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|
Attributes | |
ACN | 348712 |
Time | |
Date | 199609 |
Day | Sat |
Local Time Of Day | 0001 To 0600 |
Place | |
Locale Reference | airport : pkb |
State Reference | WV |
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 | Beech 1900 |
Operating Under FAR Part | Part 135 |
Navigation In Use | Other |
Flight Phase | climbout : takeoff other |
Flight Plan | None |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain instruction : instructor oversight : pic |
Qualification | pilot : cfi pilot : commercial pilot : atp |
Experience | flight time last 90 days : 250 flight time total : 8200 flight time type : 4991 |
ASRS Report | 348712 |
Person 2 | |
Affiliation | company : air carrier |
Function | instruction : trainee |
Qualification | pilot : instrument pilot : commercial |
Events | |
Anomaly | conflict : ground critical non adherence : far non adherence : published procedure other anomaly other anomaly other other anomaly other |
Independent Detector | other flight crewa |
Resolutory Action | flight crew : regained aircraft control flight crew : rejected takeoff flight crew : returned to intended course or assigned course |
Consequence | other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
The flight in question was the second of 2 training flts and began at XX00 local. The student was in training for captain upgrade and was beginning his fourth and final flight lesson. The 3 previous lessons had gone without incident and the student had demonstrated well above average flying skills. After engine start and checks, we taxied to runway 21. At the hold line, we stopped and before doing the takeoff final items, I briefed him on the planned maneuvers, the first of which was to be a low visibility takeoff. I explained that he was to adjust the hood so that the runway lights would just be visible. When he said he was ready we began the takeoff roll. During the initial roll my head was in the cockpit doing the takeoff checks. At 80 KTS and crosschecked, I looked up and noticed that we had drifted very close to the edge of the runway. Immediately applied left rudder and said 'my airplane.' after maneuvering the aircraft back to the centerline, I asked him what had happened and he indicated that he had been holding runway heading. I then asked him if he had been looking out. He said no, that he thought it was a no visibility takeoff. I corrected the misunderstanding, rebriefed the procedure and we taxied back and executed a second takeoff. The remainder of the flight was conducted without incident. Upon landing and shutdown, I noticed a vibration on the right side of the aircraft and saw that 2 inch portion of 1 blade was 'shredded.' we immediately checked for further damage and finding none, secured the aircraft. An inspection of the runway lights and ground track revealed that the aircraft left the runway approximately 1020 ft, drifted about 6 ft off striking a runway light at 1200 ft, and then returning to the pavement, the runway light is of the break away type. I would like to emphasize that I never felt the aircraft leave the runway or strike the light. During the subsequent flight the aircraft performed normally in all respects. The subsequent company investigation revealed a number of problems. 1) the use of the term low visibility can easily be heard as no visibility -- we will use 'reduced' visibility in the future. 2) the instructions to adjust the hood so that the runway lights are just visible is value and gives no indication of how a centerline track will be maintained. This has been replaced with instructions to adjust the hood so that 2 runway centerline stripes are visible. Emphasis will be made of using the centerline for guidance and immediately aborting if positive direction is in doubt. 3) the instructor will be careful to look outside as well as make the takeoff calls. 4) any time the aircraft comes close to the runway edge, an external check will be made to assure that no damage has been done even if the crew thinks they stayed on the runway. I would be happy to discuss this further by phone if you like.
Original NASA ASRS Text
Title: BE-1900D ACFT. TRAINEE CAPT RECEIVING INSTRUCTION TO PERFORM A LOW VISIBILITY TKOF MISUNDERSTOOD RPTR INSTRUCTOR AND THOUGHT HE WAS SUPPOSED TO HOLD THE RWY HDG ON THE TKOF ROLL AND NOT LOOK OUT AT THE RWY. DURING THE INITIAL ROLL, THE RPTR INSTRUCTOR HAD HIS HEAD IN THE COCKPIT DOING THE TKOF CHKS AND BY THE TIME HE LOOKED UP AT 80 KTS THE ACFT WAS EXITING THE SIDE OF THE RWY. SUBSEQUENT INSPECTION REVEALED THAT A PROP HAD HIT A LNDG LIGHT CAUSING DAMAGE TO BOTH THE PROP AND LIGHT. RPTR TOOK CTL AND ABORTED TKOF.
