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Columbia Accident Investigation Board Report. Volume Two

Volume II of the Report contains appendices that were cited in Volume I. The Columbia Accident Investigation Board produced many of these appendices as working papers during the investigation into the February 1, 2003 destruction of the Space Shuttle Columbia. Other appendices were produced by other organizations (mainly NASA) in support of the Board investigation. In the case of documents that have been published by others, they are included here in the interest of establishing a complete record, but often at less than full page size. Contents include: CAIB Technical Documents Cited in the Report: Reader's Guide to Volume II; Appendix D. a Supplement to the Report; Appendix D.b Corrections to Volume I of the Report; Appendix D.1 STS-107 Training Investigation; Appendix D.2 Payload Operations Checklist 3; Appendix D.3 Fault Tree Closure Summary; Appendix D.4 Fault Tree Elements - Not Closed; Appendix D.5 Space Weather Conditions; Appendix D.6 Payload and Payload Integration; Appendix D.7 Working Scenario; Appendix D.8 Debris Transport Analysis; Appendix D.9 Data Review and Timeline Reconstruction Report; Appendix D.10 Debris Recovery; Appendix D.11 STS-107 Columbia Reconstruction Report; Appendix D.12 Impact Modeling; Appendix D.13 STS-107 In-Flight Options Assessment; Appendix D.14 Orbiter Major Modification (OMM) Review; Appendix D.15 Maintenance, Material, and Management Inputs; Appendix D.16 Public Safety Analysis; Appendix D.17 MER Manager's Tiger Team Checklist; Appendix D.18 Past Reports Review; Appendix D.19 Qualification and Interpretation of Sensor Data from STS-107; Appendix D.20 Bolt Catcher Debris Analysis.

CAIB (COLUMBIA ACCIDENT INVESTIGATION BOARD)

A systematic risk management approach employed on the CloudSat project

The CloudSat Project has developed a simplified approach for fault tree analysis and probabilistic risk assessment. A system-level fault tree has been constructed to identify credible fault scenarios and failure modes leading up to a potential failure to meet the nominal mission success criteria.

risk management fault tree analysis probabilistic

A graphical language for reliability model generation

A graphical interface capability of the hybrid automated reliability predictor (HARP) is described. The graphics-oriented (GO) module provides the user with a graphical language for modeling system failure modes through the selection of various fault tree gates, including sequence dependency gates, or by a Markov chain. With this graphical input language, a fault tree becomes a convenient notation for describing a system. In accounting for any sequence dependencies, HARP converts the fault-tree notation to a complex stochastic process that is reduced to a Markov chain which it can then solve for system reliability. The graphics capability is available for use on an IBM-compatible PC, a Sun, and a VAX workstation. The GO module is written in the C programming language and uses the Graphical Kernel System (GKS) standard for graphics implementation. The PC, VAX, and Sun versions of the HARP GO module are currently in beta-testing.

Howell, Sandra V.

Graphical workstation capability for reliability modeling

In addition to computational capabilities, software tools for estimating the reliability of fault-tolerant digital computer systems must also provide a means of interfacing with the user. Described here is the new graphical interface capability of the hybrid automated reliability predictor (HARP), a software package that implements advanced reliability modeling techniques. The graphics oriented (GO) module provides the user with a graphical language for modeling system failure modes through the selection of various fault-tree gates, including sequence-dependency gates, or by a Markov chain. By using this graphical input language, a fault tree becomes a convenient notation for describing a system. In accounting for any sequence dependencies, HARP converts the fault-tree notation to a complex stochastic process that is reduced to a Markov chain, which it can then solve for system reliability. The graphics capability is available for use on an IBM-compatible PC, a Sun, and a VAX workstation. The GO module is written in the C programming language and uses the graphical kernal system (GKS) standard for graphics implementation. The PC, VAX, and Sun versions of the HARP GO module are currently in beta-testing stages.

Bavuso, Salvatore J.

