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Safety Recommendation Details

Safety Recommendation A-09-050
Details
Synopsis: On June 28, 2008, about 2215 Pacific daylight time, an ABX Air Boeing 767-200, N799AX, operating as flight 1611 from San Francisco International Airport (SFO), San Francisco, California, experienced a ground fire before engine startup. The captain and the first officer evacuated the airplane through the cockpit windows and were not injured, and the airplane was substantially damaged. The cargo flight was operating under the provisions of 14 Code of Federal Regulations (CFR) Part 121. At the time of the fire, the airplane was parked near a loading facility, all of the cargo to be transported on the flight had been loaded, and the doors had been shut.
Recommendation: TO THE FEDERAL AVIATION ADMINISTRATION: Develop inspection criteria or service life limits for flexible oxygen hoses to ensure that they meet current certification and design standards.
Original recommendation transmittal letter: PDF
Overall Status: Closed - Acceptable Action
Mode: Aviation
Location: San Francisco, CA, United States
Is Reiterated: No
Is Hazmat: No
Is NPRM: No
Accident #: DCA08MA076
Accident Reports: Ground Fire Aboard Cargo Airplane, ABX Air Flight 1611, Boeing 767-200, N799AX
Report #: AAR-09-04
Accident Date: 6/28/2008
Issue Date: 7/8/2009
Date Closed: 9/16/2015
Addressee(s) and Addressee Status: FAA (Closed - Acceptable Action)
Keyword(s): Hazmat

Safety Recommendation History
From: NTSB
To: FAA
Date: 9/16/2015
Response: We note that, on December 9, 2014, you issued final policy PS-ANM-25.1441-01, “Mitigating Fire Hazards in Gaseous Oxygen Systems.” This policy satisfies Safety Recommendations A-09-44, -48 and -50, which are classified CLOSED—ACCEPTABLE ACTION.

From: FAA
To: NTSB
Date: 7/30/2015
Response: -From Michael P. Huerta, Administrator: In our letter dated April 9, 2014, the Federal Aviation Administration (FAA) advised that we had determined that existing airworthiness standards related to these safety recommendations are adequate. As noted in our previous response to these recommendations, we drafted policy to clarify our guidance associated with the use of flexible oxygen hoses and address other potential oxygen system issues that could result in a fire. As a result, the FAA issued final policy PS-ANM-25.1441-0 1, Mitigating Fire Hazards in Gaseous Oxygen Systems, on December 9, 2014. The final policy statement is located at the following Web site: http://rgl.faa.gov/Regulatoryand_Guidance_Library/rgPolicy.nsf/0/A54651A8AABE42F486257DC4006DAD32?0penDocument. I believe the FAA has effectively addressed these safety recommendations and consider our actions complete.

From: NTSB
To: FAA
Date: 6/3/2014
Response: We note that, to address potential issues in new designs that could cause fires, you drafted a policy to clarify guidance on the use of flexible oxygen hoses and other potential oxygen system issues. We also note that the proposed policy was made available for public comment on August 28, 2013, and that you are currently reviewing comments for incorporation into the final policy. Pending issuance of the final policy, Safety Recommendations A-09-44, -48 and -50 remain classified OPEN—ACCEPTABLE RESPONSE.

From: FAA
To: NTSB
Date: 4/9/2014
Response: -From Michael P. Huerta, Administrator: In our letter dated January 15, 2013, we advised that existing airworthiness standards are adequate. As noted in our response to A-09-43 and A-09-44, we have drafted policy intended to clarify our guidance associated with the use of flexible oxygen hoses and it also addresses other potential oxygen system issues that could result in a fire. The public comment period has closed and we are reviewing comments for incorporation into a final policy. In addition to the proposed policy, the FAA issued Special Airworthiness Information Bulletin (SAIB) NM-13-34, Oxygen Systems, on May 23, 20 13 (enclosed). The SAIB was prepared due to concerns with a specific hose manufacturer. However, the FAA recommendations with respect to flexible hose inspection and maintenance programs are applicable to any similar hose installation that utilizes age-sensitive elastomer materials. I will keep the Board informed of the FAA's progress on Safety Recommendations A-09-43, -44, -48, and -50 and provide an update by September 31, 2014.

