the Senate Permanent Subcommittee on Investigations (PSI). During this sworn testimony senators asked a multitude of questions regarding Boeing’s safety culture enhancements, their commitment to improving manufacturing processes, and what action had been taken since the Alaska Airlines door plug blowout. Although Mr. Calhoun acknowledged the door blowout was a manufacturing error, he assured the committee that it was an isolated incident that would never happen again. Mr. McKenzie also stated during the hearing that:

“All of our designs are found to be compliant by FAA standards.”

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Frankly, nothing could be farther from the truth as a multitude of systems and components on 737 MAX aircraft are either non-compliant or have been granted FAA waivers regarding compliance. For example, Boeing received a waiver allowing the company to build and sell MAX airplanes that fail to comply with legally required safety design standards that were adopted back in January 2011. The design standards require a modern crew alerting system for pilots. This waiver was granted to Boeing despite outdated and confusing crew alerting systems being a factor in eight fatal crashes of Boeing aircraft resulting in 885 deaths according to official accident investigation reports.^[2]

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Another big safety concern is the lack of redundancy in the stabilizer trim motor system. This motor controls movement of the horizontal stabilizer in the tail of the airplane. The system relies on a 1960’s vintage manual crank backup that is not effective throughout the flight envelope. Currently this design flaw remains a single point of failure for the 737 MAX. To date FAA Service Difficulty Reports show at least a dozen documented Stab Trim failure incidents in the U.S. alone which resulted in multiple emergency diversions or immediate landings. These failures are occurring on nearly new airplanes.

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Additionally, during the June 18^th Senate hearing, both Boeing executives spent significant time showcasing manufacturing changes made and how the company is totally committed to safety as job one. When the Chief Engineer was questioned about accident and incident reports, Mr. McKenzie referred to their continued operational safety process where Boeing constantly monitors data and does a safety analysis and takes appropriate action. Which is the same process that resulted in the two MAX accidents, the 737 NG Blade out accident, and the Alaska Airlines door blow out accident.

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After the two MAX accidents, Boeing touted the creation of a new safety office that reports directly to the Board of Directors.^[3] Regardless of Boeing’s statements that they were changing their ways, Boeing continues to rush production and produce non-compliant airplanes, request exemptions/exceptions from safety regulations, and fail to provide design modifications to quickly fix known unsafe conditions. Incredibly, given the tragedies and incidents which have occurred, Mr. Calhoun stated he was “proud of Boeing’s safety record.” The statements made during the hearing focused on improving manufacturing quality but did not address the overall endemic safety deficit and culture resulting from a company focused on quarterly stock price rather than safety for over a decade.

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Meanwhile thousands of airplanes were produced in flawed factories where the primary focus was delivery schedule, not quality and compliance. Indeed, even after the two MAX disasters, Boeing removed thousands of quality inspections on individual airplanes without the FAA’s knowledge! The removal of these inspections did not comply with Boeing’s FAA issued production certificate. Although many, but not all, of these inspections were reinstated thanks to persistent efforts by Boeing’s IAM union, there are still several hundred Boeing airplanes that left Boeing factories without those thousands of inspections.^[4] Boeing has not committed to a systematic program to find and fix these defective airplanes. These airplanes are carrying passengers today.

Boeing leaders have stated their plans to eliminate “traveled work”, which the company defines as tasks “delayed and/or completed in a factory location other than what was originally planned.”

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Boeing CFO Brian West said, “Starting on March 1 of this year, we will no longer travel work between Wichita and our fuselage supplier [Spirit AeroSystems] and Renton [Boeing assembly plant] … It had been going on too long. So now we will only accept a fully conforming fuselage from Spirit, which means in the near term, there might be variability of supply.”

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CFO West also admitted, “For years, we prioritized the movement of the airplane through the factory over getting it done right, and that’s got to change.”^[5]

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Moreover, unsafe conditions identified on the MAX show a deeply flawed delegated certification process resulted in Boeing approving numerous changes on the MAX that are non-compliant and unsafe.^[6] Boeing has not committed to finding the root cause of these issues.

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Given the numerous 737 MAX incidents reported both publicly and privately to the Foundation, it appears there is a distinct contradiction between Boeing’s statements about quality and their aircraft performance.

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Newly Reported Unsafe Conditions, Failures and Findings

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Dutch Roll: The Southwest Airlines “Dutch roll” accident on May 25, 2024, is an issue of serious concern. This uncommanded movement of flight controls while the airplane is in a stable cruise condition is clearly a significant safety hazard. During the Permanent Subcommittee on Investigations hearing, Boeing’s Chief Engineer McKenzie made a rather bold and unsubstantiated claim that this Dutch roll was an isolated, one time occurrence. He stated, “We think there is a unique circumstance around this particular airplane that has nothing to do with design or manufacturing.” Since the NTSB investigation is not yet complete how can such an assertion be made?

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The NTSB released their preliminary report on July 9^th. In that report there was discussion of thunderstorms and winds up to 72 MPH that could have damaged the rudder system. The report confirmed the rudder has a damping system to protect it from damage during high winds. The report also provided results of functional tests indicating the rudder Power Control Units (PCUs) were not damaged by the thunderstorms. Discussion of a windstorm damaging the airplane’s rudder prior to the accident doesn’t pass the straight face test considering the amount of damage the aircraft sustained. An oscillating rudder could also be caused by a faulty or malfunctioning yaw damper as outlined in a recent engineering exemption granted to Boeing MAX airplanes by the FAA (Exemption #21246).