Health Management Applications for International Space Station

Traditional mission and vehicle management involves teams of highly trained specialists monitoring vehicle status and crew activities, responding rapidly to any anomalies encountered during operations. These teams work from the Mission Control Center and have access to engineering support teams with specialized expertise in International Space Station (ISS) subsystems. Integrated System Health Management (ISHM) applications can significantly augment these capabilities by providing enhanced monitoring, prognostic and diagnostic tools for critical decision support and mission management. The Intelligent Systems Division of NASA Ames Research Center is developing many prototype applications using model-based reasoning, data mining and simulation, working with Mission Control through the ISHM Testbed and Prototypes Project. This paper will briefly describe information technology that supports current mission management practice, and will extend this to a vision for future mission control workflow incorporating new ISHM applications. It will describe ISHM applications currently under development at NASA and will define technical approaches for implementing our vision of future human exploration mission management incorporating artificial intelligence and distributed web service architectures using specific examples. Several prototypes are under development, each highlighting a different computational approach. The ISStrider application allows in-depth analysis of Caution and Warning (C&W) events by correlating real-time telemetry with the logical fault trees used to define off-nominal events. The application uses live telemetry data and the Livingstone diagnostic inference engine to display the specific parameters and fault trees that generated the C&W event, allowing a flight controller to identify the root cause of the event from thousands of possibilities by simply navigating animated fault tree models on their workstation. SimStation models the functional power flow for the ISS Electrical Power System and can predict power balance for nominal and off-nominal conditions. SimStation uses realtime telemetry data to keep detailed computational physics models synchronized with actual ISS power system state. In the event of failure, the application can then rapidly diagnose root cause, predict future resource levels and even correlate technical documents relevant to the specific failure. These advanced computational models will allow better insight and more precise control of ISS subsystems, increasing safety margins by speeding up anomaly resolution and reducing,engineering team effort and cost. This technology will make operating ISS more efficient and is directly applicable to next-generation exploration missions and Crew Exploration Vehicles.

Alena, Richard

Derivation of Failure Rates and Probability of Failures for the International Space Station Probabilistic Risk Assessment Study

National Aeronautics and Space Administration s (NASA) International Space Station (ISS) Program uses Probabilistic Risk Assessment (PRA) as part of its Continuous Risk Management Process. It is used as a decision and management support tool to not only quantify risk for specific conditions, but more importantly comparing different operational and management options to determine the lowest risk option and provide rationale for management decisions. This paper presents the derivation of the probability distributions used to quantify the failure rates and the probability of failures of the basic events employed in the PRA model of the ISS. The paper will show how a Bayesian approach was used with different sources of data including the actual ISS on orbit failures to enhance the confidence in results of the PRA. As time progresses and more meaningful data is gathered from on orbit failures, an increasingly accurate failure rate probability distribution for the basic events of the ISS PRA model can be obtained. The ISS PRA has been developed by mapping the ISS critical systems such as propulsion, thermal control, or power generation into event sequences diagrams and fault trees. The lowest level of indenture of the fault trees was the orbital replacement units (ORU). The ORU level was chosen consistently with the level of statistically meaningful data that could be obtained from the aerospace industry and from the experts in the field. For example, data was gathered for the solenoid valves present in the propulsion system of the ISS. However valves themselves are composed of parts and the individual failure of these parts was not accounted for in the PRA model. In other words the failure of a spring within a valve was considered a failure of the valve itself.

Vitali, Roberto

Testing for Software Safety

This research focuses on testing whether or not the hazardous conditions identified by design-level fault tree analysis will occur in the target implementation. Part 1: Integrate fault tree models into functional specifications so as to identify testable interactions between intended behaviors and hazardous conditions. Part 2: Develop a test generator that produces not only functional tests but also safety tests for a target implementation in a cost-effective way. Part 3: Develop a testing environment for executing generated functional and safety tests and evaluating test results against expected behaviors or hazardous conditions. It includes a test harness as well as an environment simulation of external events and conditions.

Chen, Ken

Logic flowgraph methodology - A tool for modeling embedded systems

The logic flowgraph methodology (LFM), a method for modeling hardware in terms of its process parameters, has been extended to form an analytical tool for the analysis of integrated (hardware/software) embedded systems. In the software part of a given embedded system model, timing and the control flow among different software components are modeled by augmenting LFM with modified Petrinet structures. The objective of the use of such an augmented LFM model is to uncover possible errors and the potential for unanticipated software/hardware interactions. This is done by backtracking through the augmented LFM mode according to established procedures which allow the semiautomated construction of fault trees for any chosen state of the embedded system (top event). These fault trees, in turn, produce the possible combinations of lower-level states (events) that may lead to the top event.

Muthukumar, C. T.

A quantitative analysis of the F18 flight control system

This paper presents an informal quantitative analysis of the F18 flight control system (FCS). The analysis technique combines a coverage model with a fault tree model. To demonstrate the method's extensive capabilities, we replace the fault tree with a digraph model of the F18 FCS, the only model available to us. The substitution shows that while digraphs have primarily been used for qualitative analysis, they can also be used for quantitative analysis. Based on our assumptions and the particular failure rates assigned to the F18 FCS components, we show that coverage does have a significant effect on the system's reliability and thus it is important to include coverage in the reliability analysis.

Doyle, Stacy A.

