Serious incident McDonnell Douglas MD-11 N811DE,
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ASN Wikibase Occurrence # 353586
 
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Date:Sunday 8 November 1998
Time:23:00 LT
Type:Silhouette image of generic MD11 model; specific model in this crash may look slightly different    
McDonnell Douglas MD-11
Owner/operator:Delta Air Lines
Registration: N811DE
MSN: 48566/543
Total airframe hrs:23781 hours
Engine model:P&W 4460/4000
Fatalities:Fatalities: 0 / Occupants: 4
Aircraft damage: Minor
Category:Serious incident
Location:Atlanta, GA -   United States of America
Phase: Standing
Nature:Unknown
Departure airport:
Destination airport:
Investigating agency: NTSB
Confidence Rating: Accident investigation report completed and information captured
Narrative:
During the trip check, airport customer service personnel informed a mechanic that one of the center cargo bay longitudinal spring-lift power drive unit (PDU) powered rollers was inoperative and in the 'up' position. A mechanic, removed the powered rollers from the cargo compartment and did not have the McDonnell Douglas MD-11 Maintenance Manual in his possession at the time. The mechanic, did not open the circuit breaker for the cargo control unit (CCU) that controls the operation of the powered rollers, nor did he tag the system out of service as stipulated in the McDonnell Douglas MD-11 Maintenance Manual. While the mechanic was away from the airplane obtaining a new powered roller, the airport customer service had a crew change. The new crew, unaware that the powered roller cannon plug had been left on the floor of the cargo compartment, began loading cargo bins. The cannon plug was run over and its connecting wires cut by the cargo bins. A Delta technician started the airplane's auxiliary power unit (APU) to provide electrical power to the airplane. Other Delta technicians who were servicing the cabin observed smoke and 4 to 6 inch flames behind a floor vent of the main passenger cabin at row 12. The fire was subsequently extinguished.

Probable Cause: Failure of the Company's maintenance personnel to follow the aircraft's maintenance manual which resulted in a cargo bin fire. Contributing to the severity of the incident was the failure of the mechanic to safety the circuit breaker, and the cut/severed electrical wiring.

Accident investigation:
cover
  
Investigating agency: NTSB
Report number: ATL99IA015
Status: Investigation completed
Duration: 2 years and 9 months
Download report: Final report

Sources:

NTSB ATL99IA015

Revision history:

Date/timeContributorUpdates
10-Mar-2024 08:22 ASN Update Bot Added

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