Incident Overview

Date: Tuesday 1 March 1994
Aircraft Type: Lockheed L-1011 TriStar 1
Owner/operator: Rich International Airways
Registration Number: N303EA
Location: Fairbanks, AK – ÿ United States of America
Phase of Flight: Take off
Status: Substantial
Casualties: Fatalities: 0 / Occupants: 14
Component Affected: The Number Three engine’s intermediate compressor 6/7th rotor shaft assembly, specifically the sixth stage disc assembly.The Number Three engine’s intermediate compressor 6/7th rotor shaft assembly, specifically the sixth stage disc assembly.
Investigating Agency: NTSBNTSB
Category: Accident
On 6/7/93, a catastrophic failure of the 6th stage disc assembly on the intermediate compressor 6/7th rotor shaft in the Number Three engine resulted in a significant incident. The disc ruptured, causing fuel inlet line contamination and penetrating the Number One engine and fuselage. Fire warning systems were activated, and engine fire bottles were discharged. Residual fire was extinguished by airport fire fighters. Approximately 80% of the failed disc was found, exhibiting corrosion pitting and small fatigue cracking at the attachment holes. The largest crack was 0.13′ deep and 0.23′ wide. Metallurgical examination revealed corrosion pitting and fatigue cracking, indicating a failure of the attachment holes. A critical component, the telltale marker for the flight engineer’s Number Three engine gauge, showed a 106% reading compared to the calibrated 118% reading, indicating an overspeed condition. The rotor exceeded EPR limits and had been previously verified as safe for operation. Service Bulletin (SB) RB.211-72-9569 mandated the removal of rotor components exceeding 14,000 cycles by 4/30/93. The rotor had 16,327 cycles at the time, triggering a mandatory requirement in the UK but not in the US. The incident was likely caused by the failure of the sixth stage disc assembly due to corrosion pitting and fatigue cracking of the failed disc. A contributing factor was the airline company’s failure to fully comply with the Service Bulletin (SB) RB.211-72-9569, and foreign object damage to the Number One engine, resulting from the failure of the Number Three engine.On 6/7/93, a catastrophic failure of the 6th stage disc assembly on the intermediate compressor 6/7th rotor shaft in the Number Three engine resulted in a significant incident. The disc ruptured, causing fuel inlet line contamination and penetrating the Number One engine and fuselage. Fire warning systems were activated, and engine fire bottles were discharged. Residual fire was extinguished by airport fire fighters. Approximately 80% of the failed disc was found, exhibiting corrosion pitting and small fatigue cracking at the attachment holes. The largest crack was 0.13′ deep and 0.23′ wide. Metallurgical examination revealed corrosion pitting and fatigue cracking, indicating a failure of the attachment holes. A critical component, the telltale marker for the flight engineer’s Number Three engine gauge, showed a 106% reading compared to the calibrated 118% reading, indicating an overspeed condition. The rotor exceeded EPR limits and had been previously verified as safe for operation. Service Bulletin (SB) RB.211-72-9569 mandated the removal of rotor components exceeding 14,000 cycles by 4/30/93. The rotor had 16,327 cycles at the time, triggering a mandatory requirement in the UK but not in the US. The incident was likely caused by the failure of the sixth stage disc assembly due to corrosion pitting and fatigue cracking of the failed disc. A contributing factor was the airline company’s failure to fully comply with the Service Bulletin (SB) RB.211-72-9569, and foreign object damage to the Number One engine, resulting from the failure of the Number Three engine.

Description

AS FULL POWER WAS APPLIED FOR TAKEOFF, THERE WAS A RUPTURE OF THE 6TH STAGE DISC ON THE INTERMEDIATE COMPRESSOR 6/7TH ROTOR SHAFT ASSEMBLY IN THE #3 ENGINE. PIECES OF DISC SEVERED A FUEL INLET LINE & PENETRATED THE #1 ENGINE & THE FUSELAGE. FIRE WARNINGS FOR THE #3 & #1 ENGINES WERE ACTIVATED & ENGINE FIRE BOTTLES WERE DISCHARGED DURING AN ABORTED TAKEOFF. RESIDUAL FIRE IN ONE ENGINE WAS EXTINGUISHED BY AIRPORT FIRE FIGHTERS. ABOUT 80% OF THE FAILED DISC WAS FOUND; METALLURGICAL EXAMINATION SHOWED CORROSION PITTING & SMALL FATIGUE CRACKS AT THE ATTACHMENT HOLES. THE LARGEST CRACK WAS 0.13′ DEEP & 0.23′ WIDE. ACCORDING TO ROLLS ROYCE CALCULATIONS, THIS SIZE CRACK WOULD NOT HAVE RESULTED IN FAILURE UNLESS THE N2 ROTOR RPM HAD REACHED 118%. A TELLTALE MARKER FOR THE FLIGHT ENGINEER’S #3 N2 GAUGE SHOWED 106% (RED-LINE WAS 102.5%), BUT THE TELLTALE MARKER WAS OUT OF CALIBRATION; THEREFORE, OVERSPEED WAS NOT VERIFIED. MAX EPR FOR TAKEOFF WAS WITHIN LIMITS. SERVICE BULLETIN (SB) RB.211-72-9569 REQUIRED THAT ROTORS EXCEEDING 14,000 CYCLES BE REMOVED BY 4/30/93; THE FAILED ROTOR HAD 16,327 CYCLES. THE SB WAS ‘S-MANDATORY’ IN THE U.K., BUT IT WAS NOT MANDATORY IN THE U.S. Probable Cause: FAILURE OF THE SIXTH STAGE DISC ON THE INTERMEDIATE COMPRESSOR STAGE 6/7TH ROTOR SHAFT ASSEMBLY IN THE NUMBER THREE ENGINE, DUE TO CORROSION PITTING AND FATIGUE CRACKING OF THE FAILED DISC. A FACTOR RELATED TO THE ACCIDENT WAS: FAILURE OF THE AIRLINE COMPANY TO FOLLOW PROVISIONS OF THE SERVICE BULLETIN. FOREIGN OBJECT DAMAGE TO THE NUMBER ONE ENGINE WAS THE RESULT OF THE UNCONTAINED FAILURE OF THE NUMBER THREE ENGINE.

Primary Cause

Failure of the sixth stage disc assembly on the intermediate compressor 6/7th rotor shaft in the Number Three engine, resulting from corrosion pitting and fatigue cracking of the failed disc.Failure of the sixth stage disc assembly on the intermediate compressor 6/7th rotor shaft in the Number Three engine, resulting from corrosion pitting and fatigue cracking of the failed disc.

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