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|
Attributes | |
ACN | 435690 |
Time | |
Date | 199903 |
Day | Sun |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : sea.airport |
State Reference | WA |
Altitude | agl bound lower : 0 agl bound upper : 1000 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | tower : sea.tower |
Operator | common carrier : air carrier |
Make Model Name | Commercial Fixed Wing |
Operating Under FAR Part | Part 121 |
Navigation In Use | other |
Flight Phase | climbout : takeoff climbout : initial ground : takeoff roll |
Flight Plan | IFR |
Aircraft 2 | |
Controlling Facilities | tower : sea.tower |
Operator | common carrier : air carrier |
Make Model Name | Commercial Fixed Wing |
Operating Under FAR Part | Part 121 |
Flight Phase | climbout : initial |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : multi engine pilot : private pilot : flight engineer pilot : commercial pilot : atp pilot : instrument |
Experience | flight time last 90 days : 205 flight time total : 7500 flight time type : 875 |
ASRS Report | 435690 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Events | |
Anomaly | conflict : nmac non adherence : clearance other anomaly other |
Independent Detector | aircraft equipment : tcas other flight crewa other flight crewb |
Resolutory Action | flight crew : took evasive action |
Miss Distance | horizontal : 150 vertical : 300 |
Supplementary | |
Problem Areas | Flight Crew Human Performance Environmental Factor Airport ATC Human Performance Aircraft |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Operational Error Pilot Deviation |
Narrative:
Captain's CDU MEL'ed inoperative, all data inserted and read on first officer's CDU. Aircraft ahead cleared to cross runway 34R, position and hold runway 34L. Our flight cleared position and hold runway 34R at intersection Q shortly thereafter. FMC takeoff data based on runway 34L, so captain asked that runway 34R be inserted on takeoff page. This causes 3 things to occur: 1) reduced power setting reverts to maximum. 2) takeoff speeds deleted. 3) initial LNAV leg lost leaving a leg discontinuity. As we took the active runway at intersection Q, and as I began loading new numbers, tower cleared us for takeoff as follows: 'cleared for immediate takeoff traffic on a 2 1/2 mi final' which I acknowledged, 'cleared for takeoff runway 34R.' now, rather than leisurely typing numbers on a position and hold clearance, we had limited time to leave the runway. I continued to type during the initial takeoff roll and had the FMC programmed by 1000 ft takeoff roll (estimated). Immediately after liftoff, we got an RA 'monitor vertical speed' and a steep climb TCASII command. Traffic resolution indicated present position 300 ft below us (at maximum pitch). After RA was resolved, I informed tower of the situation. They informed me that 'roger, that was traffic off the left runway.' the captain and I looked at each other somewhat perplexed, because at no time did we ever hear takeoff clearance given to aircraft and had no idea there was a potential conflict off that runway. Tower never informed us of preceding traffic. Our concern was that due to the FMC confusion, maybe we assumed clearance was given to us when it was actually given to the other flight and tower failed to notice the simultaneous takeoff. To this day, I have no idea what aircraft caused the RA because we never were able to visually acquire the target. It's very puzzling because the only takeoff position traffic conflict I saw prior to takeoff was short final to the left runway. I never saw traffic approaching the right and thus it appears the 'cleared for immediate takeoff' clearance was either intended for or actually given to the other flight. For all I know, however, the other flight remained on the runway because we never saw him. I read back 'cleared for takeoff,' the captain verbally repeated it, and we never heard the other flight on the radio. The moral of the story for me is to be spring-loaded to stopping all computer programming as the situation demands. Sometimes the situation changes rapidly and flexibility demands the ability to adapt as required. Automation demands impacted our situational awareness due to the rapidly changing nature of the takeoff scenario. Whether we were in error or not, we did lose track of the other aircraft and that is inexcusable.
Original NASA ASRS Text
Title: AN NMAC OCCURS OFF THE '34 SET' OF RWYS AT SEA, WA.
