NASA Office of Logic Design

NASA Office of Logic Design

A scientific study of the problems of digital engineering for space flight systems,
with a view to their practical solution.

2004 MAPLD International Conference

Ronald Reagan Building and International Trade Center
Washington, D.C.

September 8-10, 2004

Seminar: Aerospace Mishaps and Lessons Learned

"Aerospace Mishaps and Lessons Learned"  will be a full-day seminar  held on Tuesday, September 7, 2004, starting at 9:00 am.  Breakfast, break service, and lunch will be provided.   Program is preliminary at this time.


This seminar will start with an introduction into failure mechanisms and root cause analysis.  Building from that base, a series of case studies will be examined in detail, exploring both the mechanisms and root causes and then discussing lessons learned from each of the mishaps.  For many of the segments as possible, people involved in either the system or the mishap investigation will be presenting.

Seminar Leader

Kevin Hames, NASA Johnson Space Center, Co-Chair for AIAA Journal Publications
Kevin Hames
NASA Johnson Space Center

Seminar Schedule (times approximate)

Time Speaker Affiliation Mishap Title, Abstract, and Mishap Reports Presentation
9:00 Richard Katz NASA Office of Logic Design Introduction Introduction
9:15 Faith Chandler NASA HQ Using Root-Cause Analysis to Understand Failures Root Cause (presentation)
Video (NASA library)
Video (


10:00 Jonathan F Binkley Aerospace Corp. The Space System Engineering Database (SSED) SSED Demo (presentation)
Video (NASA library)
Video (
10:45 BREAK      
11:00 Owen Brown DARPA Apollo 13 Mishap Video (
12:00 Kathryn Anne Weiss MIT An Analysis of Causation in Aerospace Accidents Causation (presentation)
12:45 LUNCH      
1:30 Susan C. Lee JHU/APL The Near Earth Asteroid Rendezvous (NEAR) Rendezvous Burn Anomaly NEAR (presentation)
Video (NASA library)
Video (
2:45 Rick Obenschain NASA GSFC SEASAT: Lessons Learned ... And Not Learned SEASAT (presentation)
Video (NASA library)
Video (
3:30 BREAK      
3:45 Keith E. Van Tassel NASA JSC STS-86/SAFER SAFER (main) (presentation)
SAFER (backup)

Video (NASA library)
Video (
4:30 Paul Cheng Aerospace Corp Aerospace 100 Questions That Should Be Asked During Technical Reviews 100 Questions (presentation)
Video (NASA library)
Video (
5:15 Keith Avery Mission Research Corp. STRV-1c/1d Mishap STRV-1cd (presentation)
Video (NASA library)
Video (
6:00 SESSION ENDS      
Backup Richard Katz NASA Office of Logic Design The Failure of a Small Satellite and the Loss of a Space Science Mission SMEX/WIRE
Board Report, Intro
Appendix F, Technical

Pictures from the seminar

Mishap Report Library

Lessons Learned Library

For more information please contact:

Richard B. Katz
National Aeronautics and Space Administration

2004 MAPLD International Conference Home Page

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Last Revised: February 03, 2010
Digital Engineering Institute
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