37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 223393 |
Time | |
Date | 199210 |
Day | Fri |
Local Time Of Day | 1801 To 2400 |
Place | |
Locale Reference | airport : sfo |
State Reference | CA |
Altitude | msl bound lower : 6000 msl bound upper : 6000 |
Environment | |
Flight Conditions | VMC |
Light | Night |
Aircraft 1 | |
Controlling Facilities | tracon : oak |
Operator | common carrier : air carrier |
Make Model Name | Medium Large Transport, Low Wing, 2 Turbojet Eng |
Navigation In Use | Other Other |
Flight Phase | descent : approach descent other |
Route In Use | enroute : on vectors |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : cfi pilot : flight engineer pilot : commercial pilot : atp pilot : instrument |
Experience | flight time last 90 days : 170 flight time total : 7470 flight time type : 1600 |
ASRS Report | 223393 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : cfi pilot : instrument pilot : flight engineer pilot : commercial pilot : atp |
Experience | flight time last 90 days : 120 flight time total : 5000 flight time type : 600 |
ASRS Report | 223396 |
Events | |
Anomaly | non adherence : clearance other anomaly other other spatial deviation |
Independent Detector | atc equipment other atc equipment : unspecified other controllera |
Resolutory Action | controller : issued new clearance other |
Consequence | Other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
We had been cleared on a heading of 240 degrees to intercept the sfo 095 degree radial. I was hand flying the aircraft in the expanded VOR mode with my radio in manual mode set tuned for the sfo VOR 095 degree radial. Anticipating an approach to 28R, I had briefed my first officer I would fly the sfo 095 degree radial to about the san mateo bridge and then I could be switched over to the sfo ILS 28R frequency for the rest of the approach. Just as the course indicator started to move indicating intercept of the 095 degree radial, I remember hearing a new intercept heading of 260 degrees and a descent clearance to 6000 ft MSL. My first officer dialed in 260 degrees and selected heading sel on the mode control panel as I repeated '260 degrees down to 6000 ft.' as I was already intercepting the 095 degree radial, I continued my turn on around establishing the aircraft on the 095 degree radial resulting in an aircraft heading of approximately 275 degrees. At the same time I myself reached up and selected VOR/localizer mode on the mode control panel, without stating I was doing so to my first officer. My first officer asked if I 'wanted my radio retuned.' I stated 'no, leave me on the VOR until bridge.' what I did not hear from the last ATC clearance was that the 260 degree heading was to intercept the 28L localizer, not the 095 degree radial. Just as I finished saying 'leave me on the VOR' oak approach called to ask if we were on a 260 degree heading to intercept the 28L localizer. That was the first time I remember hearing the 28L localizer being mentioned. We were issued a 230 degree heading and a descent clearance to 4000 ft MSL to cross through the 28L localizer, followed by a 310 degree heading to intercept the 28L localizer. The rest of the approach was normal followed by a normal landing.
Original NASA ASRS Text
Title: CAPT OF ACR MLG ACFT DEVIATED FROM ASSIGNED HDG DURING DSCNT FOR APCH.
Narrative: WE HAD BEEN CLRED ON A HDG OF 240 DEGS TO INTERCEPT THE SFO 095 DEG RADIAL. I WAS HAND FLYING THE ACFT IN THE EXPANDED VOR MODE WITH MY RADIO IN MANUAL MODE SET TUNED FOR THE SFO VOR 095 DEG RADIAL. ANTICIPATING AN APCH TO 28R, I HAD BRIEFED MY FO I WOULD FLY THE SFO 095 DEG RADIAL TO ABOUT THE SAN MATEO BRIDGE AND THEN I COULD BE SWITCHED OVER TO THE SFO ILS 28R FREQ FOR THE REST OF THE APCH. JUST AS THE COURSE INDICATOR STARTED TO MOVE INDICATING INTERCEPT OF THE 095 DEG RADIAL, I REMEMBER HEARING A NEW INTERCEPT HDG OF 260 DEGS AND A DSCNT CLRNC TO 6000 FT MSL. MY FO DIALED IN 260 DEGS AND SELECTED HDG SEL ON THE MODE CTL PANEL AS I REPEATED '260 DEGS DOWN TO 6000 FT.' AS I WAS ALREADY INTERCEPTING THE 095 DEG RADIAL, I CONTINUED MY TURN ON AROUND ESTABLISHING THE ACFT ON THE 095 DEG RADIAL RESULTING IN AN ACFT HDG OF APPROX 275 DEGS. AT THE SAME TIME I MYSELF REACHED UP AND SELECTED VOR/LOC MODE ON THE MODE CTL PANEL, WITHOUT STATING I WAS DOING SO TO MY FO. MY FO ASKED IF I 'WANTED MY RADIO RETUNED.' I STATED 'NO, LEAVE ME ON THE VOR UNTIL BRIDGE.' WHAT I DID NOT HEAR FROM THE LAST ATC CLRNC WAS THAT THE 260 DEG HDG WAS TO INTERCEPT THE 28L LOC, NOT THE 095 DEG RADIAL. JUST AS I FINISHED SAYING 'LEAVE ME ON THE VOR' OAK APCH CALLED TO ASK IF WE WERE ON A 260 DEG HDG TO INTERCEPT THE 28L LOC. THAT WAS THE FIRST TIME I REMEMBER HEARING THE 28L LOC BEING MENTIONED. WE WERE ISSUED A 230 DEG HDG AND A DSCNT CLRNC TO 4000 FT MSL TO CROSS THROUGH THE 28L LOC, FOLLOWED BY A 310 DEG HDG TO INTERCEPT THE 28L LOC. THE REST OF THE APCH WAS NORMAL FOLLOWED BY A NORMAL LNDG.
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.