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Attributes | |
ACN | 487669 |
Time | |
Date | 200010 |
Day | Tue |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : zzz.airport |
State Reference | US |
Altitude | agl single value : 0 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | B767-300 and 300 ER |
Operating Under FAR Part | Part 121 |
Flight Phase | ground : parked ground : preflight ground : maintenance |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : commercial pilot : flight engineer pilot : instrument pilot : multi engine pilot : atp |
Experience | flight time last 90 days : 150 flight time total : 18000 flight time type : 1800 |
ASRS Report | 487669 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : multi engine pilot : commercial pilot : instrument |
Events | |
Anomaly | aircraft equipment problem : critical non adherence : company policies other anomaly other |
Independent Detector | other flight crewa other flight crewb |
Resolutory Action | other |
Consequence | other other |
Factors | |
Maintenance | contributing factor : engineering procedure contributing factor : schedule pressure performance deficiency : logbook entry performance deficiency : non compliance with legal requirements |
Supplementary | |
Problem Areas | Company Maintenance Human Performance Chart Or Publication Aircraft |
Primary Problem | Maintenance Human Performance |
Narrative:
The inbound flight crew informed me that they had written up left engine bleed as being inoperative. When I arrived at the cockpit, maintenance was on board and said that the decision had been made to MEL the left bleed per MEL. The first officer and I began reviewing the MEL while maintenance left. The maintenance man soon returned and said he would have to close some valves per the MEL procedure. He then signed off the airworthiness in the logbook and placed an MEL sticker on the left bleed switch. We offered the MEL to him so he could look at the procedures required, but he said that he already had copies of the pertinent pages. I responded that we would not run any checklists until he was finished, but he assured us that would not be necessary. Both the first officer and I had the impression that he (maintenance) was not completely certain of the task he faced. I asked him to come back to the cockpit when the MEL maintenance items had been completed. He said he would. We continued to review the MEL as well as deal with some passenger items/concerns, as well as a distraction with a jump seat rider (which I will not address here). Finally, as we were reading the checklist, the gate agent came to the cockpit with the manifest. I asked her to keep the door open because maintenance was working on the aircraft and he would be coming to the cockpit to brief us on the finished items. She agreed and left, only to return a short while later and interrupt the checklist to say that ramp tower wanted us to close the door because it was departure time. I again told her to leave the door open because maintenance was working on the aircraft and would be coming to the cockpit. She left only to return again about two mins later. It was apparent that she was 'under the gun' by the tower personnel to close the door, no matter what. Again, the checklist had been interrupted. I left the cockpit, went to the phone in the jetway, and told the person on the line that I was abc wxx, captain of flight yzy, and that the door to the aircraft would be closed as soon as the aircraft was ready for departure. I then handed the phone to another agent whom I had previously spoken to. As I was talking on the phone, maintenance came up and said all procedures were completed. I returned to the cockpit, we completed the checklist, and pushed back 4 mins past departure time, with all paperwork on board including the logbook with the airworthiness release signed off. We pushed back and were starting the left engine, when ramp tower called and said that maintenance wanted us to shut down and be towed to a remote gate location so 'they could close a valve.' either by design to get the aircraft out on time, or by omission due to pressure to get the aircraft on time, we were dispatched with an airworthiness sign-off and incomplete maintenance work. We departed after the valve was closed. Before filing this report, I explained this episode to my chief pilot. He assured me that flight operations will back up any pilot who stops or delays the operation for safety. I appreciate this, but I am not sure it would have helped in this situation. I thought all maintenance had been performed on my aircraft before pushback. Additionally, it would have been very helpful if the tower had believed our reason for leaving the door open was a valid one. Their repeated pressure to close the door was an unwanted distraction. The real problem seemed to stem from a lack of team work across departmental lines by those involved in dispatching an aircraft. Each department seemed myopically concerned with their own agendas with only the flight crew concerned with safety.
Original NASA ASRS Text
Title: A B767-300 WAS TOWED OFF THE GATE FOR AN ON-TIME DEP AND THEN HAD THE MEL SPECIAL PROCS ACCOMPLISHED.
