37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 350845 |
Time | |
Date | 199610 |
Day | Wed |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : tlh |
State Reference | FL |
Altitude | msl bound lower : 2000 msl bound upper : 2000 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | tracon : tlh tower : phl |
Operator | common carrier : air carrier |
Make Model Name | Challenger CL604 |
Operating Under FAR Part | Part 121 |
Navigation In Use | Other |
Flight Phase | climbout : intermediate altitude other |
Route In Use | enroute : on vectors |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 253 flight time total : 6685 flight time type : 253 |
ASRS Report | 350845 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp |
Experience | flight time last 90 days : 185 flight time total : 4550 flight time type : 1450 |
ASRS Report | 351228 |
Events | |
Anomaly | aircraft equipment problem : less severe non adherence : published procedure |
Independent Detector | aircraft equipment other aircraft equipment : unspecified |
Resolutory Action | flight crew : declared emergency other |
Consequence | Other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Narrative:
On departure climbing through 1000 ft we got a thrust reverser unlock warning message. The memory item (thrust lever idle) was performed. The climb check was finished and we started on the checklist items for the thrust reverser problem. There was no airplane buffet or adverse yaw that would indicate a thrust reverser deployed. Step (2) was airspeed 200 KTS. Step (3) thrust reverser emergency stow switch press. A note that (reverser unlocked message) would stay on was there. At this point #2 engine operation could continue. However, there was no note saying so. If buffeting or adverse yaw continued engine shut down was required. I was flying and the first officer reading the checklist. He was unable to make me understand that shutting down an engine was not required. With the unlock message still illuminated I thought the safest thing would be to shut down the engine. We performed a precautionary engine shut down. The next error in judgement came when I reached over and selected the gear down while the first officer was reading a checklist, a definite breach in procedure. This was the 6TH leg on the 4TH day of a 5 day trip. Our APU was deferred requiring a single engine turn every other leg. I usually stayed in the seat guarding the brakes and getting clrncs while the first officer did the walkaround. The legs were tallahassee, miami, all day with no breaks fueling in miami. As a more senior pilot in my old airplane I could bid away from 4 and 5 day trips finding them too fatiguing. I had not slept well the previous 3 nights. I believe fatigue was a definite factor in my narrow mindedness. At present, our company is in a severe pilot shortage with the rapid growth we have been going through. A large number of contractual disagreements between the union remain. Junior manning (forcing pilots to fly on their days off) is frequent and I had already been junior manned this month. Fatigue and sick calls are being tracked closely with abusers being terminated. I had already been called into the office once last month and interviewed over a fatigue call I had made. It was insinuated that I left the company high and dry by calling fatigue so close to departure. That left me feeling that any further fatigue calls risked my job.
Original NASA ASRS Text
Title: CL65 COMMUTER ACFT CLBING THROUGH 1000 FT GOT A THRUST REVERSER UNLOCK WARNING MESSAGE. CHKLIST ACCOMPLISHED AND STILL HAD WARNING. FO ADVISED CHKLIST INFERRED OK TO CONTINUE BUT CAPT ELECTED TO SHUT DOWN ENG AND RETURN TO TLH. EMER WAS DECLARED.
Narrative: ON DEP CLBING THROUGH 1000 FT WE GOT A THRUST REVERSER UNLOCK WARNING MESSAGE. THE MEMORY ITEM (THRUST LEVER IDLE) WAS PERFORMED. THE CLB CHK WAS FINISHED AND WE STARTED ON THE CHKLIST ITEMS FOR THE THRUST REVERSER PROB. THERE WAS NO AIRPLANE BUFFET OR ADVERSE YAW THAT WOULD INDICATE A THRUST REVERSER DEPLOYED. STEP (2) WAS AIRSPD 200 KTS. STEP (3) THRUST REVERSER EMER STOW SWITCH PRESS. A NOTE THAT (REVERSER UNLOCKED MESSAGE) WOULD STAY ON WAS THERE. AT THIS POINT #2 ENG OP COULD CONTINUE. HOWEVER, THERE WAS NO NOTE SAYING SO. IF BUFFETING OR ADVERSE YAW CONTINUED ENG SHUT DOWN WAS REQUIRED. I WAS FLYING AND THE FO READING THE CHKLIST. HE WAS UNABLE TO MAKE ME UNDERSTAND THAT SHUTTING DOWN AN ENG WAS NOT REQUIRED. WITH THE UNLOCK MESSAGE STILL ILLUMINATED I THOUGHT THE SAFEST THING WOULD BE TO SHUT DOWN THE ENG. WE PERFORMED A PRECAUTIONARY ENG SHUT DOWN. THE NEXT ERROR IN JUDGEMENT CAME WHEN I REACHED OVER AND SELECTED THE GEAR DOWN WHILE THE FO WAS READING A CHKLIST, A DEFINITE BREACH IN PROC. THIS WAS THE 6TH LEG ON THE 4TH DAY OF A 5 DAY TRIP. OUR APU WAS DEFERRED REQUIRING A SINGLE ENG TURN EVERY OTHER LEG. I USUALLY STAYED IN THE SEAT GUARDING THE BRAKES AND GETTING CLRNCS WHILE THE FO DID THE WALKAROUND. THE LEGS WERE TALLAHASSEE, MIAMI, ALL DAY WITH NO BREAKS FUELING IN MIAMI. AS A MORE SENIOR PLT IN MY OLD AIRPLANE I COULD BID AWAY FROM 4 AND 5 DAY TRIPS FINDING THEM TOO FATIGUING. I HAD NOT SLEPT WELL THE PREVIOUS 3 NIGHTS. I BELIEVE FATIGUE WAS A DEFINITE FACTOR IN MY NARROW MINDEDNESS. AT PRESENT, OUR COMPANY IS IN A SEVERE PLT SHORTAGE WITH THE RAPID GROWTH WE HAVE BEEN GOING THROUGH. A LARGE NUMBER OF CONTRACTUAL DISAGREEMENTS BTWN THE UNION REMAIN. JUNIOR MANNING (FORCING PLTS TO FLY ON THEIR DAYS OFF) IS FREQUENT AND I HAD ALREADY BEEN JUNIOR MANNED THIS MONTH. FATIGUE AND SICK CALLS ARE BEING TRACKED CLOSELY WITH ABUSERS BEING TERMINATED. I HAD ALREADY BEEN CALLED INTO THE OFFICE ONCE LAST MONTH AND INTERVIEWED OVER A FATIGUE CALL I HAD MADE. IT WAS INSINUATED THAT I LEFT THE COMPANY HIGH AND DRY BY CALLING FATIGUE SO CLOSE TO DEP. THAT LEFT ME FEELING THAT ANY FURTHER FATIGUE CALLS RISKED MY JOB.
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.