37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 462305 |
Time | |
Date | 200002 |
Day | Thu |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : rno.airport |
State Reference | NV |
Altitude | msl single value : 6000 |
Environment | |
Flight Conditions | IMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | tracon : rno.tracon |
Operator | other |
Make Model Name | Medium Large Transport, Low Wing, 2 Turbojet Eng |
Operating Under FAR Part | Part 91 |
Navigation In Use | ils localizer only : 16 |
Flight Phase | climbout : initial |
Route In Use | departure sid : reno 2 |
Flight Plan | IFR |
Person 1 | |
Affiliation | government : military |
Function | flight crew : first officer |
Qualification | pilot : atp pilot : multi engine pilot : instrument pilot : commercial |
Experience | flight time last 90 days : 27 flight time total : 4300 flight time type : 2700 |
ASRS Report | 462305 |
Person 2 | |
Affiliation | government : military |
Function | flight crew : captain oversight : pic |
Qualification | pilot : commercial pilot : instrument pilot : atp pilot : multi engine |
Experience | flight time last 90 days : 170 flight time total : 5000 flight time type : 2000 |
ASRS Report | 462130 |
Events | |
Anomaly | non adherence : clearance non adherence : published procedure other spatial deviation |
Independent Detector | other controllera |
Resolutory Action | controller : issued new clearance flight crew : returned to intended or assigned course |
Supplementary | |
Problem Areas | Chart Or Publication Flight Crew Human Performance |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
For departure from rno, we had been cleared for reno 2 departure and climb to 15000 ft. As PF, I briefed the departure prior to takeoff from our military SID depiction. Due to what I believe to be a somewhat confusing layout in the SID depiction, I briefed a left turn back to fmg VORTAC after established on localizer back course and maintaining required climb rate. We flew the departure in that way, and between 6500 ft and 7500 ft MSL I started a turn left, at which time copilot asked departure for 'direct friant,' to the south. Controller then asked about our heading deviation from the SID and assigned us a 160 degree heading. I believe the primary reason for our misinterp of the SID is the lack of separation between the normal and lost communication instructions on the military plate. That led me to believe we were following initial takeoff instructions, then follow departure instructions (turn to fmg), and that the minimum climb rates shown ensured terrain clearance. The commercial plate, by comparison, does not depict the lost communication turn to fmg and clearly separates the lost communication procedure in a graphically separated area of the diagram. While the error in interpretation clearly lies with our cockpit crew, I feel that a layout more like the commercial would help significantly to prevent pilots/crews from similar errors in the future.
Original NASA ASRS Text
Title: MIL CREW IN TWIN TURBOPROP DEP RNO ON SID OFF RWY 16 AND START L TURN BEFORE CTLR ISSUES A VECTOR.
Narrative: FOR DEP FROM RNO, WE HAD BEEN CLRED FOR RENO 2 DEP AND CLB TO 15000 FT. AS PF, I BRIEFED THE DEP PRIOR TO TKOF FROM OUR MIL SID DEPICTION. DUE TO WHAT I BELIEVE TO BE A SOMEWHAT CONFUSING LAYOUT IN THE SID DEPICTION, I BRIEFED A L TURN BACK TO FMG VORTAC AFTER ESTABLISHED ON LOC BACK COURSE AND MAINTAINING REQUIRED CLB RATE. WE FLEW THE DEP IN THAT WAY, AND BTWN 6500 FT AND 7500 FT MSL I STARTED A TURN L, AT WHICH TIME COPLT ASKED DEP FOR 'DIRECT FRIANT,' TO THE S. CTLR THEN ASKED ABOUT OUR HDG DEV FROM THE SID AND ASSIGNED US A 160 DEG HDG. I BELIEVE THE PRIMARY REASON FOR OUR MISINTERP OF THE SID IS THE LACK OF SEPARATION BTWN THE NORMAL AND LOST COM INSTRUCTIONS ON THE MIL PLATE. THAT LED ME TO BELIEVE WE WERE FOLLOWING INITIAL TKOF INSTRUCTIONS, THEN FOLLOW DEP INSTRUCTIONS (TURN TO FMG), AND THAT THE MINIMUM CLB RATES SHOWN ENSURED TERRAIN CLRNC. THE COMMERCIAL PLATE, BY COMPARISON, DOES NOT DEPICT THE LOST COM TURN TO FMG AND CLRLY SEPARATES THE LOST COM PROC IN A GRAPHICALLY SEPARATED AREA OF THE DIAGRAM. WHILE THE ERROR IN INTERP CLRLY LIES WITH OUR COCKPIT CREW, I FEEL THAT A LAYOUT MORE LIKE THE COMMERCIAL WOULD HELP SIGNIFICANTLY TO PREVENT PLTS/CREWS FROM SIMILAR ERRORS IN THE FUTURE.
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.