Alaska Airlines Door Blowout Preventable, Investigators Say — And Boeing, Faa Should Have Seen It Coming

Federal accident investigators said Tuesday that an incident where a door panel flew off of a Boeing airplane over Oregon last year was preventable — and that both Boeing and the Federal Aviation Administration should have caught the cascading failures and quality control issues that caused it.

Jennifer Homendy, chair of the independent National Transportation Safety Board, opened a hearing that will determine exactly what caused the incident on board an Alaska Airlines 737 MAX 9 flight by saying the accident “never should have happened.”

She said blame so far has been unfairly placed on Boeing production floor employees over workmanship issues related to how the plane’s fuselage was constructed. But Homendy cautioned that the problems with Boeing — and the FAA’s oversight — go much deeper.

“An accident like this does not happen because of an individual, or even a group of individuals,” she said. “Aviation is much more resilient than that; an accident like this only happens when there are multiple system failures.”

Homendy also dinged the FAA, saying she has “lots of questions about where the FAA was during all of this. The FAA is the absolute last barrier of defense when it comes to ensuring aviation safety,” she said.

The FAA did not immediately respond to a request for comment, nor did Boeing.

In the aftermath of the incident, the agency stepped up its presence at Boeing, put in place a cap on 737 MAX production and, for a while, grounded the 737 MAX 9 fleet until door plugs could be inspected. The agency also created an iterative safety action plan under which Boeing is still operating.

The NTSB’s hearing is ongoing and won’t formally come to a conclusion about cause until later Tuesday. But early attention has focused on manufacturing quality problems with Boeing and its contractor Spirit AeroSystems, including suggestions that bolts that should have secured the door plug may have been missing.

In a series of congressional hearings, whistleblowers also painted Boeing as a company that had lost its way, putting too much emphasis on churning out planes and not enough on safety.

Last April, a Boeing engineer told senators that he had been told to “shut up” by the company when he raised safety concerns about their aircraft. Similar complaints about a dysfunctional safety culture from whistleblowers who came forward since the door plug blowout were highlighted at NTSB’s preliminary hearing into the incident last year.

The NTSB hearing echoed some of those concerns. Doug Brazy, the NTSB’s investigator-in-charge, on Tuesday said its investigation had unearthed issues with how Boeing documents work that’s been done during production. Last year, Homendy suggested that Boeing was “stonewalling” the agency in producing records related to who oversaw the installation of the plane’s door plug — information that seemingly no one at Boeing maintained.

Brazy additionally said the FAA’s enforcement system, current surveillance process, procedures and reporting systems “were not effective in identifying repetitive and systemic discrepancies” like these.

Though no one was killed or seriously injured during the incident, Homendy detailed harrowing moments for the flight attendants, one of whom struggled to close the door — and the pilots, who had to communicate via hand signals and yelling over the din of the depressurized plane.

She recounted a story from one of the flight’s crew who recalled comforting a mother mid-flight who believed her son had been blown out of the gaping hole the door plug left.

“I cannot overstate the seriousness of this event that jeopardized the lives of all 177 souls on board and perhaps countless others on the ground,” Homendy said.

Still, Homendy noted that Boeing and the FAA had made significant improvements and said she believed "Boeing, Spirit and the FAA will take the lessons learned from this accident to heart and again, become a world leader on aviation safety.”