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RCA Name
Report Number
Report Date
RCA Owner
Performance products
Crump, Michigan, USA
Reaction step
P-105
Actual I mpact
Safety None
Environmental 500 lbs of methyl bad-stuff leaked into dike; contained
Revenue Lost profit due to 20 hours downtime (Plant is sold out).
Delays in getting product to market
Cost Pump repair; labor & parts
Cost Clean up
Environmental Disposal of spilled methyl bad-stuff
Actual I mpact Total:
Cost
$0.00
$0.00
$100,000.00
$15,000.00
$1,500.00
$3,000.00
$119,500.00
$0.00
$5,200,000.00
$5,200,000.00
Page 2 \ 10
Report Summaries
Executive Summary
The repeat failure of the new P-105 slurry pump has caused repeat, unplanned shutdowns resulting in
lost profit and excessive expenditures due to seal leaks. The slurry contains 50% methyl bad stuff
which is an environmentally regulated chemical and requires the pump to be shut down upon detection
of a leak greater than 2kg/hr causing production losses amounting to $240,000 thus far. These losses
will increase as product demand grows.The project team was under cost- and timing- pressure, and
specified a seal that was not suitable for this service.
In order to prevent repeat seal failures, the corrective action is to install a new type of seal and stuffing
box capable of handling the solids. The preventive actions are to integrate a reliability review with all
new capital projects and to require the area reliabilty engineer to provide design criteria to the project
teams for special, known process and equipment requirements.
Cause and Effect Summary
The unplanned shutdown was caused by a seal leak of slurry pump P-105. The seal leak was the result
of a single mechanical seal being installed in slurry service. Single mechanical seals with discharge
recirc flushes in slurry service fail due to solids depositing on the seal faces. Deposits open the seal
faces as the pumped liquid evaporates across the seal faces, leaving solids behind. This opens the seal
faces creating increasingly worse seal leakage. The single mechanical seal was installed because the
project team didn't know it was not the best choice, and because it was inexpensive. The team didn't
know it wasn't the best choice because they didn't seek reliability input and because no one gave them
input upfront as to the most effective design criteria for the process and equipment requirements. The
missing input was caused by no step, or requirement, in the capital project guidelines to integrate
reliability input. The project team also went with the single seal because they were looking to cut
costs due to budget contraints imposed on them by the business and because they were projected to
be over budget. They were also in a rush to complete the project in order to get the product to market
more quickly.
Page 3 \ 10
Solutions
ID
Label
Solution
Cause
Description
Replace single seal with double mechanical seal
Single mechanical seal on pump
Note
Assigned
Due
Term
Solution
Cause
Bill Wilson
Criteria
12/26/2012
Status
Short
Cost
Pass
Approved
$10,000.00
Note
Assigned
Sue Young
Due
2/3/2013
Term
Medium
Solution
Cause
Criteria
Status
Cost
Pass
Approved
$800.00
Modify capital project steps to have reliability engineer provide list of key design critieria
for new equipment
Design choice by capital project team
Note
Assigned
Bill Wilson
Criteria
Due
2/3/2013
Status
Term
Medium
Solution
Cause
Note
Assigned
Solution
Cause
Approved
$0.00
Due
Term
Cost
Pass
Criteria
Status
Choose
Cost
Fail
Identified
$0.00
Page 4 \ 10
Note
Assigned
Due
Term
Choose
12/26/2012
Short
Criteria
Status
Cost
Pass
Selected
$2,000.00
Page 5 \ 10
Team
ID
Label
First Name
Description
Bill
Phone (1)
Rel eng
bw@stuff.com
Sue
Phone (1)
Proj eng
sy@stuff.com
Dan
Phone (1)
Group
Last Name
Machinist
dv@stuff.com
Group
Last Name
Valerio
Chris
Group
Last Name
Phone (1)
Phone (2)
Role
Group
Young
Phone (2)
Role
First Name
Wilson
Phone (2)
Role
First Name
Last Name
Description
Phone (2)
Role
First Name
Label
chris.eckert@sologic.com
Eckert
Page 6 \ 10
Evidence
ID
Label
Description
Evidence
visual observation
Cause(s)
Location
Link
Contributor
Type
Bill Wilson
Direct Observation
Quality
Evidence
Cause(s)
Location
Link
Page 7 \ 10
Contributor
Type
Choose
Direct Statement
Quality
Evidence
Cause(s)
Location
Link
Contributor
Type
Choose
Direct Statement
Quality
Evidence
Cause(s)
Location
Link
http://www.flowserve.com/Products/Seals
Page 8 \ 10
Contributor
Type
Chris Eckert
Document
Quality
Evidence
Machinist statement
Cause(s)
Location
Link
Contributor
Type
Choose
Direct Statement
Quality
Evidence
Cause(s)
Location
Link
Contributor
Type
Quality
Choose
Direct Statement
Page 9 \ 10
Label
149
Action
Cause
Assigned
Completed
Description
Choose
no
Evidence - 1
Termination Points - 6
Cause Types - 0
Unconnected Causes - 0
Empty Cause Boxes - 0
Due Date
Page 10 \ 10
Notes
ID
1
Label
Note
Description
Machinists checked clearances and tolerances, and all looked in accordance with spec
Cause
Note
Cause
Note
Cause
Verified steps
Seal Improperly installed?