From: NTSB
To: FAA
Date: 3/26/2013
Response: Although the FAA believes that existing airworthiness standards are adequate for addressing the issues raised in these recommendations, the agency also believes that new policy is needed to clarify compliance with these standards. We believe that the revised policy and guidance may address the issues for new airplane designs and new STCs, but these revisions will not mandate a change for airplanes currently in service with previously approved designs. Pending the development and issuance of those revisions, Safety Recommendations A-09-48 and -50 are classified OPEN--ACCEPTABLE RESPONSE. Regarding Safety Recommendations A-09-49 and -51, we disagree with the FAA that there is not sufficient basis for applying the proposed revisions to airplanes in service. However, because the FAA does not plan to take the actions specified in Safety Recommendations A-09-49 and -51, they are classified "Closed--Unacceptable Action."

From: FAA
To: NTSB
Date: 1/15/2013
Response: -From Michael P. Huerta, Administrator: Existing airworthiness standards require that the oxygen system be free from hazards in itself, in its method of operation, and in its effect on other components. We have determined the existing airworthiness standards are adequate, but new policy is needed to clarify compliance guidance. The policy will address oxygen issues related to these safety recommendations such as protection from inadvertent contact with electrical current and component deterioration over time. We anticipate the policy will be available for public comment by April 30, 2013. We recognize that policy and guidance will not mandate a change to airplanes currently in service with previously approved designs, but we determined existing airworthiness standards are adequate and as such fleetwide rulemaking is unnecessary. However, if we become aware of a specific design that we determine is unsafe, we would issue an AD to mandate corrective action. I will keep the Board informed on the FAA's progress on Safety Recommendations A-09-48 through -51 and provide an update by December 2013.

From: NTSB
To: FAA
Date: 10/17/2011
Response: The FAA’s response to these recommendations is unacceptable. The FAA indicated that inspections of the supernumerary oxygen system on aircraft modified in accordance with STC ST01433SE were performed shortly after the accident, and corrective actions were taken if an airplane did not conform to the STC. The FAA has not yet completed its “assessment of the underlying safety issues as related to these recommendations,” but it does not believe there is an immediate safety concern with the in-service fleet. The inspections for compliance with the STC are irrelevant to these recommendations. We indicated in the letter that transmitted these recommendations to the FAA that of particular concern was the absence of any electrical ground straps in the cockpit, the supernumerary compartment oxygen system installations, or near the oxygen supply bottles (below the cockpit) on the ABX Air 767 airplanes examined during our investigation of the ABX Air flight 1611 accident. Also, the cockpit was an original airplane installation and not part of the airplane’s modification to a cargo configuration accomplished through STC ST01433SE. The inspections for compliance with the STC, while a valuable activity, are not relevant to Safety Recommendations A-09-48 or -49. Similarly, compliance with the STC has little to do with the life limits or inspection criteria for oxygen hoses recommended in Safety Recommendations A-09-50 and -51. The FAA’s assessment of the underlying safety issues related to these recommendations may be relevant, but 2 years after these recommendations were issued, the FAA has neither completed the assessments nor taken any other actions in response. Consequently, pending completion of the recommended actions, Safety Recommendations A-09-48 through -51 are classified OPEN—UNACCEPTABLE RESPONSE.

From: FAA
To: NTSB
Date: 7/13/2011
Response: CC# 201100278: - From J. Randolph Babbitt, Administrator: Inspections of the supernumerary oxygen system on aircraft with a configuration similar to the accident airplane, modified in accordance with supplemental type certificate (STC) STO1433SE, were performed shortly after the accident. Corrective actions were taken if an aircraft did not conform to the type design specified in the STC, such as if there was insufficient separation between the oxygen system and electrical components. We have not yet completed our assessment of the underlying safety issues related to these recommendations. However, we believe there is no immediate safety concern with the in-service fleet. I will keep the Board informed of the FAA's progress and provide an updated response to these recommendations by June 2012.

From: NTSB
To: FAA
Date: 7/9/2010
Response: The NTSB is pleased that the FAA has assembled an interdisciplinary team of technical specialists to address these safety issues and looks forward to reviewing the FAA's findings related to Safety Recommendations A-09-44 and A-09-46 through -53 and, more importantly, its plan for addressing the safety deficiencies identified in these recommendations. Pending the NTSB's review of this information, Safety Recommendations A-09-44 and A-09-46 through -53 are classified OPEN – ACCEPTABLE RESPONSE.

From: FAA
To: NTSB
Date: 9/23/2009
Response: Letter Mail Controlled 10/5/2009 12:30:33 PM MC# 2090617 - From J. Randolph Babbitt, Administrator: To comprehensively address Safety Recommendations A-09-44, and A-09-46 through -53, the FAA has assembled a team of specialists from various technical disciplines to review the recommendations and assess the underlying safety issues. Following this review we will develop a plan to address each recommendation.