37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 181079 |
Time | |
Date | 199106 |
Day | Mon |
Local Time Of Day | 0001 To 0600 |
Place | |
Locale Reference | atc facility : las |
State Reference | NV |
Altitude | agl bound lower : 0 agl bound upper : 7000 |
Environment | |
Flight Conditions | VMC |
Light | Night |
Aircraft 1 | |
Controlling Facilities | tracon : las |
Operator | common carrier : air carrier |
Make Model Name | Medium Large Transport, Low Wing, 2 Turbojet Eng |
Flight Phase | climbout : takeoff ground : preflight |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 120 flight time total : 8500 flight time type : 3200 |
ASRS Report | 181079 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp |
Experience | flight time last 90 days : 230 flight time total : 3510 flight time type : 540 |
ASRS Report | 181158 |
Events | |
Anomaly | aircraft equipment problem : critical other anomaly other |
Independent Detector | other flight crewa |
Resolutory Action | none taken : detected after the fact |
Consequence | Other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
During a taxi out on a part 121 medium large transport operation, the flight crew noticed an 'equipment' caution light. Both crew members thought the light was the 'equipment cooling' light. We referenced the checklist for an equipment cooling fan malfunction. After takeoff there was an indication of no pressurization. The problem was then accurately determined. We leveled at 7000' MSL and circled around for an uneventful landing. After taxi back to the gate the east and east compartment door was found open. The door was shut. The captain determined fuel onboard to meet dispatch requirements therefore no new release was obtained and the flight was continued. After further research/discussion we determined a new release should have been obtained and a logbook entry recorded upon arrival at destination airport. The captain contacted maintenance control to insure the situation was understood. Both the captain and the first officer, later the same day, spoke face to face with a flight manager. The situation was thoroughly examined and lessons were learned.
Original NASA ASRS Text
Title: ACR CREW MISREADS CAUTION LIGHT. RETURN LAND. NO NEW RELEASE, NO LOGBOOK ENTRY.
Narrative: DURING A TAXI OUT ON A PART 121 MLG OPERATION, THE FLT CREW NOTICED AN 'EQUIP' CAUTION LIGHT. BOTH CREW MEMBERS THOUGHT THE LIGHT WAS THE 'EQUIP COOLING' LIGHT. WE REFERENCED THE CHKLIST FOR AN EQUIP COOLING FAN MALFUNCTION. AFTER TKOF THERE WAS AN INDICATION OF NO PRESSURIZATION. THE PROB WAS THEN ACCURATELY DETERMINED. WE LEVELED AT 7000' MSL AND CIRCLED AROUND FOR AN UNEVENTFUL LNDG. AFTER TAXI BACK TO THE GATE THE E AND E COMPARTMENT DOOR WAS FOUND OPEN. THE DOOR WAS SHUT. THE CAPT DETERMINED FUEL ONBOARD TO MEET DISPATCH REQUIREMENTS THEREFORE NO NEW RELEASE WAS OBTAINED AND THE FLT WAS CONTINUED. AFTER FURTHER RESEARCH/DISCUSSION WE DETERMINED A NEW RELEASE SHOULD HAVE BEEN OBTAINED AND A LOGBOOK ENTRY RECORDED UPON ARR AT DEST ARPT. THE CAPT CONTACTED MAINT CTL TO INSURE THE SITUATION WAS UNDERSTOOD. BOTH THE CAPT AND THE F/O, LATER THE SAME DAY, SPOKE FACE TO FACE WITH A FLT MGR. THE SITUATION WAS THOROUGHLY EXAMINED AND LESSONS WERE LEARNED.
Data retrieved from NASA's ASRS site as of July 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.