Tag: downtime

OM in the News: The Two‑Cent Failure That Shut Down a Factory

In operations management, small and overlooked details can have outsized consequences. A well‑known example comes from a manufacturing plant where a single 2‑cent bolt caused nearly a month of downtime. The incident illustrates that the failures that matter most are not always the ones that occur most frequently, writes Industry Week (Sept. 22, 2026).

Predictive maintenance systems (see Ch. 17 in your Heizer/Render/Munson text) are designed to monitor components that commonly wear out. Sensors track performance, data models identify warning signs, and technicians intervene before breakdowns occur. When focused on familiar failure patterns, these systems perform effectively and prevent costly interruptions.

However, predictive systems only detect what they are built to observe. In this case, the bolt that failed was not instrumented. It was considered too inexpensive, too simple, and too unlikely to break. Because it was not monitored, the system had no way to provide an early warning. When the bolt snapped, the machine stopped immediately.

The true cost of the failure was not the price of the bolt but the time required to recover. The part was specialized and not kept in inventory. It had to be ordered from a specific supplier, and until it arrived, the production line remained offline. The result was weeks of lost output—far more expensive than any of the common failures the system was designed to predict.

The OM lesson is clear: rare failures can be more damaging than frequent ones if the organization is unprepared to respond quickly. Effective maintenance planning requires looking beyond the usual wear‑and‑tear components and identifying parts that, if they failed unexpectedly, would be difficult or slow to replace.

The most costly outage often comes from the part no one thought to monitor. Recognizing this blind spot—and planning for it—is essential for building resilient operations.

Classroom Discussion Questions

  1. How should organizations balance monitoring common failures with preparing for rare but high‑impact failures?
  2. What criteria—not just failure frequency—should be used to decide which machine components deserve monitoring or backup inventory?

OM in the News: Maintenance Issues and Dead Workers

Wayne Rothering was a few months away from retirement when a machine killed him. He worked on a laminator line at a large Wisconsin furniture factory. He stopped the conveyor and stepped inside the line to fix a torn roll of paper. Behind him, powered rollers that fed 5-foot-by-6-foot slabs of fiberboard into the system continued to spin. As Rothering worked, the rollers caught hold of a board on the conveyor and propelled it into his back. Rothering was crushed to death.

Ashley Furniture paid a fine in a settlement with OSHA after Rothering’s death but didn’t admit fault

He was among hundreds of U.S. workers to die over the past decade in mishaps that a regulation known as “lockout/tagout” is supposed to prevent. The concept is simple: Before an industrial machine can be serviced, an employee must shut it down and place a lock over its power source. If that isn’t possible, the employee should place a tag telling co-workers to leave the machine off.

Lockouts are designed to prevent employees from being hurt by machines that start unexpectedly. Every year, an average of 85 people are killed and 364 suffer amputations. Violations related to the lockout standard are the most common safety citations issued by OSHA.

Incidents usually happen because employers fail to implement adequate safety measures, writes The Wall Street Journal (Oct. 4, 2024). “They take shortcuts, figure it’s too much trouble to lock it out, or they get pressure to keep productivity moving,” said a former OSHA exec. Companies often minimize downtime with alternatives that allow machines to remain powered during minor servicing.

Sometimes machinery is still operating when workers enter dangerous areas. Two years ago, Leily Lopez-Hernandez was blowing dust off a pizza company’s cooling machine. She went beneath the machine and was decapitated. After, OSHA fined the firm $2.8 million for 29 violations, 17 of which were deemed “willful”—meaning an employer purposefully disregarded regulations or acted with indifference to safety.

“It’s easy to blame the working person for failing to heed a warning or follow a procedure, but we know that’s going to happen, not because they are lazy or stupid, but because there are competing motivations,” said an industry attorney. “If the employer emphasizes production above all, so will the employee.”

Classroom discussion questions:

  1. You are the operations manager at a manufacturer. What can you do to prevent such injuries and deaths?
  2. What is the role of the Occupational Safety and Health Administration (OSHA)?