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|
Attributes | |
ACN | 218329 |
Time | |
Date | 199208 |
Day | Wed |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | atc facility : ekn |
State Reference | WV |
Altitude | msl bound lower : 24000 msl bound upper : 29000 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | artcc : zdc |
Operator | common carrier : air carrier |
Make Model Name | Medium Large Transport, Low Wing, 2 Turbojet Eng |
Navigation In Use | Other Other |
Flight Phase | cruise other descent other |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 190 flight time total : 10000 flight time type : 1000 |
ASRS Report | 218329 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : instrument pilot : commercial |
Events | |
Anomaly | altitude deviation : crossing restriction not met altitude deviation : undershoot non adherence : clearance |
Independent Detector | aircraft equipment other aircraft equipment : unspecified other controllera other flight crewa |
Resolutory Action | controller : issued new clearance flight crew : returned to intended course or assigned course other |
Consequence | Other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
At FL290, approximately 10 NM southwest of ekn, clearance was received to cross 30 NM southwest of mgw at FL240. PNF acknowledged clearance and PF entered restriction in FMC. (Flight was operating in VNAV and LNAV modes of autoplt.) after entry in FMC, PF noticed a 'bypass' annunciation in FMC routing in association with the entry of '30 southwest of mgw' fix. This was due to improper entry of this fix between mgw and 'roton' intersection. As opposed to where it really was, between ekn and 'tygar' intersection. PF was attempting to resolve this problem when it became apparent that initiation of descent was necessary to meet restriction. PF attempted to use vertical speed to initiate descent but aircraft remained at FL290. It was then noticed that altitude 'set' window was still at FL290, disallowing autoplt to descend. Altitude was reset to FL240, descent was initiated concurrent with inquiry from center as to ability to meet restriction. We responded 'unable' and flight was given a 50 degree right turn, presumably to avoid a potential conflict. At FL250, flight was cleared direct mgw to resume routing. This situation occurred because of PF's failure to follow his own SOP in such a circumstance which is to 1) reset altitude, 2) make a quick determination if aircraft is near the required descent point and initiate a descent using vertical speed or level change if necessary, 3) make appropriate entries in FMC and use VNAV for descent if appropriate. PF did these out of sequence and became distracted by an FMC irregularity, thus overshooting descent point.
Original NASA ASRS Text
Title: AN MLG ACR MISSED A XING ALT.
Narrative: AT FL290, APPROX 10 NM SW OF EKN, CLRNC WAS RECEIVED TO CROSS 30 NM SW OF MGW AT FL240. PNF ACKNOWLEDGED CLRNC AND PF ENTERED RESTRICTION IN FMC. (FLT WAS OPERATING IN VNAV AND LNAV MODES OF AUTOPLT.) AFTER ENTRY IN FMC, PF NOTICED A 'BYPASS' ANNUNCIATION IN FMC ROUTING IN ASSOCIATION WITH THE ENTRY OF '30 SW OF MGW' FIX. THIS WAS DUE TO IMPROPER ENTRY OF THIS FIX BTWN MGW AND 'ROTON' INTXN. AS OPPOSED TO WHERE IT REALLY WAS, BTWN EKN AND 'TYGAR' INTXN. PF WAS ATTEMPTING TO RESOLVE THIS PROBLEM WHEN IT BECAME APPARENT THAT INITIATION OF DSCNT WAS NECESSARY TO MEET RESTRICTION. PF ATTEMPTED TO USE VERT SPD TO INITIATE DSCNT BUT ACFT REMAINED AT FL290. IT WAS THEN NOTICED THAT ALT 'SET' WINDOW WAS STILL AT FL290, DISALLOWING AUTOPLT TO DSND. ALT WAS RESET TO FL240, DSCNT WAS INITIATED CONCURRENT WITH INQUIRY FROM CTR AS TO ABILITY TO MEET RESTRICTION. WE RESPONDED 'UNABLE' AND FLT WAS GIVEN A 50 DEG R TURN, PRESUMABLY TO AVOID A POTENTIAL CONFLICT. AT FL250, FLT WAS CLRED DIRECT MGW TO RESUME ROUTING. THIS SITUATION OCCURRED BECAUSE OF PF'S FAILURE TO FOLLOW HIS OWN SOP IN SUCH A CIRCUMSTANCE WHICH IS TO 1) RESET ALT, 2) MAKE A QUICK DETERMINATION IF ACFT IS NEAR THE REQUIRED DSCNT POINT AND INITIATE A DSCNT USING VERT SPD OR LEVEL CHANGE IF NECESSARY, 3) MAKE APPROPRIATE ENTRIES IN FMC AND USE VNAV FOR DSCNT IF APPROPRIATE. PF DID THESE OUT OF SEQUENCE AND BECAME DISTRACTED BY AN FMC IRREGULARITY, THUS OVERSHOOTING DSCNT POINT.
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.