Monte Carlo Simulation of Markov, Semi-Markov, and Generalized Semi- Markov Processes in Probabilistic Risk Assessment

A standard tool of reliability analysis used at NASA-JSC is the event tree. An event tree is simply a probability tree, with the probabilities determining the next step through the tree specified at each node. The nodal probabilities are determined by a reliability study of the physical system at work for a particular node. The reliability study performed at a node is typically referred to as a fault tree analysis, with the potential of a fault tree existing.for each node on the event tree. When examining an event tree it is obvious why the event tree/fault tree approach has been adopted. Typical event trees are quite complex in nature, and the event tree/fault tree approach provides a systematic and organized approach to reliability analysis. The purpose of this study was two fold. Firstly, we wanted to explore the possibility that a semi-Markov process can create dependencies between sojourn times (the times it takes to transition from one state to the next) that can decrease the uncertainty when estimating time to failures. Using a generalized semi-Markov model, we studied a four element reliability model and were able to demonstrate such sojourn time dependencies. Secondly, we wanted to study the use of semi-Markov processes to introduce a time variable into the event tree diagrams that are commonly developed in PRA (Probabilistic Risk Assessment) analyses. Event tree end states which change with time are more representative of failure scenarios than are the usual static probability-derived end states.

English, Thomas

Accounting for Point Estimate Uncertainty in Space Systems Reliability and Risk Analysis

Understanding and accounting for uncertainty in risk analysis is a critical step in the management and communication of risk in engineered systems. The component and system-level analysis to determine the probability of a negative outcome and its consequence is often quantified by a point estimate. Many Program and Enterprise decisions involving technical concerns and issues rely on reliability engineering activities to produce quantified risk analysis to inform the decision making process. At NASA, it is common to use a Probabilistic Risk Analysis (PRA) to inform the overall risk to Loss of Mission or Loss of Crew that involves integration across all spacecraft subsystem fault trees to produce an overall probability of mission failure. The point estimate is an estimate of this overall probability and is an immediate result of a fault tree model. It is the result of a model where the probability of each event is taken to be equal to its mean. The value provides an approximation of the overall mean without running any uncertainty calculations (e.g., no sampling). Using only the point estimate can lead to a false sense of precision and the point estimate may not match the resulting mean when uncertainty is taken into consideration. This paper will explore five conditions that can cause the PRA model mean to diverge from the point estimate and will provide engineers and managers insight into the importance of understanding uncertainty in the elements of PRA models.

Paul J Collier

Accelerated Monte Carlo Simulation for Safety Analysis of the Advanced Airspace Concept

Safe separation of aircraft is a primary objective of any air traffic control system. An accelerated Monte Carlo approach was developed to assess the level of safety provided by a proposed next-generation air traffic control system. It combines features of fault tree and standard Monte Carlo methods. It runs more than one order of magnitude faster than the standard Monte Carlo method while providing risk estimates that only differ by about 10%. It also preserves component-level model fidelity that is difficult to maintain using the standard fault tree method. This balance of speed and fidelity allows sensitivity analysis to be completed in days instead of weeks or months with the standard Monte Carlo method. Results indicate that risk estimates are sensitive to transponder, pilot visual avoidance, and conflict detection failure probabilities.

Thipphavong, David

Rocket engine system reliability analyses using probabilistic and fuzzy logic techniques

The reliability of rocket engine systems was analyzed by using probabilistic and fuzzy logic techniques. Fault trees were developed for integrated modular engine (IME) and discrete engine systems, and then were used with the two techniques to quantify reliability. The IRRAS (Integrated Reliability and Risk Analysis System) computer code, developed for the U.S. Nuclear Regulatory Commission, was used for the probabilistic analyses, and FUZZYFTA (Fuzzy Fault Tree Analysis), a code developed at NASA Lewis Research Center, was used for the fuzzy logic analyses. Although both techniques provided estimates of the reliability of the IME and discrete systems, probabilistic techniques emphasized uncertainty resulting from randomness in the system whereas fuzzy logic techniques emphasized uncertainty resulting from vagueness in the system. Because uncertainty can have both random and vague components, both techniques were found to be useful tools in the analysis of rocket engine system reliability.

Hardy, Terry L.

Model authoring system for fail safe analysis

The Model Authoring System is a prototype software application for generating fault tree analyses and failure mode and effects analyses for circuit designs. Utilizing established artificial intelligence and expert system techniques, the circuits are modeled as a frame-based knowledge base in an expert system shell, which allows the use of object oriented programming and an inference engine. The behavior of the circuit is then captured through IF-THEN rules, which then are searched to generate either a graphical fault tree analysis or failure modes and effects analysis. Sophisticated authoring techniques allow the circuit to be easily modeled, permit its behavior to be quickly defined, and provide abstraction features to deal with complexity.

Sikora, Scott E.

