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Pilot of a commuter small transport attempted to start the wrong engine. He had given hand signals to ground personnel to clear the #2 engine, but then began to start the #1 engine. First officer and ramp agent were several ft from the rotating propeller. Reporter cites fatigue.
| Attributes | |
| ACN | 329964 |
| Time | |
| Date | 199603 |
| Day | Tue |
| Local Time Of Day | 1201 To 1800 |
| Place | |
| Locale Reference | airport : aus |
| State Reference | TX |
| Altitude | agl bound lower : 0 agl bound upper : 0 |
| Environment | |
| Flight Conditions | VMC |
| Light | Dusk |
| Aircraft 1 | |
| Operator | common carrier : air carrier |
| Make Model Name | Commercial Fixed Wing |
| Operating Under FAR Part | Part 135 |
| Flight Phase | other |
| Flight Plan | IFR |
| Person 1 | |
| Affiliation | company : air carrier |
| Function | flight crew : captain oversight : pic |
| Qualification | pilot : atp |
| Experience | flight time last 90 days : 181 flight time total : 4350 flight time type : 2220 |
| ASRS Report | 329964 |
| Person 2 | |
| Affiliation | company : air carrier |
| Function | flight crew : first officer |
| Qualification | pilot : commercial pilot : instrument |
| Events | |
| Anomaly | other anomaly other |
| Independent Detector | other flight crewa |
| Resolutory Action | other |
| Consequence | Other |
| Supplementary | |
| Primary Problem | Flight Crew Human Performance |
| Air Traffic Incident | Pilot Deviation |
Narrative:
Passenger had completed enplaning through the airstair door, and the first officer was at the base of the airstair door completing the weight and balance form. I made eye contact from the cockpit with the ramp agent and gave him the signal to start the #2 engine. He acknowledged, and I proceeded with the engine start. I accidentally hit the start button for the #1 engine (buttons are about 1 inch apart, unlabeled). The first officer and ramp agent were several ft from the turning propeller, and were uninjured. As soon as I realized that I had initiated the start on the wrong engine, I aborted the start prior to 10% RPM, before fuel flow and ignition had commenced. This has never occurred before or since to me while acting as PIC. This was my tenth leg of the day (and last) and I had flown nine legs and 6.9 hours up to that point. The only excuse for making this type of mistake is fatigue. I was tired. My fix for this is the following: get the best rest possible prior to going to work, and be very deliberate when engaging the start of either engine.
Original NASA ASRS Text
Title: PLT OF A COMMUTER SMT ATTEMPTED TO START THE WRONG ENG. HE HAD GIVEN HAND SIGNALS TO GND PERSONNEL TO CLR THE #2 ENG, BUT THEN BEGAN TO START THE #1 ENG. FO AND RAMP AGENT WERE SEVERAL FT FROM THE ROTATING PROP. RPTR CITES FATIGUE.
Narrative: PAX HAD COMPLETED ENPLANING THROUGH THE AIRSTAIR DOOR, AND THE FO WAS AT THE BASE OF THE AIRSTAIR DOOR COMPLETING THE WT AND BAL FORM. I MADE EYE CONTACT FROM THE COCKPIT WITH THE RAMP AGENT AND GAVE HIM THE SIGNAL TO START THE #2 ENG. HE ACKNOWLEDGED, AND I PROCEEDED WITH THE ENG START. I ACCIDENTALLY HIT THE START BUTTON FOR THE #1 ENG (BUTTONS ARE ABOUT 1 INCH APART, UNLABELED). THE FO AND RAMP AGENT WERE SEVERAL FT FROM THE TURNING PROP, AND WERE UNINJURED. AS SOON AS I REALIZED THAT I HAD INITIATED THE START ON THE WRONG ENG, I ABORTED THE START PRIOR TO 10% RPM, BEFORE FUEL FLOW AND IGNITION HAD COMMENCED. THIS HAS NEVER OCCURRED BEFORE OR SINCE TO ME WHILE ACTING AS PIC. THIS WAS MY TENTH LEG OF THE DAY (AND LAST) AND I HAD FLOWN NINE LEGS AND 6.9 HRS UP TO THAT POINT. THE ONLY EXCUSE FOR MAKING THIS TYPE OF MISTAKE IS FATIGUE. I WAS TIRED. MY FIX FOR THIS IS THE FOLLOWING: GET THE BEST REST POSSIBLE PRIOR TO GOING TO WORK, AND BE VERY DELIBERATE WHEN ENGAGING THE START OF EITHER ENG.
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.