37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 118803 |
Time | |
Date | 198907 |
Day | Mon |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : clt |
State Reference | NC |
Altitude | agl bound lower : 0 agl bound upper : 0 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | Medium Large Transport, Low Wing, 2 Turbojet Eng |
Navigation In Use | Other Other |
Flight Phase | climbout : takeoff ground other : taxi |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : cfi pilot : atp |
Experience | flight time last 90 days : 200 flight time total : 11500 flight time type : 400 |
ASRS Report | 118803 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp |
Events | |
Anomaly | non adherence : published procedure non adherence : far other anomaly other |
Independent Detector | other flight crewa |
Resolutory Action | flight crew : overcame equipment problem |
Consequence | Other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
I was captain on air carrier xx flight a from clt to lax on jul/mon/89. The takeoff data was received by ACARS and from an agent. Due to high weight and temperature a flaps 5 'improved climb' takeoff was to be utilized. All bug speeds were set correctly for the flaps 5 'improved climb' takeoff. The speeds are obtained from data received via ACARS, rather than the v-speed chart (which is used for normal takeoffs). During the before takeoff checklist, I confirmed the flaps were set at 1 degree. I was halfway down the runway when I realized we should have used flaps 5 degree. I reached over and set the flaps from 1 degree to 5 degree, and we continued with a normal takeoff. I believe I allowed the wrong flap setting to be utilized because I am used to using flaps 1 degree during climb limited takeoffs. In fact it was only several months earlier that flaps 1 'improved climb' data was removed from our performance manuals as part of the 'mirror image' policy of the xx-xy merger. The first officer told me he thought all 'improved climb' takeoffs were flaps 1 degree. He said he was sure he made the same mistake at least once before. I also believe the lack of a takeoff warning should be examined. Since the flaps were in the takeoff range, the confign warning system was satisfied. I believe the fmcs should be utilized to generate all takeoff v-speeds and a warning if the proper flap setting is not set. Air carrier xx's medium large transport fleet is equipped with a performance management system which can give such warnings to the flight crew.
Original NASA ASRS Text
Title: ACR MLG FLT CREW MAKES TKOF WITH FLAPS SET AT ALTERNATE POSITION AND ADJUSTS SETTING ON THE ROLL.
Narrative: I WAS CAPT ON ACR XX FLT A FROM CLT TO LAX ON JUL/MON/89. THE TKOF DATA WAS RECEIVED BY ACARS AND FROM AN AGENT. DUE TO HIGH WEIGHT AND TEMPERATURE A FLAPS 5 'IMPROVED CLIMB' TKOF WAS TO BE UTILIZED. ALL BUG SPEEDS WERE SET CORRECTLY FOR THE FLAPS 5 'IMPROVED CLIMB' TKOF. THE SPEEDS ARE OBTAINED FROM DATA RECEIVED VIA ACARS, RATHER THAN THE V-SPEED CHART (WHICH IS USED FOR NORMAL TKOFS). DURING THE BEFORE TKOF CHECKLIST, I CONFIRMED THE FLAPS WERE SET AT 1 DEG. I WAS HALFWAY DOWN THE RWY WHEN I REALIZED WE SHOULD HAVE USED FLAPS 5 DEG. I REACHED OVER AND SET THE FLAPS FROM 1 DEG TO 5 DEG, AND WE CONTINUED WITH A NORMAL TKOF. I BELIEVE I ALLOWED THE WRONG FLAP SETTING TO BE UTILIZED BECAUSE I AM USED TO USING FLAPS 1 DEG DURING CLIMB LIMITED TKOFS. IN FACT IT WAS ONLY SEVERAL MONTHS EARLIER THAT FLAPS 1 'IMPROVED CLIMB' DATA WAS REMOVED FROM OUR PERFORMANCE MANUALS AS PART OF THE 'MIRROR IMAGE' POLICY OF THE XX-XY MERGER. THE F/O TOLD ME HE THOUGHT ALL 'IMPROVED CLIMB' TKOFS WERE FLAPS 1 DEG. HE SAID HE WAS SURE HE MADE THE SAME MISTAKE AT LEAST ONCE BEFORE. I ALSO BELIEVE THE LACK OF A TKOF WARNING SHOULD BE EXAMINED. SINCE THE FLAPS WERE IN THE TKOF RANGE, THE CONFIGN WARNING SYSTEM WAS SATISFIED. I BELIEVE THE FMCS SHOULD BE UTILIZED TO GENERATE ALL TKOF V-SPEEDS AND A WARNING IF THE PROPER FLAP SETTING IS NOT SET. ACR XX'S MLG FLEET IS EQUIPPED WITH A PERFORMANCE MGMNT SYSTEM WHICH CAN GIVE SUCH WARNINGS TO THE FLT CREW.
Data retrieved from NASA's ASRS site as of August 2007 and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.