Investigating the root causes of major failures of critical components – With a case study of asbestos cement pipes

Abstract Root cause analysis (RCA) is an essential step in quality and reliability improvement. However, it is not straightforward because most of the time, failure analysis does not always consider the whole system approach. Different applications, scenarios, and objectives require different adaptations and modifications of the approach. In this paper, we present a study of RCA by analyzing major failures of critical components. While many researchers have used and developed various tools and techniques to improve RCA in this aspect, applications of this research in practice still lack. In this study, one of the more established models; Issue-Based Information System (IBIS) using DesignVUE, is implemented in a water utility set up to solve the problem of major failures of Asbestos Cement (AC) pipes. In this work, we present a case study of major failures with serious consequences of pipe failures in a water system. Incorporating RCA with IBIS is useful in mapping a debate on engineering problems that occur in service. A major mistake made when carrying out RCA of engineering related failures is isolating a failed component overlooking the involvement of other players and their role to prevent reoccurrence of failures.