As a result of this occurrence the Bureau of Air Safety Investigation, now the ATSB, issued interim recommendations (IRs) to the manufacturer, regulators and operators on 27 May 1999 and identified the following safety deficiency:
Cracking and failure of main landing gear (MLG) trunnion pin actuator attach lugs of Boeing 737 aircraft prevents retraction of the MLG and may result in damage to the aircraft structure. While the manufacturer's service information regarding MLG corrosion requires a general one-time inspection of the trunnion pin, the accomplishment instructions do not specifically direct inspection to the attach lugs for cracking. The inspection of the trunnion pin is not mandated by regulatory authorities.
IR19990046
The Bureau of Air Safety Investigation recommends that Boeing Commercial Airplane Group alert Boeing 737 operators to this safety deficiency and implement an appropriate inspection program.
Boeing response
Boeing responded that it did not agree that failure of the 737 MLG actuator trunnion pin would result in damage to aircraft structure and, as a result, did not consider this failure mode was a safety issue. A metallurgical examination of the failed trunnion pin by Boeing determined that improper restoration of finishes during trunnion pin overhaul was the likely cause of corrosion that resulted in the trunnion pin failure. Boeing released Maintenance Tip, 737-MT-32-009 R1, in January 2001, to highlight the need to properly restore corrosion prevention compounds when landing gear components are removed and replaced during maintenance.
Boeing advised that investigation of other in-service occurrences of trunnion pin lug fractures concluded that some of these fractures were due to a high preload on the clevis due to bolt clamp up. As a result, Boeing revised the Airplane Maintenance Manual (AMM) 32-32-11 in 1997 to reduce the bolt nut torque when installing the actuator rod end bolt at the clevis in question. This was to reduce the clamp up loads and accompanying stresses that may contribute to the initiation of lug stress corrosion cracking.
Boeing advised that given their evaluation of the consequences of the trunnion pin failure, they considered that the maintenance tip accomplished the action to notify operators to the need for proper maintenance to avoid corrosion in these parts.
Response classification: CLOSED-ACCEPTED
IR19990047
The Bureau of Air Safety Investigation recommends that Boeing Commercial Airplane Group review the effectiveness of Service Bulletin 737-32-1198 revision 2.
Boeing response Boeing responded that it had completed a review of the entire 737 MLG for corrosion problems and did not anticipate releasing further service bulletins or similar type documents relative to the trunnion pin failure. Additionally, Boeing considered that the aforementioned service bulletin was properly categorised and did not need to be upgraded to an "Alert" level bulletin.
Response classification: CLOSED-ACCEPTED
IR19990048
The Bureau of Air Safety Investigation recommends that the Federal Aviation Administration (FAA) note the safety deficiency and recommendations and take appropriate action as considered necessary to ensure the integrity of Boeing 737 main landing gear trunnion pin assemblies.
FAA response
The FAA responded that an inability to retract the landing gear was not considered a safety deficiency since the landing gear was in the down and locked position. The FAA considered that an airworthiness directive to mandate the inspections under the service bulletin was not warranted. The FAA after considering there had been four cases of lug failures, advised that they would recommend that the manufacturer consider adding instructions to inspect for corrosion and cracks in the lugs to the subject service bulletin.
Response classification: CLOSED-ACCEPTED
IR19990049
The Bureau of Air Safety Investigation recommends that the Civil Aviation Safety Authority (CASA) note the safety deficiency and interim recommendations and initiate appropriate action as considered necessary to ensure the integrity of Australian Boeing 737 main landing gear trunnion pin assemblies.
CASA response
CASA responded that Boeing was currently reviewing the entire Boeing 737 landing gear assembly for corrosion problems and was expected to address this, and other faults, via service bulletin or similar document. CASA advised it would continue to monitor the manufacturers response to this problem.
CASA also advised that pending issue of such data by the manufacturer, both Australian operators had developed inspections to check the trunnion pin lugs for corrosion. CASA believed that this action was appropriate under its existing regulatory framework, and the inspections carried out were suitable to prevent further problems. CASA considered that issue of an Airworthiness Directive was unnecessary because of the operators' actions and the impending issue of improved manufacturer's data.
Note: Qantas and Ansett were the only Australian Boeing 737 operators at the time the recommendation was issued
Response classification: CLOSED-ACCEPTED
IR19990050
The Bureau of Air Safety Investigation recommends that Australian operators of Boeing 737 note the above safety deficiency and interim recommendations and take appropriate action as considered necessary to ensure the integrity of Boeing 737 main landing gear trunnion pin assemblies.
The Australian operators of Boeing 737 aircraft conducted a visual inspection of the MLG trunnion pins of their fleet of B737 aircraft shortly after this event. Qantas issued an Engineering Instruction (EI 737-032-0105) on 06 May 1999 to perform ultrasonic inspections for cracks in trunnion pins that had approximately 10,000 cycles since new or overhaul. Ansett raised an Alert Engineering Release (B73-32-10-19) on 08 April 1999 to perform a lug ultrasonic inspection on Boeing 737 MLG trunnion pins at 10,000 flight cycles or 4 years since new or overhauled. Repeat inspection was to be at 600 cycle intervals.
Note: Qantas and Ansett were the only Australian Boeing 737 operators at the time the recommendation was issued.
Response classification: CLOSED-ACCEPTED