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|
Attributes | |
ACN | 358498 |
Time | |
Date | 199701 |
Day | Tue |
Local Time Of Day | 0601 To 1200 |
Place | |
Locale Reference | airport : cle |
State Reference | OH |
Altitude | agl bound lower : 0 agl bound upper : 0 |
Environment | |
Flight Conditions | VMC |
Light | Dawn |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | B737-300 |
Operating Under FAR Part | Part 121 |
Navigation In Use | Other Other |
Flight Phase | other |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp |
Experience | flight time last 90 days : 240 flight time total : 10000 flight time type : 3000 |
ASRS Report | 358498 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Events | |
Anomaly | conflict : ground critical non adherence : far non adherence : published procedure |
Independent Detector | other other : unspecified |
Resolutory Action | none taken : detected after the fact |
Consequence | other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
Pushback was being accomplished from gate in cle. Captain was communicating with ground crew through interphone. I was coordinating communications with ground control on #1 VHF radio. Normal engine start procedure of #2 and #1 engines was accomplished during pushback. Prior to after start checklist, we received weight & balance information via ACARS which I proceeded to load into FMC. We were anticipating a short taxi and wanted to accomplish as much as we could prior to taxi out. I was not monitoring the pushback over the interphone so as to keep clear communications with cle ground controller. Captain called for the after start checklist which we read and completed. Captain stated we were ready to taxi, at which time I requested such from ground control. We were cleared to taxi. I visually checked forward and right and responded, 'clear right.' as captain applied taxi power, we received several quick bell signals through the interphone and observed the blue call bell cockpit annunciator. I switched to service interphone to communicate with the flight attendants, who I assumed were calling us. I received no response. The bells continued and then realized the signal was coming from the ground pushback crew. The captain immediately stopped the aircraft. We were informed that the aircraft had taxied over the disconnected tow bar. Captain had not received a wave off signal from pushback crew. By the time I was back in the loop, I did not question whether or not we had been cleared to taxi from ground crew as the captain had called for the after start checklist and taxi. No wave off was received by captain. First officer was programming FMC and monitoring ground control, placing him out of the loop. We were using a new ICAO pushback procedure that had been poorly implemented and not strictly enforced between flcs and pushback crews. Some questionable phraseology was used between ground pushback crew and cockpit, adding to false assumptions that the pushback crew was not clear of aircraft.
Original NASA ASRS Text
Title: B737-300 PUSHBACK HAD STARTED BOTH ENGS AND WAS ANTICIPATING WAVE OFF. FO WAS PROGRAMMING FMC WITH ACARS INFO WHEN CAPT ADVISED READY TO TAXI. GND CTL CLRED FLT TO TAXI AND CAPT ADDED PWR. CGP ADVISED NOSE GEAR RAN OVER TOW BAR. CAPT HAD NOT RECEIVED ALL CLR SALUTE.
Narrative: PUSHBACK WAS BEING ACCOMPLISHED FROM GATE IN CLE. CAPT WAS COMMUNICATING WITH GND CREW THROUGH INTERPHONE. I WAS COORDINATING COMS WITH GND CTL ON #1 VHF RADIO. NORMAL ENG START PROC OF #2 AND #1 ENGS WAS ACCOMPLISHED DURING PUSHBACK. PRIOR TO AFTER START CHKLIST, WE RECEIVED WT & BAL INFO VIA ACARS WHICH I PROCEEDED TO LOAD INTO FMC. WE WERE ANTICIPATING A SHORT TAXI AND WANTED TO ACCOMPLISH AS MUCH AS WE COULD PRIOR TO TAXI OUT. I WAS NOT MONITORING THE PUSHBACK OVER THE INTERPHONE SO AS TO KEEP CLR COMS WITH CLE GND CTLR. CAPT CALLED FOR THE AFTER START CHKLIST WHICH WE READ AND COMPLETED. CAPT STATED WE WERE READY TO TAXI, AT WHICH TIME I REQUESTED SUCH FROM GND CTL. WE WERE CLRED TO TAXI. I VISUALLY CHKED FORWARD AND R AND RESPONDED, 'CLR R.' AS CAPT APPLIED TAXI PWR, WE RECEIVED SEVERAL QUICK BELL SIGNALS THROUGH THE INTERPHONE AND OBSERVED THE BLUE CALL BELL COCKPIT ANNUNCIATOR. I SWITCHED TO SVC INTERPHONE TO COMMUNICATE WITH THE FLT ATTENDANTS, WHO I ASSUMED WERE CALLING US. I RECEIVED NO RESPONSE. THE BELLS CONTINUED AND THEN REALIZED THE SIGNAL WAS COMING FROM THE GND PUSHBACK CREW. THE CAPT IMMEDIATELY STOPPED THE ACFT. WE WERE INFORMED THAT THE ACFT HAD TAXIED OVER THE DISCONNECTED TOW BAR. CAPT HAD NOT RECEIVED A WAVE OFF SIGNAL FROM PUSHBACK CREW. BY THE TIME I WAS BACK IN THE LOOP, I DID NOT QUESTION WHETHER OR NOT WE HAD BEEN CLRED TO TAXI FROM GND CREW AS THE CAPT HAD CALLED FOR THE AFTER START CHKLIST AND TAXI. NO WAVE OFF WAS RECEIVED BY CAPT. FO WAS PROGRAMMING FMC AND MONITORING GND CTL, PLACING HIM OUT OF THE LOOP. WE WERE USING A NEW ICAO PUSHBACK PROC THAT HAD BEEN POORLY IMPLEMENTED AND NOT STRICTLY ENFORCED BTWN FLCS AND PUSHBACK CREWS. SOME QUESTIONABLE PHRASEOLOGY WAS USED BTWN GND PUSHBACK CREW AND COCKPIT, ADDING TO FALSE ASSUMPTIONS THAT THE PUSHBACK CREW WAS NOT CLR OF ACFT.
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.