RSRM Nozzle Anomalous Throat Erosion Investigation Overview

In September, 1996, anomalous pocketing erosion was observed in the aft end of the throat ring of the nozzle of one of the reusable solid rocket motors (RSRM 56B) used on NASA's space transportation system (STS) mission 79. The RSRM throat ring is constructed of bias tape-wrapped carbon cloth/ phenolic (CCP) ablative material. A comprehensive investigation revealed necessary and sufficient conditions for occurrence of the pocketing event and provided rationale that the solid rocket motors for the subsequent mission, STS-80, were safe to fly. The nozzles of both of these motors also exhibited anomalous erosion similar to, but less extensive than that observed on STS-79. Subsequent to this flight, the investigation to identify both the specific causes and the corrective actions for elimination of the necessary and sufficient conditions for the pocketing erosion was intensified. A detailed fault tree approach was utilized to examine potential material and process contributors to the anomalous performance. The investigation involved extensive constituent and component material property testing, pedigree assessments, supplier audits, process audits, full scale processing test article fabrication and evaluation, thermal and thermostructural analyses, nondestructive evaluation, and material performance tests conducted using hot fire simulation in laboratory test beds and subscale and full scale solid rocket motor static test firings. This presentation will provide an over-view of the observed anomalous nozzle erosion and the comprehensive, fault-tree based investigation conducted to resolve this issue.

Clinton, R. G., Jr.

Development and validation of techniques for improving software dependability

A collection of document abstracts are presented on the topic of improving software dependability through NASA grant NAG-1-1123. Specific topics include: modeling of error detection; software inspection; test cases; Magnetic Stereotaxis System safety specifications and fault trees; and injection of synthetic faults into software.

Knight, John C.

From Informal Safety-Critical Requirements to Property-Driven Formal Validation

Most of the efforts in formal methods have historically been devoted to comparing a design against a set of requirements. The validation of the requirements themselves, however, has often been disregarded, and it can be considered a largely open problem, which poses several challenges. The first challenge is given by the fact that requirements are often written in natural language, and may thus contain a high degree of ambiguity. Despite the progresses in Natural Language Processing techniques, the task of understanding a set of requirements cannot be automatized, and must be carried out by domain experts, who are typically not familiar with formal languages. Furthermore, in order to retain a direct connection with the informal requirements, the formalization cannot follow standard model-based approaches. The second challenge lies in the formal validation of requirements. On one hand, it is not even clear which are the correctness criteria or the high-level properties that the requirements must fulfill. On the other hand, the expressivity of the language used in the formalization may go beyond the theoretical and/or practical capacity of state-of-the-art formal verification. In order to solve these issues, we propose a new methodology that comprises of a chain of steps, each supported by a specific tool. The main steps are the following. First, the informal requirements are split into basic fragments, which are classified into categories, and dependency and generalization relationships among them are identified. Second, the fragments are modeled using a visual language such as UML. The UML diagrams are both syntactically restricted (in order to guarantee a formal semantics), and enriched with a highly controlled natural language (to allow for modeling static and temporal constraints). Third, an automatic formal analysis phase iterates over the modeled requirements, by combining several, complementary techniques: checking consistency; verifying whether the requirements entail some desirable properties; verify whether the requirements are consistent with selected scenarios; diagnosing inconsistencies by identifying inconsistent cores; identifying vacuous requirements; constructing multiple explanations by enabling the fault-tree analysis related to particular fault models; verifying whether the specification is realizable.

Cimatti, Alessandro

System Safety Analysis of Complex NASA Systems with Model-Based Engineering

The emergence of model-based engineering is transforming design and analysis methodologies [5]. A recognized benefit of model-based engineering is the existence of a “single source of truth” about the system that becomes the authoritative source of data and information for designers, analysts, and developers. This promotes consistency and efficiency as the design emerges and can be used to further optimize the design. Integrating System Safety Engineers to the “single source of truth” will ensure that the outputs of their assessments and analyses are relevant to the design as it evolves. Use of an integrated system model enables near immediate evaluation of a design change as well as development of operational processes for risk assessment and communication. Such models can enable efficient and timely analysis of system hazards (e.g., hazard fault tree analysis and procedure simulations) and produce complete, accurate, and more consistent products (e.g., hazard reports and safety requirement evaluations). Therefore, an agency-sponsored team at Goddard Space Flight Center (GSFC) recently completed a System Safety Study of modeling and testing capabilities as part of a Model-Based Safety and Mission Assurance Initiative (MBSMAI). Using an existing model developed for reliability analyses [1], GSFC modeling and system safety experts performed system safety analysis/modeling and produced safety products. The team evaluated model-based feasibility to support System Safety Engineering, developed safety analysis modeling processes, and identified tool capability advancement/development needs. These study results indicate model-based engineering is valid and useable for System

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