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|
Attributes | |
ACN | 224197 |
Time | |
Date | 199210 |
Day | Sat |
Local Time Of Day | 0601 To 1200 |
Place | |
Locale Reference | airport : ord |
State Reference | IL |
Altitude | agl bound lower : 0 agl bound upper : 0 |
Environment | |
Flight Conditions | VMC |
Light | Dawn |
Aircraft 1 | |
Controlling Facilities | tower : ord |
Operator | common carrier : air carrier |
Make Model Name | Widebody, Low Wing, 3 Turbojet Eng |
Navigation In Use | Other |
Flight Phase | descent : approach landing other |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp |
Experience | flight time last 90 days : 210 flight time total : 5700 flight time type : 800 |
ASRS Report | 224197 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Events | |
Anomaly | incursion : landing without clearance non adherence : far non adherence : clearance other anomaly other |
Independent Detector | other controllera |
Resolutory Action | none taken : detected after the fact |
Consequence | faa : reviewed incident with flight crew |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
About 12 mi out (ord runway 9R localizer) flight was cleared for ILS runway 9R, maintain 4000 until carley speed 170 to deana, contact tower at deana 120.75. Read back and dialed in tower frequency. At this point, something (I don't recall what) distraction me. I may not have completed entry of tower frequency. Upon receiving OM signal at deana, I contacted tower on the frequency I had dialed in earlier: 'tower, air carrier X heavy inside deana.' the controller (a woman) said something to someone else, then said: 'who's calling.' I replied: 'air carrier X heavy inside deana.' the controller replied and said 'cleared to land' to someone, although I must admit I did not hear to whom the clearance was addressed. I assumed it was us. About this time we completed configuring for landing. There was some confusion concerning final approach 'bug' speed. I thought the captain was slowing too much, so I rechked the figures and informed the captain. We got the bug corrected, but the communication in the cockpit was confusing and contributed to misinterp of what we heard on the radio. As the approach continued, the distrs continued as the localizer and GS indications became erratic. The GPWS began to annunciate 'GS,' even though, visually we appeared to be very near the normal glide path and the localizer kept swinging back and forth, though our course was steady. In any case, there were constant conditions requiring attention throughout the approach and no one verified the landing clearance. After landing, we heard nothing from tower during rollout, which is unusual at ord (this had me wondering why, but it was obviously no time to investigate), upon clearing the runway, I called ground control and received instructions to taxi to the ramp. Then the controller asked if we had communicated with tower. To this I replied, 'negative' thinking he meant during rollout. I then amended my reply: 'we contacted tower twice inside deana and were cleared to land, but we heard nothing after that.' the controller replied that tower said they heard nothing from us. At this time, we entered the ramp area and the frequency was changed again. It was only later that it occurred to me that I might have dialed the wrong frequency and, coincidentally, contacted some other tower controller. Then, upon hearing someone cleared to land, assumed it to have been what I expected to hear, which was 'air carrier X, cleared to land.' it was, however, impossible to verify this, as several frequency changes had occurred since. Contributing factors: fatigue (being west coast based, we had arisen very early in the eastern time zone to fly this leg). Cockpit distraction (poor intra-cockpit communications, erratic ILS indications, bogus GPWS warning). Lack of backup (no one in the cockpit was paying any attention to the radio, but me and I, apparently, was not paying it enough). Complacency (this routine method of conducting approachs is used so often by scheduled carrier pilots that we begin hearing what we expect to hear rather than listen to what is actually being said).
Original NASA ASRS Text
Title: UNAUTHORIZED LNDG. NO CLRNC LNDG RECEIVED.
