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|
Attributes | |
ACN | 280988 |
Time | |
Date | 199408 |
Day | Tue |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | atc facility : czqx |
State Reference | NF |
Altitude | msl bound lower : 31000 msl bound upper : 31000 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | artcc : czqx tower : fca |
Operator | common carrier : air carrier |
Make Model Name | MD-11 |
Operating Under FAR Part | Part 121 |
Navigation In Use | Other Other |
Flight Phase | cruise other |
Route In Use | enroute : atlantic enroute : other oceanic |
Flight Plan | IFR |
Person 1 | |
Affiliation | Other |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 200 flight time total : 9000 |
ASRS Report | 280988 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : commercial pilot : instrument |
Events | |
Anomaly | non adherence : clearance other spatial deviation |
Independent Detector | other controllera |
Resolutory Action | flight crew : returned to intended course or assigned course flight crew : became reoriented |
Consequence | Other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
The scheduled flight time was 8 hours and 58 mins and I was anticipating at least 1 more leg on this day. I had flown as a '2 man flight crew' more than once in a 30 day period, therefore I was subject to far part 121.525, which limits my 'flight deck duty' time to 8 hours. At about 3 hours into the flight I turned the flight deck over to my first officer and the international relief officer and retired to the crew bunk for crew rest. Approximately 1 hour and 30 mins later the international relief officer who had occupied my (the left) seat woke me to advise me that the aircraft had been navigated to an improper position. Our clearance was to N60 W60 and we had crossed N61 W60. The error was discovered when gander ATC asked which position our clearance was to. At this time gander cleared the aircraft to the subsequent position and advised that they (gander ATC) would be filing a 'gross navigational error report.' our company procedures very clearly explain how to properly verify aircraft position during INS navigation. Checking present position against clrncs and subsequent position before proceeding, and plotting all position as well as mid points to verify proper course. When I queried the 2 crew members of these procedures they said they were familiar with them but had not complied with them. No further anomalies. Callback conversation with reporter revealed the following information: reporter states that the error occurred because of an incorrectly loaded position in the INS. The error would have been caught and deviation would have been much less if the first officer and international relief officer had followed company requirements to verify position as stated. Reporter had no choice but to leave the flight deck to comply with FARS.
Original NASA ASRS Text
Title: WDB HAS 'GROSS NAV ERROR' WHEN FLYING OVER ATLANTIC OCEAN.
Narrative: THE SCHEDULED FLT TIME WAS 8 HRS AND 58 MINS AND I WAS ANTICIPATING AT LEAST 1 MORE LEG ON THIS DAY. I HAD FLOWN AS A '2 MAN FLC' MORE THAN ONCE IN A 30 DAY PERIOD, THEREFORE I WAS SUBJECT TO FAR PART 121.525, WHICH LIMITS MY 'FLT DECK DUTY' TIME TO 8 HRS. AT ABOUT 3 HRS INTO THE FLT I TURNED THE FLT DECK OVER TO MY FO AND THE IRO AND RETIRED TO THE CREW BUNK FOR CREW REST. APPROX 1 HR AND 30 MINS LATER THE IRO WHO HAD OCCUPIED MY (THE L) SEAT WOKE ME TO ADVISE ME THAT THE ACFT HAD BEEN NAVIGATED TO AN IMPROPER POS. OUR CLRNC WAS TO N60 W60 AND WE HAD CROSSED N61 W60. THE ERROR WAS DISCOVERED WHEN GANDER ATC ASKED WHICH POS OUR CLRNC WAS TO. AT THIS TIME GANDER CLRED THE ACFT TO THE SUBSEQUENT POS AND ADVISED THAT THEY (GANDER ATC) WOULD BE FILING A 'GROSS NAVIGATIONAL ERROR RPT.' OUR COMPANY PROCS VERY CLRLY EXPLAIN HOW TO PROPERLY VERIFY ACFT POS DURING INS NAV. CHKING PRESENT POS AGAINST CLRNCS AND SUBSEQUENT POS BEFORE PROCEEDING, AND PLOTTING ALL POS AS WELL AS MID POINTS TO VERIFY PROPER COURSE. WHEN I QUERIED THE 2 CREW MEMBERS OF THESE PROCS THEY SAID THEY WERE FAMILIAR WITH THEM BUT HAD NOT COMPLIED WITH THEM. NO FURTHER ANOMALIES. CALLBACK CONVERSATION WITH RPTR REVEALED THE FOLLOWING INFO: RPTR STATES THAT THE ERROR OCCURRED BECAUSE OF AN INCORRECTLY LOADED POS IN THE INS. THE ERROR WOULD HAVE BEEN CAUGHT AND DEV WOULD HAVE BEEN MUCH LESS IF THE FO AND IRO HAD FOLLOWED COMPANY REQUIREMENTS TO VERIFY POS AS STATED. RPTR HAD NO CHOICE BUT TO LEAVE THE FLT DECK TO COMPLY WITH FARS.
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.