37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 187416 |
Time | |
Date | 199108 |
Day | Sat |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : dfw |
State Reference | TX |
Altitude | msl bound lower : 10000 msl bound upper : 10300 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | tracon : dfw |
Operator | common carrier : air carrier |
Make Model Name | Medium Large Transport, Low Wing, 2 Turbojet Eng |
Navigation In Use | Other |
Flight Phase | climbout : intermediate altitude |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp pilot : flight engineer pilot : cfi |
Experience | flight time last 90 days : 225 flight time total : 8000 flight time type : 3000 |
ASRS Report | 187416 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp |
Events | |
Anomaly | altitude deviation : overshoot non adherence : clearance |
Independent Detector | other flight crewa |
Resolutory Action | flight crew : returned to intended course or assigned course |
Consequence | Other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
Our airline uses a 3 altimeter cockpit. Below 10000 ft the captain and first officer altimeters are set to QFE. The third altimeter is always on qnh. The first officer was flying. We were on climb out from dfw to an initial altitude of 10000 ft. I had reset my altimeter to qnh about 1000 ft below level off. The first officer kept his on QFE. I called the mandatory '9 for 10 thousand.' the first officer acknowledged and continued to look for traffic at 11000 ft and 1 O'clock called out by departure control. He was hand flying. At 200 ft from level off altitude I noticed the first officer still climbing at a large rate and still preoccupied with acquiring the traffic. I stated 'there's your altitude' at which time he began his level off and overshot by 200 ft. He explained he was focusing on his QFE altimeter. While he reset his altimeter he allowed the aircraft to gradually climb again. I stated 'watch your altitude' and physically pushed the yoke forward. We stopped our climb at 10300 ft. I believe a QFE altimeter is not necessary in our cockpits. This incident shows how distraction and unsafe it can be if a relatively inexperienced pilot has to deal with it in a high work environment. If I hadn't called out our correct altitude we surely would have leveled off at 10000 ft on QFE instead of qnh. That would have put us only 400 ft from the 11000 ft traffic!
Original NASA ASRS Text
Title: ACR MLG ALT DEV OVERSHOT DURING CLB OUT FROM DFW. FO WAS LOOKING AT THE WRONG ALTIMETER.
Narrative: OUR AIRLINE USES A 3 ALTIMETER COCKPIT. BELOW 10000 FT THE CAPT AND FO ALTIMETERS ARE SET TO QFE. THE THIRD ALTIMETER IS ALWAYS ON QNH. THE FO WAS FLYING. WE WERE ON CLBOUT FROM DFW TO AN INITIAL ALT OF 10000 FT. I HAD RESET MY ALTIMETER TO QNH ABOUT 1000 FT BELOW LEVEL OFF. THE FO KEPT HIS ON QFE. I CALLED THE MANDATORY '9 FOR 10 THOUSAND.' THE FO ACKNOWLEDGED AND CONTINUED TO LOOK FOR TFC AT 11000 FT AND 1 O'CLOCK CALLED OUT BY DEP CTL. HE WAS HAND FLYING. AT 200 FT FROM LEVEL OFF ALT I NOTICED THE FO STILL CLBING AT A LARGE RATE AND STILL PREOCCUPIED WITH ACQUIRING THE TFC. I STATED 'THERE'S YOUR ALT' AT WHICH TIME HE BEGAN HIS LEVEL OFF AND OVERSHOT BY 200 FT. HE EXPLAINED HE WAS FOCUSING ON HIS QFE ALTIMETER. WHILE HE RESET HIS ALTIMETER HE ALLOWED THE ACFT TO GRADUALLY CLB AGAIN. I STATED 'WATCH YOUR ALT' AND PHYSICALLY PUSHED THE YOKE FORWARD. WE STOPPED OUR CLB AT 10300 FT. I BELIEVE A QFE ALTIMETER IS NOT NECESSARY IN OUR COCKPITS. THIS INCIDENT SHOWS HOW DISTR AND UNSAFE IT CAN BE IF A RELATIVELY INEXPERIENCED PLT HAS TO DEAL WITH IT IN A HIGH WORK ENVIRONMENT. IF I HADN'T CALLED OUT OUR CORRECT ALT WE SURELY WOULD HAVE LEVELED OFF AT 10000 FT ON QFE INSTEAD OF QNH. THAT WOULD HAVE PUT US ONLY 400 FT FROM THE 11000 FT TFC!
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.