Line-shack wreck: a lesson in maintenance risk management

Mech, Winter, 2003 by Russ Raines

A slightly overcast, warm, summer day found three hard-charging members of line division working normal flight ops ashore. They were part of the Forward-Deployed Naval Forces in Atsugi, Japan. They took a break and were inside the line shack doing paperwork, making coffee, and watching their outdoor brethren launch and recover more SH-60Bs. Unbeknownst to these professionals, danger lurked nearby--but not in the form of turning rotor blades or FOD. This danger was a more insidious kind: an unassuming mini-truck from base hazmat.

After an uneventful delivery to the squadron, the young airman in charge of the truck and his recently arrived junior partner decided that a training opportunity was at hand. With this being Japan, the steering wheel is on the right side. Of course, that means the gear shift is on the driver's left. What followed almost was comical, except for the serious potential for injury.

The clincher is that the young apprentice never had driven a vehicle with a manual transmission. He was licensed of course, but, in Japan, no driving test is required for military personnel only a written one. With the delivery complete, the senior airman took this great opportunity to teach his partner how to drive a stick shift.

This sequence of events leads to ORM time. Operational risk management is concerned with managing and controlling risk. The process also stipulates not to accept unnecessary risk. A quick review of the facts show four clear problems in this case: We have two junior individuals, on the flight line with aircraft turning, in a vehicle with tile driving controls on the opposite side, and with a lack of skill or knowledge on how to drive a stick shift.

What followed is predictable. The young apprentice belted his seatbelt, started the vehicle, found first gear, and mistakenly popped the clutch. The vehicle suddenly lurched forward, gathering speed. As the stationary line shack loomed into view and grew bigger in his windshield, the driver realized the danger. Had he been a surface-warfare Sailor, he would have realized that constant bearing, decreasing range (CBDR) means imminent collision. He attempted to stop the truck with what he thought was the brake but realized--to his horror--was the accelerator.

The hazmat truck hit the line shack at a 90-degree angle, collapsing the north wall. The three occupants inside the building were shocked at the noise, confused at the sight of the nose of a small truck in their personal space, but happy to he alive.

We were thankful no one was injured, and the only loss was to the driver's ego. The line shack will be repaired, and line division temporarily will have to put up with a northern exposure during the rainy season.

What are the learning points? ORM is not just for aircrew. Maintenance ORm does exist, and it is taught at the navy's School of Aviation Safety [and is being introduced at FASO and NAMTRAUs--Ed.]. Ask your command's safety officer about it!

You don't need formal education in ORM, merely a solid foundation in identifying the risks inherent in the tasks you do reach day.

L.Cdr. Raines is the safety officer at HSL-51.