The United States Senate Committee on Commerce, Science, and Transportation has released its final report after months of investigations on the Boeing 737 MAX debacle. The report noted some troubling findings, including faults from both Boeing and the FAA.
The report
The US Senate Committee on Commerce, Science, and Transportation began an investigation in April of 2019, just a few weeks after the Ethiopian Airlines Boeing 737 MAX crash that led to a flurry of countries grounding the MAX, pending a formal review.
Over the last 20 months, the FAA, Boeing, other stakeholders, and many other regulatory agencies have been thoroughly reviewing the 737 MAX and preparing for its return to commercial flight. Meanwhile, in Washington, the Senate Committee held its own hearings and investigation. The report has finally been released, just a few weeks after the FAA officially ungrounded the Boeing 737 MAX.
The official report laid out the following findings of note:
- FAA senior managers have not been held accountable for failure to develop and deliver training in flight standards
- The FAA continues to retaliate against whistleblowers
- The FAA repeatedly permitted Southwest Airlines to operate dozens of aircraft in an unknown airworthiness condition for several years
- During 737 MAX recertification testing, Boeing inappropriately influenced FAA human factor simulator testing of pilot reaction times involving a Maneuvering Characteristics Augmentation System (MCAS) failure
Chairman Roger Wicker of Mississippi stated the following on the report release seen by Simple Flying:
“Twenty months ago, the Commerce Committee launched an investigation into FAA safety oversight. We have received disclosures from more than 50 whistleblowers, conducted numerous FAA staff interviews, and reviewed over 15,000 pages of relevant documents. Our findings are troubling. The report details a number of significant examples of lapses in aviation safety oversight and failed leadership in the FAA. It is clear that the agency requires consistent oversight to ensure their work to protect the flying public is executed fully and correctly.”
Boeing released the following statement:
“Boeing is committed to improving aviation safety, strengthening our safety culture, and rebuilding trust with our customers, regulators, and the flying public. We take seriously the Committee’s findings and will continue to review the report in full. We have learned many hard lessons from the Lion Air Flight 610 and Ethiopian Flight 302 accidents, and we will never forget the lives lost on board. The events and lessons learned have reshaped our company and further focused our attention on our core values of safety, quality, and integrity. Over the past twenty years, commercial aviation has become the safest form of travel in the world due to a commitment – by industry, the FAA, and Congress – to a fact-based, evidence-driven approach to improving safety.”
Whistleblowers
The Commerce Committee received information from 57 whistleblowers over the course of the investigation, which found “insufficient training, improper certification, FAA management acting favorably toward operators, and management undermining of frontline inspectors.”
What was even more concerning was that these concerns were often accompanied by retaliation against people who reported safety violations and a lack of FAA safety management culture.
The Committee report recommended additional education on whistleblower rights and prohibitions on retaliation while also ensuring that whistleblower information is heard and considered.
Boeing’s inappropriate influence
One finding from the report was that Boeing “inappropriately influenced FAA human factor simulator testing of pilot reaction times.” This was in relation to testing regarding MCAS.
Based on whistleblower information and testimony, the Committee report concluded that both “FAA and Boeing officials involved in the conduct of this test had established a pre-determined outcome to reaffirm a long-held human factor assumption related to pilot reaction time to a runaway stabilizer.” The language is clear; the Committee believes that Boeing officials “inappropriately coached test pilots.” The Committee faulted both the FAA and Boeing, as it appears to the Committee that both were attempting to cover up important information.
Southwest Airlines
Not directly related to the Boeing 737 MAX tragedy, but in a similar vein, the Committee found concerns regarding the oversight of Southwest Airlines.
According to the report, between 2013 and 2017, Southwest acquired 88 planes from “foreign manufactures and put them into service after issuing airworthiness certificates that were predicated on deficient information.” Whistleblowers repeatedly alerted the FAA management over non-compliance and a risk to the flying public. However, FAA managers clearly favored the airline and did not support the frontline inspectors.
The Committee concluded:
- Southwest Airlines successfully exerts improper influence on the FAA to gain favorable treatment related to regulatory compliance and voluntary reporting program
- The FAA appears to select managers in the Southwest Airlines Certificate Management Office (CMO) who lack reasonable experience and do not provide effective regulatory compliance or enforcement
- FAA has failed to hold employees accountable for lapses in oversight of Southwest Airlines
In October of 2019, the Director of the Office of Audit and Evaluation (AAE) sent a memo urging FAA Administrator Dickson to ground the remaining uninspected aircraft until the inspections could be completed. Administrator Dickson refused and gave Southwest a few more months to complete the inspections that should have been completed before the aircraft ever flew in US airspace.
What comes next?
This is the latest government report to fault both the FAA and Boeing over the 737 MAX debacle. While this report did not specifically delve into the issues of the certification process, it focused heavily on the FAA itself and its relationships with external stakeholders. The FAA has long had problems within the organization, and for years there have been attempts to rectify the situation at the FAA.
Boeing has repeatedly highlighted that it will be taking the lessons from this tragedy and moving on to become a better organization and keep air traffic one of the safest forms of transportation there is.
The FAA will also need to clean up its act. Congress wants to see the agency reviewed and improved so that it takes whistleblower complaints, misconduct investigations, accountability, and aviation safety very seriously.
What do you make of the report from the Senate Committee on Commerce, Science, and Transportation on the 737 MAX? Let us know in the comments!