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Passenger Oxygen Generators: The recent Airworthiness Directive AD 2024-13-02 for all Boeing Company Model 737-8, 737- 9, and 737-8200 airplanes and Model 737-700, -800, and -900ER series airplanes is another example of a defect resulting in an unsafe condition. This directive was issued to airlines after the FAA received multiple reports of passenger service unit (PSU) oxygen generators shifting out of their position because of a retention failure. The Foundation was provided documentation showing the oxygen generators on the Alaska Airlines Flight 1282 also shifted. These oxygen generators can get very hot, over 400 degrees Fahrenheit. This condition could result in a non-functional oxygen generator, electrical arcing, smoke, and/or fire. Despite this recent issue, Mr. Calhoun was resolute in his statement to the subcommittee: “We cannot allow one unsafe airplane to leave our factory.”

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Braking System & Emergency Lighting: The Foundation continues to receive numerous reports about ongoing 737 MAX deficiencies. For example, brake components on MAX airplanes are cracking; tire valve core assemblies are loose, and in some cases, mechanics have been able to pull them out by hand. Additionally, tires with unusually low pressures have been found. We have also seen what appears to be very large numbers of emergency lighting failures. These do not appear to be “normal” wear and tear items.    

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Life Preservers: The last bit of news we are hearing concerns the onboard life preservers on MAX aircraft. Although these vests are rarely used, should they be needed, they are essential to passenger safety. We all have heard the flight attendant’s departure briefing that includes, “A life vest is located under or between your seats. To wear it, tear open the plastic package, remove the life vest, and slip it over your head.” Imagine in an actual ditching emergency if the plastic package was difficult to tear open? It has been brought to the Foundation’s attention that some of these life vest bags have been sealed with a much stronger adhesive that can’t be easily torn open by hand. Although likely a supplier issue, it’s a situation that Boeing must address and correct in short order.

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We would like Boeing and the FAA to comment on the criticality of these reports.

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In the Spirit of Transparency

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Boeing’s new CEO, Kelly Ortberg, served as the CEO of Collins Aerospace Company from December 2018 to February 2020. Prior to that he served as the President, CEO & Chairman of Rockwell Collins, Inc. It is the Foundation’s understanding that Rockwell Collins built the two Angle of Attack Sensors and the MCAS software that failed during both 737 MAX crashes and played a role in deactivating the AOA Disagree Alert on both airplanes. In the spirit of transparency, Mr. Ortberg should be asked to explain Rockwell Collins role as a Boeing supplier involved in both disasters.

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Everyone agrees that safe airline travel is essential, and that Boeing must be a leader in the industry. For decades the company has built thousands of 737 aircraft that have served us well. Clearly the company has changed and the airplanes they produce are no longer the industry gold standard. Two fatal crashes, a deferred prosecution agreement, 20 months of grounded aircraft, and an extensive recertification process should have had a significant impact on Boeing’s leadership. While they say they have made vast improvements; claim to be designing, manufacturing and certifying safe airplanes once again, the evidence outlined above says otherwise. With a plethora of problems manifested in incidents and accidents as well as identified by whistleblowers and end users, the standard PR from the C-Suite just isn’t enough.

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The Foundation strongly recommends Boeing openly acknowledge safety shortfalls and expend resources to quickly fix problems. And that Boeing provide the public with a list of all known non compliances, manufacturing defects and unsafe conditions and a plan for addressing these shortfalls on both currently produced and the fleet of in-service airplanes.

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The Foundation for Aviation Safety                              

www.foundationforaviationsafety.org

Passengers, airline & government employees can report flight safety incidents or other aviation safety related matters at this site https://www.foundationforaviationsafety.org/safetyreport

^[1] Cowl Anti Ice, Rudder Control HIRF and Lightning, 787 Lightning Protection Features, 767 FQIS/Fuel Tank Ignition Sources

^[2] Eight Reasons Why Boeing Needs to Upgrade the 737 MAX Crew Alerting System, Joe Jacobsen, 11/21/23

^[3] https://www.seattletimes.com/business/boeing-aerospace/boeing-works-to-absorb-lessons-from-the-max-crashes-and-improve-safety/ Seattle Times, May 24, 2023, Dominic Gates

^[4] NTSB hearing for Alaska Airlines Flight 1282, IAM Representative’s testimony, Washington, DC, Aug 6-7, 2024

^[5] https://www.industryweek.com/operations/continuous-improvement/article/55001296/boeing-executives-failed-to-lead-waved-off-lean Industry Week, April 1, 2024, Mark Graban

^[6] Some other examples: Chafed wire bundles causing spoilers to deploy resulting in uncommanded rolls of the airplane; Engine Anti Ice system that cannot be run for more than 5 minutes in dry air; Smoke in Cockpit following bird strikes; Oxygen Generators Shifting in Place; MCAS; Stabilizer Wiring that is improperly routed, and Standby Power Control Units lacking proper Electrical Bonding & Grounding