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Essay Samples > Research > A Failure of Engineering Managers
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A Failure of Engineering Managers

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This paper will discuss both the environmental and human factors that were associated with the launching of Space Shuttle Challenger on January 28, 1986. Only 73 seconds after the launch, the Space Shuttle Challenger exploded destroying the spaceship and all the seven crew members aboard. The paper will explore the cause and contributing factors to the Challenger tragedy. The paper will especially focus on NASA’s use of the group decision support system (GDSS) to making the decision launch that led to failure in communication.
Background Information
The NASA Orbiter Vehicle Designation (OV-099) otherwise known as Space Shuttle Challenger was NASA’s the second orbiter to be put into space after Columbia. Space Shuttle Challenger’s maiden flight was scheduled on April 4, 1983. The orbiter completed nine missions but unfortunately it broke apart on its tenth mission just 73 seconds after its launch in January 28, 1986. The STS-1-L resulted in the death of all of its seven crew members. This accident resulted to grounding of the shuttle fleet for two and half years and missions resumed later in 1988 with another Space Shuttle Challenger, STS-26. The Challenger was replaced by Space Shuttle Endeavour that was launched later in 1992.
The Event
On January 28, 1986, only 73 seconds after launching, the Space Shuttle Challenger exploded and broke leading to deaths of all its crew members. The Space Shuttle Challenger exploded and disintegrated over the Atlantic Ocean, off the central Florida coast ate around 11.39 a.m. EST (EFO Staff). According to The Challenger Disaster, the immediate cause of the explosion was a burn through an O-ring that sealed one of the solid rocket boosters. This is said to have ripped apart at high altitude. The proximate cause was the leakage of two rubber O rings located in a segmented rocket booster. Because of the prevailing environmental conditions (the temperature was estimated to be about -20 degrees F), the rings lost their ability to stop the hot blowby gas. At launch, the ambient temperature was in the low of 30s.
The Structure of the Challenger Disaster
NASA had the benefit of the public support and a generous funding after the success of the Apollo program to land man in the moon. President Nixon on January 5, 1972 declared that his government had approved the Shuttle program.
The shuttle had a solid rocket booster (SRB) that housed the portion of the Challenger that malfunctioned causing the accident. The work of the SRB is to hold the rocket fuel and thus in essence is the one that powers the shuttle into outer space. The work of the SRB is to direct all of the rocket’s exhaust gas downwards, thus propelling the rocket upward. After a successful lift off, the SRB will disconnect from the shuttle and returns to the earth for any later use (The Challenger Disaster, n.d.).
The SRB is basically a cylindrical shell that has a layer of insulation. Within the shell, there are joint seals made of two O-rings and zinc chromate putty. Zinc chromate putty is meant to protect the O-rings from extreme temperatures and gases; hence it is used to protect the rings because it acts as an insulator between the joint seal and the gaps. The O-rings are basically elastic rings that can contract or expand to be able to fill the gaps in the joint seal. If these O-rings do not properly seal the gaps, then it is very possible that exhaust gases will get into the internal structure of the rocket. Because of the extreme temperatures of the exhaust gases, they will affect the internal joint called the Tang and Clevis. The Tang and Clevis are two main parts of a joint held together with 177 pins and they cannot withstand high temperatures if the O-rings are not working properly.
Technical Problems
The paper will start by exploring at the mechanical aspects that Challenger faced: blow holes, joint rotation, O-Rings and the response of O-Rings during low temperatures. The seal’s condition is also important and engineers were meant to make sure that it was never damaged. Therefore, engineers increased pressure of the leak test above the pressure that the zinc putty could withstand. This was meant to ensure that the O-ring correctly covered the gap without the putty’s help.
Human Factors That Contributed To the Tragedy 
The failure of the Shuttle Challenger was caused by the failure of SRB, although human decision prior to the launch was in itself flawed. The decision reached to launch the rocket was found to be based upon faulty group decision support information and further provoked by mismanagement of information. Some of the contributing factors that led to destruction of the challenger are discussed below;
Environmental Factors
A heterogeneous process was used to develop an economical, social and political support for the shuttle to meet the needs of organization goals rather than a mission with specific goals and mission. Thus after it became operational, the shuttle was exposed to a myriad from multitude of other users. This meant that the shuttle had to live to the promises of NASA, with all the pressure on the management team. an example is when Reagan Administration declared that the shuttle be declared operational even before passing through the development stage (Launius, 1992). This simply means that the environment within NASA before the launch of Challenger was a short cut infiltrated by conflict and stress.
Decision Support System (DSS)
Just before the launch of Challenger, the probability of disaster continued to grow due to the growing demands that were being placed on NASA (Launius, 1992).   With 24 other successful launches, NASA was feeling a false sense of security. However, Jarman and Kouzmin (1990) asserts that before to the launch of STS 51-L, NASA as an organizations was faced with territorial and internal strafes; an internal disease of decay.