Narrative: CAPT'S CDU MEL'ED INOP, ALL DATA INSERTED AND READ ON FO'S CDU. ACFT AHEAD CLRED TO CROSS RWY 34R, POS AND HOLD RWY 34L. OUR FLT CLRED POS AND HOLD RWY 34R AT INTXN Q SHORTLY THEREAFTER. FMC TKOF DATA BASED ON RWY 34L, SO CAPT ASKED THAT RWY 34R BE INSERTED ON TKOF PAGE. THIS CAUSES 3 THINGS TO OCCUR: 1) REDUCED PWR SETTING REVERTS TO MAX. 2) TKOF SPDS DELETED. 3) INITIAL LNAV LEG LOST LEAVING A LEG DISCONTINUITY. AS WE TOOK THE ACTIVE RWY AT INTXN Q, AND AS I BEGAN LOADING NEW NUMBERS, TWR CLRED US FOR TKOF AS FOLLOWS: 'CLRED FOR IMMEDIATE TKOF TFC ON A 2 1/2 MI FINAL' WHICH I ACKNOWLEDGED, 'CLRED FOR TKOF RWY 34R.' NOW, RATHER THAN LEISURELY TYPING NUMBERS ON A POS AND HOLD CLRNC, WE HAD LIMITED TIME TO LEAVE THE RWY. I CONTINUED TO TYPE DURING THE INITIAL TKOF ROLL AND HAD THE FMC PROGRAMMED BY 1000 FT TKOF ROLL (ESTIMATED). IMMEDIATELY AFTER LIFTOFF, WE GOT AN RA 'MONITOR VERT SPD' AND A STEEP CLB TCASII COMMAND. TFC RESOLUTION INDICATED PRESENT POS 300 FT BELOW US (AT MAX PITCH). AFTER RA WAS RESOLVED, I INFORMED TWR OF THE SIT. THEY INFORMED ME THAT 'ROGER, THAT WAS TFC OFF THE L RWY.' THE CAPT AND I LOOKED AT EACH OTHER SOMEWHAT PERPLEXED, BECAUSE AT NO TIME DID WE EVER HEAR TKOF CLRNC GIVEN TO ACFT AND HAD NO IDEA THERE WAS A POTENTIAL CONFLICT OFF THAT RWY. TWR NEVER INFORMED US OF PRECEDING TFC. OUR CONCERN WAS THAT DUE TO THE FMC CONFUSION, MAYBE WE ASSUMED CLRNC WAS GIVEN TO US WHEN IT WAS ACTUALLY GIVEN TO THE OTHER FLT AND TWR FAILED TO NOTICE THE SIMULTANEOUS TKOF. TO THIS DAY, I HAVE NO IDEA WHAT ACFT CAUSED THE RA BECAUSE WE NEVER WERE ABLE TO VISUALLY ACQUIRE THE TARGET. IT'S VERY PUZZLING BECAUSE THE ONLY TKOF POS TFC CONFLICT I SAW PRIOR TO TKOF WAS SHORT FINAL TO THE L RWY. I NEVER SAW TFC APCHING THE R AND THUS IT APPEARS THE 'CLRED FOR IMMEDIATE TKOF' CLRNC WAS EITHER INTENDED FOR OR ACTUALLY GIVEN TO THE OTHER FLT. FOR ALL I KNOW, HOWEVER, THE OTHER FLT REMAINED ON THE RWY BECAUSE WE NEVER SAW HIM. I READ BACK 'CLRED FOR TKOF,' THE CAPT VERBALLY REPEATED IT, AND WE NEVER HEARD THE OTHER FLT ON THE RADIO. THE MORAL OF THE STORY FOR ME IS TO BE SPRING-LOADED TO STOPPING ALL COMPUTER PROGRAMMING AS THE SIT DEMANDS. SOMETIMES THE SIT CHANGES RAPIDLY AND FLEXIBILITY DEMANDS THE ABILITY TO ADAPT AS REQUIRED. AUTOMATION DEMANDS IMPACTED OUR SITUATIONAL AWARENESS DUE TO THE RAPIDLY CHANGING NATURE OF THE TKOF SCENARIO. WHETHER WE WERE IN ERROR OR NOT, WE DID LOSE TRACK OF THE OTHER ACFT AND THAT IS INEXCUSABLE.
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.