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|
Attributes | |
ACN | 193508 |
Time | |
Date | 199110 |
Day | Wed |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : ewr |
State Reference | NJ |
Altitude | msl bound lower : 8000 msl bound upper : 9600 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | tracon : n90 |
Operator | common carrier : air carrier |
Make Model Name | Large Transport, Low Wing, 3 Turbojet Eng |
Flight Phase | cruise other descent other |
Route In Use | enroute : on vectors |
Flight Plan | IFR |
Aircraft 2 | |
Operator | common carrier : air carrier |
Make Model Name | Medium Large Transport, Low Wing, 2 Turbojet Eng |
Flight Phase | climbout : intermediate altitude |
Route In Use | departure other departure sid : sid enroute : on vectors |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : second officer |
Qualification | pilot : instrument pilot : flight engineer pilot : commercial pilot : atp |
Experience | flight time last 90 days : 200 flight time total : 2500 flight time type : 400 |
ASRS Report | 193508 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : commercial pilot : instrument pilot : flight engineer pilot : atp |
Experience | flight time last 90 days : 215 flight time total : 15000 flight time type : 1000 |
ASRS Report | 193143 |
Events | |
Anomaly | altitude deviation : excursion from assigned altitude non adherence : clearance non adherence : published procedure |
Independent Detector | aircraft equipment other aircraft equipment : unspecified other controllera |
Resolutory Action | flight crew : took evasive action none taken : unable |
Consequence | faa : reviewed incident with flight crew |
Miss Distance | horizontal : 2000 vertical : 500 |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
On initial vectors to ewr, approach called traffic at '12 O'clock 8600 ft appears in climb.' soon after, TCASII gave TA, then RA of 'climb, monitor vertical speed.' presentation on TA/vsi indicated maintain level attitude, we climbed to approximately 9600 ft above traffic. First officer maintained visual contact with traffic at all times. Approach control called and asked if we were responding to TCASII RA, and we replied in affirmative. Uneventful approach and landing at ewr after this incident. We came relatively close to other aircraft, approximately 1/4-1/2 NM. Appears that captain who was flying at the time responded to TCASII aural command of climb and misinterpreted presentation on TA/vsi to maintain level attitude. Initially when he started to climb, I stated 'descend' because of presentation on TA/vsi. After climbing approximately 1000 ft TA/vsi showed green arc at approximately 2000 plus FPM. Initial picture on TA/vsi was red arc from '0' to plus 6000 FPM climb and no indication (clear) from '0' to minus 6000 FPM descent. Supplemental information from acn 193143. This incident was caused by my misinterp of the TCASII which was reinforced by hearing 'climb.' I had perceived the aircraft to be below us from the initial call out when in fact he was at 8600 or above us. I do not know if the traffic was called out before I leveled at 8000 which was our crossing restriction over robbinsville or after I leveled off which may have put it above us. My perception of the danger as below climbing into us caused me to 'lock in' to this thought. My future actions were then programmed to react accordingly. My first officer is sure he also heard an initial climb command from TCASII. The so does not remember hearing one. My possible initial misreading of the vsi was a result of this conception missed. I did not 'see' the TCASII blip and interpret it to be above us. The sudden loud call outs by the TCASII and my perceived thought of an aircraft climbing toward us caused me to react before I took time to check all displays and assure myself of what they were saying. It is a very frightening experience to see how I could react in a directly opposite direction to an event of this type.
Original NASA ASRS Text
Title: TCASII RA AND TRACON APCH CTLR'S PHRASEOLOGY AND FLC RESPONSE CREATES A POTENTIAL CONFLICT LTSS IN THIS ALTDEV ALT EXCURSION FROM ASSIGNED.
Narrative: ON INITIAL VECTORS TO EWR, APCH CALLED TFC AT '12 O'CLOCK 8600 FT APPEARS IN CLB.' SOON AFTER, TCASII GAVE TA, THEN RA OF 'CLB, MONITOR VERT SPD.' PRESENTATION ON TA/VSI INDICATED MAINTAIN LEVEL ATTITUDE, WE CLBED TO APPROX 9600 FT ABOVE TFC. FO MAINTAINED VISUAL CONTACT WITH TFC AT ALL TIMES. APCH CTL CALLED AND ASKED IF WE WERE RESPONDING TO TCASII RA, AND WE REPLIED IN AFFIRMATIVE. UNEVENTFUL APCH AND LNDG AT EWR AFTER THIS INCIDENT. WE CAME RELATIVELY CLOSE TO OTHER ACFT, APPROX 1/4-1/2 NM. APPEARS THAT CAPT WHO WAS FLYING AT THE TIME RESPONDED TO TCASII AURAL COMMAND OF CLB AND MISINTERPRETED PRESENTATION ON TA/VSI TO MAINTAIN LEVEL ATTITUDE. INITIALLY WHEN HE STARTED TO CLB, I STATED 'DSND' BECAUSE OF PRESENTATION ON TA/VSI. AFTER CLBING APPROX 1000 FT TA/VSI SHOWED GREEN ARC AT APPROX 2000 PLUS FPM. INITIAL PICTURE ON TA/VSI WAS RED ARC FROM '0' TO PLUS 6000 FPM CLB AND NO INDICATION (CLR) FROM '0' TO MINUS 6000 FPM DSCNT. SUPPLEMENTAL INFO FROM ACN 193143. THIS INCIDENT WAS CAUSED BY MY MISINTERP OF THE TCASII WHICH WAS REINFORCED BY HEARING 'CLB.' I HAD PERCEIVED THE ACFT TO BE BELOW US FROM THE INITIAL CALL OUT WHEN IN FACT HE WAS AT 8600 OR ABOVE US. I DO NOT KNOW IF THE TFC WAS CALLED OUT BEFORE I LEVELED AT 8000 WHICH WAS OUR XING RESTRICTION OVER ROBBINSVILLE OR AFTER I LEVELED OFF WHICH MAY HAVE PUT IT ABOVE US. MY PERCEPTION OF THE DANGER AS BELOW CLBING INTO US CAUSED ME TO 'LOCK IN' TO THIS THOUGHT. MY FUTURE ACTIONS WERE THEN PROGRAMMED TO REACT ACCORDINGLY. MY FO IS SURE HE ALSO HEARD AN INITIAL CLB COMMAND FROM TCASII. THE SO DOES NOT REMEMBER HEARING ONE. MY POSSIBLE INITIAL MISREADING OF THE VSI WAS A RESULT OF THIS CONCEPTION MISSED. I DID NOT 'SEE' THE TCASII BLIP AND INTERPRET IT TO BE ABOVE US. THE SUDDEN LOUD CALL OUTS BY THE TCASII AND MY PERCEIVED THOUGHT OF AN ACFT CLBING TOWARD US CAUSED ME TO REACT BEFORE I TOOK TIME TO CHK ALL DISPLAYS AND ASSURE MYSELF OF WHAT THEY WERE SAYING. IT IS A VERY FRIGHTENING EXPERIENCE TO SEE HOW I COULD REACT IN A DIRECTLY OPPOSITE DIRECTION TO AN EVENT OF THIS TYPE.
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.