37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 326914 |
Time | |
Date | 199601 |
Day | Wed |
Local Time Of Day | 1801 To 2400 |
Place | |
Locale Reference | airport : jfk |
State Reference | NY |
Altitude | agl bound lower : 0 agl bound upper : 0 |
Environment | |
Flight Conditions | VMC |
Light | Night |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | SF 340B |
Operating Under FAR Part | Part 121 |
Flight Phase | ground : preflight |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 120 flight time total : 8000 flight time type : 3900 |
ASRS Report | 326914 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : commercial pilot : instrument |
Events | |
Anomaly | aircraft equipment problem : critical other anomaly other |
Independent Detector | other other : unspecified |
Resolutory Action | flight crew : declared emergency none taken : detected after the fact other |
Consequence | faa : investigated other Other |
Supplementary | |
Primary Problem | Aircraft |
Air Traffic Incident | Pilot Deviation |
Narrative:
During engine start a mechanic opened the cabin door and told flight attendant there were flames from left engine tailpipe. Flight attendant then reports to cockpit 'left hand engine on fire' and immediately orders evacuate/evacuation without waiting for captain's response. I (captain) shut down engines by placing condition levers in fuel off and pulling left fire 'T' handle. There were no cockpit indications of a fire but the itt was as high as 998 degrees C. I realize there is no fire, only a start that goes bad. I must have got distracted during start and did not look at ng and itt until it was stable. I did not have time to stop flight attendant from starting evacuate/evacuation since I was busy shutting engines down. During this, first officer asked if I want equipment and I say yes since we have an uncontrolled evacuate/evacuation that was not ordered and I did not know if anybody got hurt jumping out. I did not follow through with emergency evacuate/evacuation checklist nor engine fire checklist since I did not order evacuate/evacuation and there was no fire. Evacuate/evacuation could have been prevented if flight attendant had only waited a few seconds for a response from me. It created a potential disaster with people jumping out not knowing if engines were shut down properly and propellers still spinning. Nobody got hurt, fire trucks responded and as I stated there was no fire. Callback conversation with reporter revealed the following information: reporter stated that he was given additional training in the aircraft simulator covering engine starting procedures since the engine in this incident had to be inspected due to the temperature limits being exceeded. He said that if the flight attendant would have delayed the evacuate/evacuation call a moment, he could have checked engine and determined that there was no fire. He was concerned for the safety of the passenger running into a propeller during evacuate/evacuation. Another aircraft was substituted for this flight. The company's remedial training has temporarily satisfied the FAA that appropriate action was taken for this mistake.
Original NASA ASRS Text
Title: CAPT OF AN MDT FAILED TO STOP A 'HOT ENG START' BEFORE THE FLT ATTENDANT HAD ORDERED ACFT EVAC BASED ON A MECH ASKING HER TO ADVISE THE CAPT THERE WERE FLAMES COMING OUT OF ONE OF THE ENG TAILPIPES.
Narrative: DURING ENG START A MECH OPENED THE CABIN DOOR AND TOLD FLT ATTENDANT THERE WERE FLAMES FROM L ENG TAILPIPE. FLT ATTENDANT THEN RPTS TO COCKPIT 'L HAND ENG ON FIRE' AND IMMEDIATELY ORDERS EVAC WITHOUT WAITING FOR CAPT'S RESPONSE. I (CAPT) SHUT DOWN ENGS BY PLACING CONDITION LEVERS IN FUEL OFF AND PULLING L FIRE 'T' HANDLE. THERE WERE NO COCKPIT INDICATIONS OF A FIRE BUT THE ITT WAS AS HIGH AS 998 DEGS C. I REALIZE THERE IS NO FIRE, ONLY A START THAT GOES BAD. I MUST HAVE GOT DISTRACTED DURING START AND DID NOT LOOK AT NG AND ITT UNTIL IT WAS STABLE. I DID NOT HAVE TIME TO STOP FLT ATTENDANT FROM STARTING EVAC SINCE I WAS BUSY SHUTTING ENGS DOWN. DURING THIS, FO ASKED IF I WANT EQUIP AND I SAY YES SINCE WE HAVE AN UNCTLED EVAC THAT WAS NOT ORDERED AND I DID NOT KNOW IF ANYBODY GOT HURT JUMPING OUT. I DID NOT FOLLOW THROUGH WITH EMER EVAC CHKLIST NOR ENG FIRE CHKLIST SINCE I DID NOT ORDER EVAC AND THERE WAS NO FIRE. EVAC COULD HAVE BEEN PREVENTED IF FLT ATTENDANT HAD ONLY WAITED A FEW SECONDS FOR A RESPONSE FROM ME. IT CREATED A POTENTIAL DISASTER WITH PEOPLE JUMPING OUT NOT KNOWING IF ENGS WERE SHUT DOWN PROPERLY AND PROPS STILL SPINNING. NOBODY GOT HURT, FIRE TRUCKS RESPONDED AND AS I STATED THERE WAS NO FIRE. CALLBACK CONVERSATION WITH RPTR REVEALED THE FOLLOWING INFO: RPTR STATED THAT HE WAS GIVEN ADDITIONAL TRAINING IN THE ACFT SIMULATOR COVERING ENG STARTING PROCS SINCE THE ENG IN THIS INCIDENT HAD TO BE INSPECTED DUE TO THE TEMP LIMITS BEING EXCEEDED. HE SAID THAT IF THE FLT ATTENDANT WOULD HAVE DELAYED THE EVAC CALL A MOMENT, HE COULD HAVE CHKED ENG AND DETERMINED THAT THERE WAS NO FIRE. HE WAS CONCERNED FOR THE SAFETY OF THE PAX RUNNING INTO A PROP DURING EVAC. ANOTHER ACFT WAS SUBSTITUTED FOR THIS FLT. THE COMPANY'S REMEDIAL TRAINING HAS TEMPORARILY SATISFIED THE FAA THAT APPROPRIATE ACTION WAS TAKEN FOR THIS MISTAKE.
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.