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Atlas / ASRS / ACN 2047663

NASA · Aviation Safety Reporting System

Maintenance technician found un-installed engine bolt during maintenance troubleshooting due to jamb of engine twist grip.

ACN 2047663 2023-10 Bell Helicopter 412 Maintenance Reports

What is ASRS?

The Aviation Safety Reporting System is NASA's voluntary, confidential, non- punitive incident-reporting system, established 1976. Pilots, controllers, dispatchers, and maintenance technicians file reports describing safety- relevant events. NASA de-identifies every report before adding it to the public database. Reports are not investigated by NASA, the FAA, or the NTSB — they represent the reporter's perspective.

Pilot narrative

Verbatim from the de-identified NASA record. First-person account by the reporter. NASA strips identifying details (names, company, specific time); anonymization placeholders are ZZZ, X, Y.

Engine bolt located after jamb of #1 engine twist grip and subsequent trouble shooting with magnet in inaccessible area adjacent to engine idle cutoff inner bellcrank. Bolt appears to be un-installed with anti-seize present and no safety wire installed in head of 12-point engine bolt. Last engine maintenance in area Day 1 per documented maintenance records. Installation if engine verified. No other FOD found. Use of borescope, visually thru open panels, or magnet after disassembly/reassembly of engine components with performed.

NASA classification — Anomalies

  • Aircraft Equipment Problem
  • Deviation / Discrepancy - Procedural

NASA classification — Assessments

Contributing Factors / Situations
Aircraft · Human Factors
Primary Problem
Human Factors

ASRS reports are voluntarily submitted, de-identified by NASA, and represent the reporter's perspective. The presence of reports on a topic cannot be used to infer prevalence in the National Airspace System. The authoritative source is the NASA ASRS Database Online at asrs.arc.nasa.gov ↗.