<< >> NASA ASRS Report 197838, December 1991

After parking medium large transport aircraft and completing checklists. Flight crew left aircraft with #2 engine running.

Attributes
ACN	197838
Time
Date	199112
Day	Wed
Local Time Of Day	1801 To 2400
Place
Locale Reference	airport : dfw
State Reference	TX
Altitude	agl bound lower : 0 agl bound upper : 0
Environment
Flight Conditions	VMC
Light	Night
Aircraft 1
Controlling Facilities	artcc : zhn
Operator	common carrier : air carrier
Make Model Name	Medium Large Transport, Low Wing, 2 Turbojet Eng
Flight Phase	ground : parked
Flight Plan	IFR
Person 1
Affiliation	company : air carrier
Function	flight crew : captain oversight : pic
Qualification	pilot : atp pilot : flight engineer pilot : commercial pilot : instrument
Experience	flight time last 90 days : 110 flight time total : 8000 flight time type : 360
ASRS Report	197838
Person 2
Affiliation	company : air carrier
Function	flight crew : first officer
Qualification	pilot : instrument pilot : commercial
Events
Anomaly	non adherence : far non adherence : published procedure non adherence other
Independent Detector	other flight crewa other other : unspecified
Resolutory Action	none taken : detected after the fact
Consequence	Other
Supplementary
Primary Problem	Flight Crew Human Performance
Air Traffic Incident	Pilot Deviation

Narrative:

Situation involved an unscheduled equipment change and gate change. Taxi in was extremely short and normal shutdown of #2 engine during taxi in was not done. Aircraft parked at remote pad, shutdown checks called for and first officer reported complete. However, in fact, #2 engine was left running. Crew left ramp to continue flight on another aircraft. Company maintenance found aircraft with #2 still running and secured same. Contributing factors include: night operations into unfamiliar parking area, unexpected gate change and equipment change coupled with deviation from normal single engine taxi procedures and hurrying to reach new aircraft. Situation created unnecessary hazards to ground crew and equipment due to a lapse in crew coordination and cockpit resource management principles. End result was an extensive discussion of event between crew members and a redoubled effort not to let habit and every day routine expectations override the need to thoroughly complete every task and checklist regardless of situation.

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Original NASA ASRS Text

Title: AFTER PARKING MLG ACFT AND COMPLETING CHKLISTS. FLC LEFT ACFT WITH #2 ENG RUNNING.

Narrative: SITUATION INVOLVED AN UNSCHEDULED EQUIP CHANGE AND GATE CHANGE. TAXI IN WAS EXTREMELY SHORT AND NORMAL SHUTDOWN OF #2 ENG DURING TAXI IN WAS NOT DONE. ACFT PARKED AT REMOTE PAD, SHUTDOWN CHKS CALLED FOR AND FO RPTED COMPLETE. HOWEVER, IN FACT, #2 ENG WAS LEFT RUNNING. CREW LEFT RAMP TO CONTINUE FLT ON ANOTHER ACFT. COMPANY MAINT FOUND ACFT WITH #2 STILL RUNNING AND SECURED SAME. CONTRIBUTING FACTORS INCLUDE: NIGHT OPS INTO UNFAMILIAR PARKING AREA, UNEXPECTED GATE CHANGE AND EQUIP CHANGE COUPLED WITH DEV FROM NORMAL SINGLE ENG TAXI PROCS AND HURRYING TO REACH NEW ACFT. SITUATION CREATED UNNECESSARY HAZARDS TO GND CREW AND EQUIP DUE TO A LAPSE IN CREW COORD AND COCKPIT RESOURCE MGMNT PRINCIPLES. END RESULT WAS AN EXTENSIVE DISCUSSION OF EVENT BTWN CREW MEMBERS AND A REDOUBLED EFFORT NOT TO LET HABIT AND EVERY DAY ROUTINE EXPECTATIONS OVERRIDE THE NEED TO THOROUGHLY COMPLETE EVERY TASK AND CHKLIST REGARDLESS OF SITUATION.

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.