Incident: Structural Cracks Found in Boeing 737 NG Aircraft.

Published Date: 2019-10-10

Postmortem Analysis
Timeline 1. The software failure incident involving structural cracks in Boeing 737 NG jets was reported on October 10, 2019 [Article 90398].
System 1. Boeing 737 NG's pickle fork component [Article 90398]
Responsible Organization unknown
Impacted Organization 1. Airlines such as Southwest and Gol were impacted by the software failure incident [90398].
Software Causes unknown
Non-software Causes 1. Structural cracks in the "pickle fork" part of the fuselage were discovered in the 737 NG jets during inspections ordered by the Federal Aviation Administration [Article 90398]. 2. The cracks were found when some used passenger jets were being stripped down for conversion to freighter jets [Article 90398]. 3. The problem was not related to software but rather a physical issue with the aircraft's structure [Article 90398].
Impacts 1. Structural cracks were discovered in 38 Boeing 737 NG jets, leading to the limited grounding of these aircraft [Article 90398].
Preventions 1. Implementing more rigorous quality control measures during the manufacturing process to detect and prevent structural defects like the cracks found in the 737 NG jets [Article 90398]. 2. Conducting more frequent and thorough inspections of aircraft components, such as the "pickle fork," to identify potential issues before they escalate into safety concerns [Article 90398]. 3. Enhancing communication and collaboration between aircraft manufacturers like Boeing and regulatory bodies like the Federal Aviation Administration to ensure timely identification and resolution of safety issues [Article 90398].
Fixes 1. The software failure incident involving structural cracks in the 737 NG jets could be fixed through a repair plan developed by Boeing in collaboration with customers [90398].
References 1. Boeing 2. Federal Aviation Administration (FAA) 3. Southwest Airlines 4. Gol Airlines

Software Taxonomy of Faults

Category Option Rationale
Recurring unknown The articles do not mention any software failure incident related to either one_organization or multiple_organization. Therefore, the information about the software failure incident happening again at a specific organization or across multiple organizations is unknown.
Phase (Design/Operation) design Unknown
Boundary (Internal/External) within_system (a) within_system: The software failure incident related to the structural cracks in the 737 NG jets was due to factors originating from within the system. The cracks were found during inspections ordered by the Federal Aviation Administration, and Boeing notified the FAA, which then ordered the inspections [Article 90398]. This indicates that the issue was internal to the system and not caused by external factors.
Nature (Human/Non-human) non-human_actions (a) The software failure incident in this case is not directly related to non-human actions but rather to structural cracks found in the 737 NG jets, specifically in the "pickle fork" component that helps attach the wings to the aircraft. This issue was discovered during inspections ordered by the Federal Aviation Administration, indicating a physical fault rather than a software-related failure [Article 90398]. (b) The software failure incident is not attributed to human actions but rather to a structural issue with the pickle fork component in the 737 NG jets. The problem was discovered during inspections ordered by the Federal Aviation Administration, and Boeing is actively working on developing a repair plan for the affected planes [Article 90398].
Dimension (Hardware/Software) hardware (a) The software failure incident occurring due to hardware: - The article mentions structural cracks found in 38 Boeing 737 NG jets, specifically in a part of the fuselage known as a "pickle fork" which helps attach the wings to the aircraft. These cracks were discovered during inspections ordered by the Federal Aviation Administration [Article 90398]. (b) The software failure incident occurring due to software: - The article does not mention any software-related contributing factors that led to the failure incident.
Objective (Malicious/Non-malicious) non-malicious (a) The software failure incident mentioned in the article is non-malicious. The failure was due to structural cracks discovered in the 737 NG jets, specifically in the "pickle fork" part of the fuselage, which helps attach the wings to the aircraft. These cracks were found during inspections ordered by the Federal Aviation Administration, and Boeing is actively working on developing a repair plan to address the issue [Article 90398].
Intent (Poor/Accidental Decisions) unknown The software failure incident reported in the article is not related to poor or accidental decisions. Instead, it is about structural cracks discovered in Boeing 737 NG jets, specifically in the "pickle fork" part of the fuselage, which led to the grounding of some planes for safety concerns [Article 90398].
Capability (Incompetence/Accidental) unknown (a) The software failure incident related to development incompetence is not mentioned in the provided article [90398]. (b) The software failure incident related to an accidental factor is not mentioned in the provided article [90398].
Duration permanent The software failure incident reported in the articles is not related to a temporary or permanent failure caused by software issues. The incident described pertains to structural cracks found in Boeing 737 NG aircraft, specifically in the "pickle fork" component, which is a part of the fuselage that helps attach the wings to the aircraft. This issue is related to a physical problem with the aircraft structure rather than a software failure [Article 90398].
Behaviour other (a) crash: The article mentions that all 737 Max jets have been grounded since March following two fatal crashes in Ethiopia and Indonesia, believed to have been caused by an automatic safety feature on that jet [90398]. (b) omission: The article does not specifically mention any instances of the system omitting to perform its intended functions. (c) timing: The article does not mention any instances of the system performing its intended functions too late or too early. (d) value: The article does not mention any instances of the system performing its intended functions incorrectly. (e) byzantine: The article does not mention any instances of the system behaving erroneously with inconsistent responses and interactions. (f) other: The other behavior mentioned in the article is related to structural cracks found in 38 737 NG jets, impacting the safety and airworthiness of the aircraft [90398].

IoT System Layer

Layer Option Rationale
Perception None None
Communication None None
Application None None

Other Details

Category Option Rationale
Consequence death, harm (a) death: People lost their lives due to the software failure - The article mentions two fatal crashes of the 737 Max jets in Ethiopia and Indonesia, which resulted in the deaths of 346 crew and passengers [Article 90398].
Domain transportation (a) The failed system in this incident is related to the aviation industry, specifically affecting Boeing's 737 NG jets and their structural components like the "pickle fork" [Article 90398].

Sources

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