Before the launch of STS 51-L, it appeared that NASA had no formal decision support program (DSS) that was initialized for the shuttle. Jarman and Kouzmin (1990) strongly suggest that there is evidence that important decisions were made simply by ‘satisfaction’ and consciously "muddling through.” This implies that NASA was just operating in a semi-uncontrolled decision making at the same time serving international research, the military with a shuttle that was declared to be operational (by the president) before its developmental stage was even complete (Kramer, 1987).
The Decision to Launch
GDSS Situational Analysis
There was no group support between NASA and developers of the shuttle. The subcontractor responsible for development of the o-rings was Thiokol. The GDSS system between Thiokol and NASA had the same-time-place conference rooms that were well connected with speaker phones and a computer interface. Thiokol was briefing NASA on January 27, 1986 over the concerns of the next day’s landing. Engineers at Thiokol were concerned that extremely cold temperature would have an effect on the O-rings and hinder their performance. The mission was thus scheduled for cancellation due to bad weather, but NASA was not ready for that (Kramer, et al. 1987). NASA and Thiokol were aware that SRB seals needed upgrading but felt it was not so critical. GDSS information indicated that O-rings would perform under predicated temperatures, Thiokol were not sure about their testing. On the eve of the launch, Thiokol briefed NASA on the flawed GDSS data base. NASA insisted on the launch and Thiokol bowed to pressure later recommending to NASA for the launch.
Group Support system-Critical Analysis
An opportunity for a significant human error was obviously provided by the environment from which NASA and its affiliated developers operated. Nevertheless, during their GDSSS meeting before STS 51-L, they had a golden chance to escape disaster. These are reasons for the flawed GDSS and its information managers:
First, the “O” was known by Thiokol several months before Challenger Launch just for sake of staying on schedule. NASA got to know but due to treatment as allow risk situation, the problem was “down played” and this was GDSS‘s first flawed information. Failure to know the O-rings situation’s significance, they never gave credence to the advice of Thiokol engineers’ recommendations. However, it would be safe to launch according to data GDSS meeting for the forecasted temperature but NASA did like the source of the conflicting advice
Second, the delaying of the Shuttle launch was not welcome for all the group members were waiting for the launch.
Third, all GDSS thought it good to stick to the norms of the group .Although the Thiokol engineers strongly recommended that the launch be scrubbed but changed their stand when threatened with expulsion of the program      
And last, all the parties were afraid of the public response in case of a cancellation as there had been other cancellations (6 of them).
The GDSS was flawed as it is said that the database contained erroneous information and thus could not be trusted to test the O-rings.
Aftermath and Recommendations
Ethics and MSS/DSS- Human Factors Management
The question of how ethical consideration was managed by NASA and Thiokol is pivotal to the Challenger Shuttle’s launch decision and therefore a brief overview will be given. 
The area of information accuracy will form the first area of ethical concern. The fact that the managers of both NASA and Thiokol had little regard to the concerns of the engineers of Thiokol is really disturbing. All group members arrived at a decision with acknowledge that the decision was founded on information that was flawed. Secondly, in the decision made, the operational goals were fist while safety was put last. There was only one GDSS member expressed fears for serious concerns for the potential loss of life. Also,   there was discouragement of open and free communication before and during the meeting of GDSS through mind guarding, self-censorship and direct pressure which are some of group dynamics use in meetings. There is also a situation if known to individuals, which might cause social harm unless acted upon with integrity. So they have responsibility to have any authority contacted to manage and make sure that situation is under control for public interest’s sake.
The sciences that analyses and manages human factors have began to define the addition of MSS/DSS as a way of conducting business in a socially responsive manner (Turban). For the government agencies of large public project for instance the Shuttle program. The level of effectiveness that was needed to support the Challenger project, it can be argued, may not have been achieved by the GDSS technology. This was not the case as shown by the success of the DSS used in the prior Apollo mission. Social and ethical considerations in making a decision were discarded for the sake of schedule, cost and the demands of external environment, in the Challenger program.
The primary cause and contributing factors linked to the challenger tragedy has led to many conclusions .The author’s opinion is that the ability of each member to have voted anonymously was the key factor that would have maintained the integrity of the GDSS and quality of the decision made by GDSS. Following Thiokol’s presentation to NASA, IT was shown that that most of the GDSS group members got so concerned with the O-ring situation and believed that the opinions which Thiokol engineers  expressed were cause for serious consideration of  cancelling the launch(5). However, only selected senior officials were allowed to vote their “opinion” which was done verbally and only after NASA requested them to do so. From this paper’s conducted research, the author has a conviction that if the carrying out of the anonymous vote had been conducted of the total GDSS membership, there was to follow decision to cancel the launch. The decision for the Challenger Shuttle launch and its subsequent destruction had major effect on society and our space program’s management. The unique mission of the Challenger and Christa McAuliffe’s death opened the door for discussion and research on how DSS is used by managers to make decisions that will affect the trust of the public.

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