Narrative: THE FLT IN QUESTION WAS THE SECOND OF 2 TRAINING FLTS AND BEGAN AT XX00 LCL. THE STUDENT WAS IN TRAINING FOR CAPT UPGRADE AND WAS BEGINNING HIS FOURTH AND FINAL FLT LESSON. THE 3 PREVIOUS LESSONS HAD GONE WITHOUT INCIDENT AND THE STUDENT HAD DEMONSTRATED WELL ABOVE AVERAGE FLYING SKILLS. AFTER ENG START AND CHKS, WE TAXIED TO RWY 21. AT THE HOLD LINE, WE STOPPED AND BEFORE DOING THE TKOF FINAL ITEMS, I BRIEFED HIM ON THE PLANNED MANEUVERS, THE FIRST OF WHICH WAS TO BE A LOW VISIBILITY TKOF. I EXPLAINED THAT HE WAS TO ADJUST THE HOOD SO THAT THE RWY LIGHTS WOULD JUST BE VISIBLE. WHEN HE SAID HE WAS READY WE BEGAN THE TKOF ROLL. DURING THE INITIAL ROLL MY HEAD WAS IN THE COCKPIT DOING THE TKOF CHKS. AT 80 KTS AND XCHKED, I LOOKED UP AND NOTICED THAT WE HAD DRIFTED VERY CLOSE TO THE EDGE OF THE RWY. IMMEDIATELY APPLIED L RUDDER AND SAID 'MY AIRPLANE.' AFTER MANEUVERING THE ACFT BACK TO THE CTRLINE, I ASKED HIM WHAT HAD HAPPENED AND HE INDICATED THAT HE HAD BEEN HOLDING RWY HDG. I THEN ASKED HIM IF HE HAD BEEN LOOKING OUT. HE SAID NO, THAT HE THOUGHT IT WAS A NO VISIBILITY TKOF. I CORRECTED THE MISUNDERSTANDING, REBRIEFED THE PROC AND WE TAXIED BACK AND EXECUTED A SECOND TKOF. THE REMAINDER OF THE FLT WAS CONDUCTED WITHOUT INCIDENT. UPON LNDG AND SHUTDOWN, I NOTICED A VIBRATION ON THE R SIDE OF THE ACFT AND SAW THAT 2 INCH PORTION OF 1 BLADE WAS 'SHREDDED.' WE IMMEDIATELY CHKED FOR FURTHER DAMAGE AND FINDING NONE, SECURED THE ACFT. AN INSPECTION OF THE RWY LIGHTS AND GND TRACK REVEALED THAT THE ACFT LEFT THE RWY APPROX 1020 FT, DRIFTED ABOUT 6 FT OFF STRIKING A RWY LIGHT AT 1200 FT, AND THEN RETURNING TO THE PAVEMENT, THE RWY LIGHT IS OF THE BREAK AWAY TYPE. I WOULD LIKE TO EMPHASIZE THAT I NEVER FELT THE ACFT LEAVE THE RWY OR STRIKE THE LIGHT. DURING THE SUBSEQUENT FLT THE ACFT PERFORMED NORMALLY IN ALL RESPECTS. THE SUBSEQUENT COMPANY INVESTIGATION REVEALED A NUMBER OF PROBS. 1) THE USE OF THE TERM LOW VISIBILITY CAN EASILY BE HEARD AS NO VISIBILITY -- WE WILL USE 'REDUCED' VISIBILITY IN THE FUTURE. 2) THE INSTRUCTIONS TO ADJUST THE HOOD SO THAT THE RWY LIGHTS ARE JUST VISIBLE IS VALUE AND GIVES NO INDICATION OF HOW A CTRLINE TRACK WILL BE MAINTAINED. THIS HAS BEEN REPLACED WITH INSTRUCTIONS TO ADJUST THE HOOD SO THAT 2 RWY CTRLINE STRIPES ARE VISIBLE. EMPHASIS WILL BE MADE OF USING THE CTRLINE FOR GUIDANCE AND IMMEDIATELY ABORTING IF POSITIVE DIRECTION IS IN DOUBT. 3) THE INSTRUCTOR WILL BE CAREFUL TO LOOK OUTSIDE AS WELL AS MAKE THE TKOF CALLS. 4) ANY TIME THE ACFT COMES CLOSE TO THE RWY EDGE, AN EXTERNAL CHK WILL BE MADE TO ASSURE THAT NO DAMAGE HAS BEEN DONE EVEN IF THE CREW THINKS THEY STAYED ON THE RWY. I WOULD BE HAPPY TO DISCUSS THIS FURTHER BY PHONE IF YOU LIKE.
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.