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By Andy Pasztor and Andrew Tangel
Inadequate U.S. safety oversight, combined with Boeing Co.'s failures to properly assess and communicate important design changes, contributed to two fatal 737 MAX crashes, according to the most comprehensive outside review of the plane's approval process.
The findings released Friday, assembled by a panel of U.S. safety experts and nine foreign aviation regulators, criticized the Federal Aviation Administration on a range of issues, including relying on outdated certification procedures, maintaining insufficient technical staff and failing to fully incorporate human factors in approving automated cockpit systems.
According to the panel, the FAA should consider fundamental changes to its longstanding oversight and engineering principles because aircraft designs have become more complex, with different systems interacting in unforeseeable ways. Because traditional "regulations and standards will not address every conceivable scenario," according to the nearly 70-page document, the new focus should be on more flexible agency responses, particularly earlier and deeper involvement of FAA experts in reviewing important design decisions.
The FAA also should rely less on pilot reactions as fail-safe protections in emergencies and incorporate likely real-world cockpit responses as part of formal risk analyses, the group determined.
In the case of the 737 MAX, the panel found the FAA fell short in many of those areas.
FAA chief Steve Dickson said in a statement, "I will review every recommendation and take appropriate action." He added that "we welcome this scrutiny and are confident that our openness to these efforts will further bolster aviation safety world-wide."
Overall, the findings paint a picture of an FAA certification process lacking predictability, needing updated technical guidance and prone to inadequate communication between industry and government participants. In addition to broad policy recommendations, the report is filled with dozens of findings and observations targeting specific phases of the certification process.
The outside experts -- who included representatives from Europe, Canada, China, Indonesia and Brazil -- were equally critical of lapses by the Chicago plane maker in devising an automated stall-protection system, called MCAS, which misfired to bring down the two jets, taking 346 lives. In crashes five months apart, the planes nosedived in Indonesia and Ethiopia after faulty sensor data prompted MCAS to similarly push down the noses of the aircraft despite efforts by pilots to pull out of steep dives.
Boeing, among other missteps, failed to update its own safety analyses or inform the FAA about the extent of design changes that made MCAS more powerful, according to the document. "The information and discussions about MCAS were so fragmented and were delivered to disconnected groups, " according to the panel, meaning that relevant FAA officials didn't have a complete sense of the automated flight-control feature's operation, fully recognize its potential hazards or conduct a truly independent assessment of whether it met safety requirements.
In addition, the report noted there was an indication of "undue pressure" on some Boeing engineers working on the system as designated FAA representatives. Such an indication, according to the outside experts, "further erodes the level of assurance in this system of delegation."
A Boeing spokesperson said the company is "committed to working with the FAA in reviewing the recommendations and helping to continuously improve the process and approach used to validate and certify airplanes going forward."
The panel criticized Boeing's own process for designing MCAS, saying it failed to identify the system's potential hazards. The group said the plane maker also should have highlighted MCAS to federal regulators given its important differences compared with a military refueling tanker's version of the system that included key safeguards.
Making MCAS for the 737 MAX rely on pilot action as a primary backstop, before dealing with the system's potential hazards, "is not in accordance with Boeing's process instructions for safe design," according to the findings.
The report follows comments by Boeing Chief Executive Dennis Muilenburg, who has defended the company's development of the 737 MAX. In April, Mr. Muilenburg said there had been "no technical slip," adding in a call with investors: "There was no surprise or gap or unknown here or something that somehow slipped through a certification process."
The report raises concerns "that undue pressure may have been placed on individuals at the FAA and Boeing to get the MAX into service as quickly as possible," said Rep. Peter DeFazio of Oregon, the Democratic chairman of the House Infrastructure and Transportation Committee, who is heading up another review of the jet's approval. Mr. Muilenburg is scheduled to testify before Mr. DeFazio's committee Oct. 30.
The safety panel's recommendations, as reported earlier by The Wall Street Journal, also touched on inadequate data sharing by the FAA with international authorities.
Some of the recommended changes were previously outlined by the U.S. National Transportation Safety Board in a separate move, while others already have been embraced by the FAA's leadership.
The panel, called the Joint Authorities Technical Review, originally was assembled by the FAA as part of a strategy to promote international consensus and pave the way for speedy return of the MAX fleet to commercial service. But as the study group delved into the missteps that beset the troubled jet -- and Boeing's effort to devise software fixes lagged many months behind schedule -- the report turned into a pointed, sometimes harshly worded critique of the FAA's current system for approving new airplane designs.
Write to Andy Pasztor at firstname.lastname@example.org and Andrew Tangel at Andrew.Tangel@wsj.com
(END) Dow Jones Newswires
October 11, 2019 17:19 ET (21:19 GMT)
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