Transitory
Terminated because:
Pump handles
regulated chemical
END
Non-transitory
Evidence
Omission - Transitory
Omission - Non-transitory
www.sologic.com
Desire to be in
compliance with all
environmental
regulations
Focal Point
Solution Implemented
Terminated because:
END
Desired state
Evidence
EH&S Manager statement
Decision not to
exceed allowable
emissions
Evidence
EH&S Manager statement
Desire to be good
environmental
stewards
Evidence
Operations Supv statement
Terminated because:
END
Desired state
Evidence
and
or
Leaking seal is
safety hazard
Evidence
Terminated because:
END
Evidence
Single seal is
relatively
inexpensive
Evidence
Project engineer statement
Design choice by
capital project team
Terminated because:
Desired state
Machinist statement
Evidence
Evidence
visual observation
Solutions
Project team
over-ran budget
Decision to repair
pump P-105
Pass
Status
Evidence
Approved
END
Desired state
END
Evidence
Terminated because:
System under
pressure
Terminated because:
Inexperienced
project team
Risk
Evidence
Terminated because:
END
Evidence
END
Evidence
Terminated because:
visual observation
Project engineer statement
Evidence
Project engineer statement
Evidence
visual observation
No one recognized
the need
Reliability group
never provided
feedback
Evidence
Evidence
Evidence
visual observation
Machinist statement
Pass
Status
Approved
Evidence
Evidence
Evidence
Solutions
Capital projects
group never asked
No reliability
personnel assigned
to project team
No information or
knowledge to spec
anything different
Evidence
Status
Solutions
Criteria
Pass
and
or
Criteria
END
c
Project engineer statement
Single mechanical
seal on pump
Terminated because:
Risk
Approved
Status Identified
Not confident that seal-less pump would be
able to handle the large solids present
No design standards
for this application
Connects to:
Evidence
visual observation
20 hours of
production outage
(Pump seal
replacement)
Reliability input
not required in
project guiidelines
visual observation
Connects to:
Conventional
stuffing box
installed
Seal Improperly
installed?
Terminated because:
END
Terminated because:
END
END
Evidence
Machinist statement
Terminated because:
Evidence
Evidence
Risk
Evidence
visual observation
Solutions
1 hour to LOTO
Pass
Status
Selected
Evidence
visual observation
Evidence
visual observation
Terminated because:
END
Evidence
and
or
Evidence
Terminated because:
visual observation
END
No clean, external
seal flush
12 hours to replace
seal in shop
Small amount of
pumped fluid leaks
across seal faces
No information or knowledge to spec anything different
Total turnaround
time = 20 hours
visual observation
visual observation
END
Evidence
Evidence
Evidence
Evidence
Terminated because:
Connects to:
Machinist statement
One face is
stationary
Heat generated by
seal face friction
Terminated because:
END
Liquid vaporizes
Evidence
visual observation
3 hours to reinstall
Pumped fluid
contains solids
Terminated because:
END
Evidence
Evidence
visual observation
Evidence
Seal mfg literature
Evidence
visual observation
Evidence
Machinist statement
Solids in fluid
accumulate on seal
faces
High friction
coefficient
Evidence
2 hours to de-LEO
and recommission
Evidence
Single mechnical
seals unable to
tolerate solids
Evidence
visual observation
Evidence
visual observation
Evidence
Seal mfg literature
Accumulated solids
opens faces
Solids stick to
faces
Evidence
1 hour to flush and
drain
Evidence
visual observation
Seal mfg literature
Machinist statement
Evidence
visual observation
visual observation
Machinist statement
Terminated because:
END
Inability to cool
faces
Evidence
Seal mfg literature
Terminated because:
END
Evidence
visual observation
Terminated because:
END