An Agency of the European Union

Your safety is our mission.

Patrick KY Executive Director

EP TRAN Committee Meeting29 October 2020

BOEING 737 MAX

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2

01

Agenda

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EASA conditions for Return to Service

02 EASA activities

03 Outcomes

04 Next Steps

3

Return to Service - EASA conditions

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Accidents of JT610 and ET302 are deemed sufficiently understood

Design changes proposed by Boeing to address the issues highlighted by the accidents are EASA approved and their embodiment is mandated

Additional independent design review has been completed by EASA

BOEING 737 MAX flight crews have been adequately trained

As set from the very first days after the grounding:

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Return to Service - EASA design review

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To ensure that no similar weaknesses in the design are present in the other (safety critical) areas of the BOEING 737 MAX design

Objective

Scope

Targeted assessment of the aircraft handling qualities: stability, maneuverability, stall identification.

Flight Control System and all associated functions/systems including (but not limited to): the displays, the crew alerting system, the sensors and the autopilot.

Critical review of credit taken for crew recognition of, and reaction to, failures (including Human Factor assessment)

Comprehensive re-analysis of the multiple effects of sensor failures

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EASA activities - Overview

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Team

20 multi-disciplinary experts, including test pilots and engineers

> 15.000 working hours over 19 months

Reviews

Safety AnalysisSimulator dataFlight test dataCrew proceduresTraining requirements

Effort Flight Control Computer

x4 System audits at Boeing

Simulator sessions

Engineering Simx2Full flight Simx2

Human Factor

Participation toLine crew evaluation with

4 different airline flight crews

EASA Flight tests

x4 Software audits at Collins

Joint Operational Evaluation

EU airline captainsx2EASA observersx2

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EASA activities – Flight tests

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Simulator

Used to evaluate many failures, including combinations of failures, in a controlled environment.

Well-suited to pilot behaviourobservation (human factors)

Adequately-representative for most cases

Aircraft

Used to check aircraft behaviourwith MCAS on & off (simulator not accurate at high angle of attack)

Perfectly representative for stability & control

[Also enabled to check simulator representativeness]

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Additional activities

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Review of the Safety Recommendations made available through the accident reports, the Joint Authorities Technical Review (JATR) report, the US Department of Transport (DoT) Special Committee report

Review of whistleblower reports and similar reports, received directly by the Agency or indirectly (e.g. hearings performed by the US congress)

Classification into two categories:

→ Inclusion in the scope of the additional independent design review if relevant to the BOEING 737 MAX safety

→ Inclusion in the wider scope of Lessons Learned project

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Outcome – comparison before/after

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BEFORE

Upon failure of one single Angle-of-Attack (AoA) sensor:

The MCAS activates: repeated nose down orders

The stick shaker activates on the pilot control columns

Multiple alerts are simultaneously displayed in the cockpit

However - there is no alert that highlights the AoA failure, which is the root cause

The crew procedures are not well adapted to this scenario

The pilots do not know about the MCAS, there is no training addressing this problem

If the crew does not react appropriately, forces needed to recover manually may be too high

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Outcome – comparison before/after

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AFTER

Upon failure of one single Angle-of-Attack (AoA) sensor:

The MCAS does not activate

The stick shaker activates on the pilot control columns, but it can be inhibited by the crew

The alert pointing to the AoA failure is displayed, the crew procedure covers this scenario

This scenario, and others involving the MCAS, are trained at the simulator

The system and its wiring are modified to prevent further erroneous nose down orders

The system will automatically stop any rapid nose down order before the forces needed to recover manually are too high

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Outcome - Summary

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Design deficiencies have been fixed

Design review beyond MCAS led to additional design improvements

Aircraft is stable even without MCAS.

Crew procedures improved.

Crew training program revised and complemented with Full Flight Simulator.

One-off return to service training on top of initial/recurrent training.

EASA confident that the corrections in the design, the improvement of the crew procedures and the extension of the crew training program will ensure a safe return to service of the aircraft.

Further safety improvements (“3rd synthetic AoA) planned to be developed within the next 2 years, and retrofitted on in service airplanes.

Enhanced continued operational safety monitoring.

Design safety Human Factor

EASA confidence Follow-up

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EASA design review was independent but coordinated with the US, Canada and Brazil.

Good level of cooperation and support (e.g. organisation of the EASA flight tests in Vancouver)

Information sharing and mutual respect

Willingness to reach common conditions for return to service as far as possible

Conditions for return to service:

Design change: identical for all 4 authorities

Crew procedures: EASA and Transport Canada allow the crew to inhibit an erroneous stick shaker.EASA impose additional (temporary) operational limitations due to lack of AoA integrity

Crew training: identical for all 4 authorities

International cooperation

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Next steps

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Final review of Boeing justifications

Airworthiness & Safety Directives to be released for pubic consultation

Coordination with EASA MSfor lift of airspace restrictions & Webinar with National Authorities on crew training implementation

Operations may resume worldwide end of this year / beginning of next year, also depending on the COVID context

Flight tests on a BOEING 737 MAX in Vancouver

Joint Operational Evaluation for crew training assessment

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… and after Return to Service

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Certification

Regulation, Procedures

& Working methods

Cooperation

with FAA

BOEING 737 MAX

NEXT BOEING MODELS

ALL NEW AIRCRAFT

Increased scrutiny

on critical areas

(Flight controls,

Crew Alerting System)

“3rd synthetic AoA”design enhancement

Enhanced monitoring of

operations & training

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Your safety is our mission.easa.europa.eu/connect

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