21L.A.3 Reporting system

of the European Parliament and of the Council lays down requirements on the reporting, analysis and follow-up of occurrences in civil aviation. Compliance with point 21L.A.3 of Part 21 Light does not exempt organisations from compliance with Regulation (EU) No 376/2014. For each category of reporter, Regulation (EU) 2015/1018 defines the nature of items to be mandatorily reported. Regulation (EU) No 376/2014 also considers voluntary reporting of other items that are perceived by the reporter as a threat to aviation safety. Point 21L.A.3 lays down requirements for the mandatory reporting of events to the competent authority in view of performing the necessary activities linked to the continued airworthiness of products or parts. For Part 21 Light design and production organisations and natural or legal persons that use Subpart R for production, the reportability criteria (i.e. potential unsafe condition) are the same as for Regulation (EU) No 376/2014. Furthermore, compliance with Regulation (EU) No 376/2014 does not exempt organisations from compliance with point 21L.A.3. However, this should not give rise to two parallel reporting systems, and point 21L.A.3 and Regulation (EU) No 376/2014 should be seen as complementary in that respect. In practice, this means that reporting obligations under point 21L.A.3 on one hand and reporting obligations under Regulation (EU) No 376/2014 on the other hand are compatible. These reporting obligations may be discharged using one reporting channel. In addition, any natural or legal person that has more than one role subject to the obligation to report may discharge all those obligations through a single report. Natural or legal persons (organisations) are encouraged to properly describe this in their procedures, to address cases in which the responsibilities are discharged on behalf of the organisation.

COLLECTION, INVESTIGATION AND ANALYSIS OF EVENTS In the context of the following AMC and GM, the term ‘event’ refers to any failure, malfunction, defect, error, near miss, hazard identification, incident, accident or other occurrence that is subject to a reporting system. The ‘collection’, ‘investigation’ and ‘analysis’ functions of the reporting system should include means to: analyse events and related available information; identify adverse trends; investigate the associated root cause(s); and determine any necessary corrective action(s). It should also allow the determination of reportable occurrences as required under points 21L.A.3(a)(3) or 21L.A.3(b)(3), as applicable. In addition, for parts whose failure could lead to an unsafe condition, the ‘analysis’ function of the reporting system should ensure that reports and information sent, or available, to the design approval holder or declarant of a declaration of design compliance are fully investigated so that the exact nature of any event and its effect on continuing airworthiness is understood. This may then result in changes to the design and/or to the instructions for continued airworthiness (ICAs), and/or in establishing a mitigation plan to prevent or minimise the possibility of such occurrences in the future, as necessary. The ‘analysis’ is not limited to those occurrences that require the involvement of the Agency under point 21L.A.3(e).

GENERAL — SYSTEM FOR COLLECTING OCCURRENCE REPORTS The term ‘collecting’ means the setting up of systems and procedures which should enable relevant failures, malfunctions and defects, or other occurrences, to be properly collected when they occur. As the collection system needs to accept reports that originate outside the organisation (from operators, maintenance organisation, suppliers, etc.), it is necessary to inform possible reporters of the existence of the system and the appropriate means to introduce reports into it. This does not presume that direct access to the system is to be granted if other mechanisms are more appropriate. The collection system should also ensure the collection, through an internal reporting scheme, of internal errors, near misses and hazards that are perceived by the reporter as an actual or potential aviation safety risk. Considerations for the collection of information related to events should include the following: grouping of events; analysis of failure rates; the early rejection of parts from service; and comparison with the certification assumptions.

GENERAL Approval holders of minor changes and minor repairs or declarants of a design compliance for a minor change or minor repair other than the natural or legal person that submitted the declaration under Part 21 Light Subpart C do not have to comply with the requirements in point 21L.A.3(a), since according to the classification criteria for design changes and repairs (see points 21L.A.63 and 21L.A.203), minor changes and minor repairs have no appreciable effect on the characteristics affecting the airworthiness of a product. However, it should be noted that the obligations under Regulation (EU) No 376/2014 and its implementing acts still apply.

GENERAL A certificate is ‘deemed to have been issued under this Annex’ if a certificate holder has elected to use Article 2a of Regulation (EU) No 748/2012 and that certificate is now governed by the provisions of Annex Ib (Part 21 Light) to Regulation (EU) No 748/2012 as detailed in the type-certificate data sheet or supplemental type-certificate data sheet.

EVENTS REPORTED VOLUNTARILY TO THE ORGANISATION Any natural person or legal person may voluntarily report to an organisation any event that is perceived by that person as posing an actual or potential hazard to aviation safety. Voluntary reports may be originated by:

(a)persons that are not listed in Article 4(6) of Regulation (EU) No 376/2014; or

(b)persons that are listed in Article 4(6) of Regulation (EU) No 376/2014, even though such events are not included in Regulation (EU) 2015/2018;

(c)an organisation, if such organisation cannot determine whether the event should be mandatorily reported. Example: A maintenance staff member in a maintenance organisation reports to their maintenance organisation a perceived aircraft design issue that is not covered by Regulation (EU) 2015/2018. The maintenance organisation should make a final assessment on the voluntary report and if it assesses that the reported event ‘may involve an actual or potential aviation safety risk’, then it should mandatorily report it to the type-certificate holder or declarant, the competent authority, etc., as per point 145.A.60 ‘Occurrence reporting’ of Annex II (Part-145) to Regulation (EU) No 1321/2014. If the maintenance organisation cannot determine whether a safety risk exists (due to a lack of competence, lack of data, etc.), it could voluntarily report it to the type-certificate holder or declarant for further assessment.