Narrative: ABOUT 12 MI OUT (ORD RWY 9R LOC) FLT WAS CLRED FOR ILS RWY 9R, MAINTAIN 4000 UNTIL CARLEY SPD 170 TO DEANA, CONTACT TWR AT DEANA 120.75. READ BACK AND DIALED IN TWR FREQ. AT THIS POINT, SOMETHING (I DON'T RECALL WHAT) DISTR ME. I MAY NOT HAVE COMPLETED ENTRY OF TWR FREQ. UPON RECEIVING OM SIGNAL AT DEANA, I CONTACTED TWR ON THE FREQ I HAD DIALED IN EARLIER: 'TWR, ACR X HVY INSIDE DEANA.' THE CTLR (A WOMAN) SAID SOMETHING TO SOMEONE ELSE, THEN SAID: 'WHO'S CALLING.' I REPLIED: 'ACR X HVY INSIDE DEANA.' THE CTLR REPLIED AND SAID 'CLRED TO LAND' TO SOMEONE, ALTHOUGH I MUST ADMIT I DID NOT HEAR TO WHOM THE CLRNC WAS ADDRESSED. I ASSUMED IT WAS US. ABOUT THIS TIME WE COMPLETED CONFIGURING FOR LNDG. THERE WAS SOME CONFUSION CONCERNING FINAL APCH 'BUG' SPD. I THOUGHT THE CAPT WAS SLOWING TOO MUCH, SO I RECHKED THE FIGURES AND INFORMED THE CAPT. WE GOT THE BUG CORRECTED, BUT THE COM IN THE COCKPIT WAS CONFUSING AND CONTRIBUTED TO MISINTERP OF WHAT WE HEARD ON THE RADIO. AS THE APCH CONTINUED, THE DISTRS CONTINUED AS THE LOC AND GS INDICATIONS BECAME ERRATIC. THE GPWS BEGAN TO ANNUNCIATE 'GS,' EVEN THOUGH, VISUALLY WE APPEARED TO BE VERY NEAR THE NORMAL GLIDE PATH AND THE LOC KEPT SWINGING BACK AND FORTH, THOUGH OUR COURSE WAS STEADY. IN ANY CASE, THERE WERE CONSTANT CONDITIONS REQUIRING ATTN THROUGHOUT THE APCH AND NO ONE VERIFIED THE LNDG CLRNC. AFTER LNDG, WE HEARD NOTHING FROM TWR DURING ROLLOUT, WHICH IS UNUSUAL AT ORD (THIS HAD ME WONDERING WHY, BUT IT WAS OBVIOUSLY NO TIME TO INVESTIGATE), UPON CLRING THE RWY, I CALLED GND CTL AND RECEIVED INSTRUCTIONS TO TAXI TO THE RAMP. THEN THE CTLR ASKED IF WE HAD COMMUNICATED WITH TWR. TO THIS I REPLIED, 'NEGATIVE' THINKING HE MEANT DURING ROLLOUT. I THEN AMENDED MY REPLY: 'WE CONTACTED TWR TWICE INSIDE DEANA AND WERE CLRED TO LAND, BUT WE HEARD NOTHING AFTER THAT.' THE CTLR REPLIED THAT TWR SAID THEY HEARD NOTHING FROM US. AT THIS TIME, WE ENTERED THE RAMP AREA AND THE FREQ WAS CHANGED AGAIN. IT WAS ONLY LATER THAT IT OCCURRED TO ME THAT I MIGHT HAVE DIALED THE WRONG FREQ AND, COINCIDENTALLY, CONTACTED SOME OTHER TWR CTLR. THEN, UPON HEARING SOMEONE CLRED TO LAND, ASSUMED IT TO HAVE BEEN WHAT I EXPECTED TO HEAR, WHICH WAS 'ACR X, CLRED TO LAND.' IT WAS, HOWEVER, IMPOSSIBLE TO VERIFY THIS, AS SEVERAL FREQ CHANGES HAD OCCURRED SINCE. CONTRIBUTING FACTORS: FATIGUE (BEING W COAST BASED, WE HAD ARISEN VERY EARLY IN THE EASTERN TIME ZONE TO FLY THIS LEG). COCKPIT DISTR (POOR INTRA-COCKPIT COMS, ERRATIC ILS INDICATIONS, BOGUS GPWS WARNING). LACK OF BACKUP (NO ONE IN THE COCKPIT WAS PAYING ANY ATTN TO THE RADIO, BUT ME AND I, APPARENTLY, WAS NOT PAYING IT ENOUGH). COMPLACENCY (THIS ROUTINE METHOD OF CONDUCTING APCHS IS USED SO OFTEN BY SCHEDULED CARRIER PLTS THAT WE BEGIN HEARING WHAT WE EXPECT TO HEAR RATHER THAN LISTEN TO WHAT IS ACTUALLY BEING SAID).
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.