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|
Attributes | |
ACN | 227027 |
Time | |
Date | 199211 |
Day | Thu |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | atc facility : dxo |
State Reference | MI |
Altitude | msl bound lower : 7000 msl bound upper : 7000 |
Environment | |
Flight Conditions | IMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | tracon : dtw |
Operator | common carrier : air carrier |
Make Model Name | Any Unknown or Unlisted Aircraft Manufacturer |
Flight Phase | descent other |
Route In Use | enroute : on vectors |
Flight Plan | IFR |
Aircraft 2 | |
Operator | general aviation : personal |
Make Model Name | Any Unknown or Unlisted Aircraft Manufacturer |
Flight Phase | cruise other |
Route In Use | enroute : on vectors |
Flight Plan | IFR |
Person 1 | |
Affiliation | government : faa |
Function | controller : approach |
Qualification | controller : radar |
Experience | controller non radar : 3 controller radar : 4 |
ASRS Report | 227027 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Events | |
Anomaly | conflict : airborne less severe non adherence : published procedure non adherence : required legal separation |
Independent Detector | other controllera |
Resolutory Action | controller : issued new clearance other |
Consequence | faa : investigated |
Miss Distance | horizontal : 14400 vertical : 700 |
Supplementary | |
Primary Problem | ATC Human Performance |
Air Traffic Incident | Operational Error |
Narrative:
2 aircraft arriving dtw, base leg traffic descending to 7000 according to SOP. Downwind air carrier X was slowed to appropriate airspeed and descended to 7000. Air carrier X was descended to wrong altitude not in accordance with SOP. SOP calls for downwind to descend to 8000. Error was made by controller, even missed it on readback. Both aircraft were switched to final controller who noticed the downwind air carrier X through 8000, then assigned the right altitude after loss of separation with aircraft Y. Downwind air carrier X on tape replay never made frequency contact with final controller. It's quite possible had air carrier X called on frequency, this would have been caught.
Original NASA ASRS Text
Title: ACR X DSCNT TO OCCUPIED ALT HAD LTSS FROM ACFT Y. SYS ERROR.
Narrative: 2 ACFT ARRIVING DTW, BASE LEG TFC DSNDING TO 7000 ACCORDING TO SOP. DOWNWIND ACR X WAS SLOWED TO APPROPRIATE AIRSPD AND DSNDED TO 7000. ACR X WAS DSNDED TO WRONG ALT NOT IN ACCORDANCE WITH SOP. SOP CALLS FOR DOWNWIND TO DSND TO 8000. ERROR WAS MADE BY CTLR, EVEN MISSED IT ON READBACK. BOTH ACFT WERE SWITCHED TO FINAL CTLR WHO NOTICED THE DOWNWIND ACR X THROUGH 8000, THEN ASSIGNED THE RIGHT ALT AFTER LOSS OF SEPARATION WITH ACFT Y. DOWNWIND ACR X ON TAPE REPLAY NEVER MADE FREQ CONTACT WITH FINAL CTLR. IT'S QUITE POSSIBLE HAD ACR X CALLED ON FREQ, THIS WOULD HAVE BEEN CAUGHT.
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.