INTERNAL SAFETY REPORTING SCHEME The internal safety reporting scheme is part of the overall collection system. The objective of this GM is to provide specific guidance on the internal safety reporting scheme only.

(a)The overall objectives of the internal safety reporting scheme are to: collect information that is reported by the organisation’s staff; and use that reported information to improve the safety of operations. Each internal safety reporting scheme should include provisions for confidentiality and enable and encourage free and frank reporting of events as those listed in point 21L.A.3(a)(1)(i) and (ii). This is facilitated by the establishment of a just culture.

(b)The specific objectives of the internal safety reporting scheme are to:

(1)enable an assessment of the safety implications of each relevant event that is reported, including previous similar events, so that any necessary action can be initiated; and

(2)ensure that lessons from relevant events are shared so that other persons and other entities within the organisation may learn from them.

(c)The internal safety reporting scheme is an essential part of the overall management system or the production control system and should be complementary to the routine procedures and control systems; it is not intended to duplicate or supersede any of them. The internal safety reporting scheme is a tool to identify those instances in which routine procedures have failed or may fail.

(d)All safety-related reports should be retained, as the significance of such reports may only become obvious later.

(e)The collection and analysis of timely, appropriate and accurate data will allow the organisation to react to the information that it receives, and to take the necessary action.

REPORTING TO THE COMPETENT AUTHORITY Within the overall limit of 72 hours, the degree of urgency for the submission of a report should be determined by the level of risk that is judged to have resulted from the occurrence. If an occurrence is judged by the person identifying the possible unsafe condition to have resulted in an immediate and particularly significant hazard, the Agency (or the competent authority of the Member State as required) should be advised immediately and by the fastest possible means (telephone, fax, email, telex, etc.) of whatever details are available at the time. The initial report must be followed up by a full written report within 72 hours. An example would be an uncontained engine failure resulting in damage to the aircraft’s primary structure. In all other cases, the submission of the report may be delayed up to a maximum of 72 hours after determination of the possible unsafe condition, in order to provide more details.

REPORTING TO THE COMPETENT AUTHORITY — GENERAL

(a)The reference to ‘aware of’ an occurrence implies that the organisation identifies the event as one that falls into the category of occurrences to be reported — usually when the organisation determines that the event is reportable. The 72-hour period starts when the possible unsafe condition is identified.

(b)Regulation (EU) 2015/1018 lays down a generic ‘list classifying occurrence in civil aviation to be mandatorily reported’. This list should not be understood as being an exhaustive collection of all issues that may pose a significant risk to aviation safety and, therefore, reporting should not be limited to the items listed in that Regulation.

(c)AMC-20 ‘General Acceptable Means of Compliance for Airworthiness of Products, Parts and Appliances’ provides further details on occurrence reporting (AMC 20-8).

(d)Point 21L.A.3(a)(3) requires the reporting of occurrences that may result in an unsafe condition. AMC1 21L.B.23(b) may be used to assist in the determination of an unsafe condition.

FOLLOW-UP AND CLOSURE OF REPORTED OCCURRENCES

(a)The organisation should transmit the following information to the competent authority within 30 days from the date of notification of the occurrence to the competent authority:

(1)the latest position of the organisation responsible for design as to whether an unsafe condition is confirmed;

(2)the results of the analysis and of the first investigation — including the cause(s) of the occurrence, if known; and

(3)the measures it has taken, intends to take or proposes to be taken, including:

(i)containment measures that have already been defined by the reporting organisation and put in place (if any); and

(ii)in the case of reports made by the organisation responsible for design, for unsafe conditions, a risk assessment supporting that the product can be operated safely until the corrective action is defined and implemented, or that immediate mitigation measures need to be implemented until a more refined risk assessment can be provided. Organisations are encouraged to provide a complete analysis and follow-up as soon as available and, in principle, no later than 3 months after the occurrence notification. It is recognised that analysing an occurrence may take longer than 3 months, especially if the investigation is complex or where the services of a specialist investigator are required. The requirements for follow-up are not intended to jeopardise the quality and thoroughness of an occurrence analysis. It may be detrimental to safety if the analysis is completed in a rush within the encouraged 3-month period without properly establishing the root cause(s), making a risk assessment and determining whether remedial action is required. The designer (any natural or legal person that holds a type certificate, supplemental type certificate, major repair design approval, or that has declared the compliance of an aircraft design, or a design change or repair design to it under this Annex) and the production organisation (any natural or legal person that has declared their production capability under Subpart G of this Annex, or that produces a product or part under Subpart R) should cooperate, as necessary, to ensure that any corrective action can be implemented. In addition, affected organisations are expected to cooperate under their respective regulatory framework from the reporting of an occurrence until its closure, to ensure complete results. The final (close-out) report should include: the final designer position as to whether an unsafe condition exists; the results of the occurrence analysis and of the final investigation, including the cause(s) of the occurrence; any corrective and preventive action by the reporting organisation; and in the case of reports made by the organisation responsible for the design, a risk assessment supporting that those corrective and preventive measures allow the product to be operated safely.

(b)Notwithstanding point (a), when the organisation identifies that no unsafe condition exists as a result of its analysis of a voluntarily reported occurrence, it can delay further communication to the competent authority up to the issue of the final report and report the occurrence as closed upon issue (data exchange). In such cases, no follow-up report should be submitted. The final report to EASA should include confirmation and justification that no unsafe condition exists. The organisation is requested to provide information on the cause(s) of the occurrence and on the corrective or preventive action that was taken by the organisation. This way of reporting should not be understood as an accepted deviation from the requirements of Part 21 Light. If at any stage during the investigation, the organisation identifies that a possible unsafe condition exists, it should communicate it to EASA by means of a mandatory report within 72 hours.