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The Challenger Accident. Magnus Jansson, Electrical Engineering Fredrik Mannesson, Engineering and Industrial Management Per Martinell, Civil Engineering. The Challenger Accident. Mechanical causes Administrative causes Mechanical redesign Changes in administrative procedures
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The Challenger Accident • Magnus Jansson, Electrical Engineering • Fredrik Mannesson, Engineering and Industrial Management • Per Martinell, Civil Engineering
The Challenger Accident • Mechanical causes • Administrative causes • Mechanical redesign • Changes in administrative procedures • Summary Source: JSC Digital Image Collection - STS51L <http://images.jsc.nasa.gov/iams/html/pao/STS51L.htm>
The Challenger Accident • Mechanical causes • The tendency for holes to form in the putty which protected the seals from the high temperature exhaust gases • The erosion of the O-rings due to contact with the hot gases which penetrated the putty • An instantaneous increase in the size of the gap between mating sections of the booster caused by the high internal pressures of the solid rocket booster • The inability of the seal to quickly respond to the changing gap size during low temperature operating conditions
The Challenger Accident • Administrative Causes • Engineers and managers different views on O-ring erosion • Engineers: • Alarmed by O-ring erosion in 1984 • Renewed concerns when secondary O-ring also eroded • Delay Challenger launch until temperature reaches 12 °C
The Challenger Accident • Administrative Causes, continued • Managers: • O-ring erosion acceptable • No previous incident due to O-ring erosion • No method of quantifying risk • Result: Substantial difference in risk awareness
The Challenger Accident • Administrative Causes, continued • Strict chain of command: Engineers Group Manager Project Manager … • Difficult communicate concerns upward: • Problems mitigated or silenced • Adhere to chain of command • Result: Only one path for information to travel
The Challenger Accident • Administrative Causes, continued • Challenger delayed several times • Desire to keep flight rate
The Challenger Accident • Mechanical Redesign • Blowhole solution • O-ring erosion solution • Joint rotation solution • Poor resilience solution
The Challenger Accident • Changes in Administrative Procedures • Shuttle management restructure • Hazard analysis review • Improved communication • Flight rate revision
The Challenger Accident • Summary • Causes of solid rocket booster joints failure: • Blow holes • O-ring erosion • Increased gap size • Lack of O-ring resiliency • Redesign of field joint
The Challenger Accident • Summary, continued • Flawed communication and administrative policies • Restructure of shuttle management • Review of hazard analysis • Improving communication • Revision of flight rate