Narrative: THE INBOUND FLC INFORMED ME THAT THEY HAD WRITTEN UP L ENG BLEED AS BEING INOP. WHEN I ARRIVED AT THE COCKPIT, MAINT WAS ON BOARD AND SAID THAT THE DECISION HAD BEEN MADE TO MEL THE L BLEED PER MEL. THE FO AND I BEGAN REVIEWING THE MEL WHILE MAINT LEFT. THE MAINT MAN SOON RETURNED AND SAID HE WOULD HAVE TO CLOSE SOME VALVES PER THE MEL PROC. HE THEN SIGNED OFF THE AIRWORTHINESS IN THE LOGBOOK AND PLACED AN MEL STICKER ON THE L BLEED SWITCH. WE OFFERED THE MEL TO HIM SO HE COULD LOOK AT THE PROCS REQUIRED, BUT HE SAID THAT HE ALREADY HAD COPIES OF THE PERTINENT PAGES. I RESPONDED THAT WE WOULD NOT RUN ANY CHKLISTS UNTIL HE WAS FINISHED, BUT HE ASSURED US THAT WOULD NOT BE NECESSARY. BOTH THE FO AND I HAD THE IMPRESSION THAT HE (MAINT) WAS NOT COMPLETELY CERTAIN OF THE TASK HE FACED. I ASKED HIM TO COME BACK TO THE COCKPIT WHEN THE MEL MAINT ITEMS HAD BEEN COMPLETED. HE SAID HE WOULD. WE CONTINUED TO REVIEW THE MEL AS WELL AS DEAL WITH SOME PAX ITEMS/CONCERNS, AS WELL AS A DISTRACTION WITH A JUMP SEAT RIDER (WHICH I WILL NOT ADDRESS HERE). FINALLY, AS WE WERE READING THE CHKLIST, THE GATE AGENT CAME TO THE COCKPIT WITH THE MANIFEST. I ASKED HER TO KEEP THE DOOR OPEN BECAUSE MAINT WAS WORKING ON THE ACFT AND HE WOULD BE COMING TO THE COCKPIT TO BRIEF US ON THE FINISHED ITEMS. SHE AGREED AND LEFT, ONLY TO RETURN A SHORT WHILE LATER AND INTERRUPT THE CHKLIST TO SAY THAT RAMP TWR WANTED US TO CLOSE THE DOOR BECAUSE IT WAS DEP TIME. I AGAIN TOLD HER TO LEAVE THE DOOR OPEN BECAUSE MAINT WAS WORKING ON THE ACFT AND WOULD BE COMING TO THE COCKPIT. SHE LEFT ONLY TO RETURN AGAIN ABOUT TWO MINS LATER. IT WAS APPARENT THAT SHE WAS 'UNDER THE GUN' BY THE TWR PERSONNEL TO CLOSE THE DOOR, NO MATTER WHAT. AGAIN, THE CHKLIST HAD BEEN INTERRUPTED. I LEFT THE COCKPIT, WENT TO THE PHONE IN THE JETWAY, AND TOLD THE PERSON ON THE LINE THAT I WAS ABC WXX, CAPT OF FLT YZY, AND THAT THE DOOR TO THE ACFT WOULD BE CLOSED AS SOON AS THE ACFT WAS READY FOR DEP. I THEN HANDED THE PHONE TO ANOTHER AGENT WHOM I HAD PREVIOUSLY SPOKEN TO. AS I WAS TALKING ON THE PHONE, MAINT CAME UP AND SAID ALL PROCS WERE COMPLETED. I RETURNED TO THE COCKPIT, WE COMPLETED THE CHKLIST, AND PUSHED BACK 4 MINS PAST DEP TIME, WITH ALL PAPERWORK ON BOARD INCLUDING THE LOGBOOK WITH THE AIRWORTHINESS RELEASE SIGNED OFF. WE PUSHED BACK AND WERE STARTING THE L ENG, WHEN RAMP TWR CALLED AND SAID THAT MAINT WANTED US TO SHUT DOWN AND BE TOWED TO A REMOTE GATE LOCATION SO 'THEY COULD CLOSE A VALVE.' EITHER BY DESIGN TO GET THE ACFT OUT ON TIME, OR BY OMISSION DUE TO PRESSURE TO GET THE ACFT ON TIME, WE WERE DISPATCHED WITH AN AIRWORTHINESS SIGN-OFF AND INCOMPLETE MAINT WORK. WE DEPARTED AFTER THE VALVE WAS CLOSED. BEFORE FILING THIS RPT, I EXPLAINED THIS EPISODE TO MY CHIEF PLT. HE ASSURED ME THAT FLT OPS WILL BACK UP ANY PLT WHO STOPS OR DELAYS THE OP FOR SAFETY. I APPRECIATE THIS, BUT I AM NOT SURE IT WOULD HAVE HELPED IN THIS SIT. I THOUGHT ALL MAINT HAD BEEN PERFORMED ON MY ACFT BEFORE PUSHBACK. ADDITIONALLY, IT WOULD HAVE BEEN VERY HELPFUL IF THE TWR HAD BELIEVED OUR REASON FOR LEAVING THE DOOR OPEN WAS A VALID ONE. THEIR REPEATED PRESSURE TO CLOSE THE DOOR WAS AN UNWANTED DISTR. THE REAL PROB SEEMED TO STEM FROM A LACK OF TEAM WORK ACROSS DEPARTMENTAL LINES BY THOSE INVOLVED IN DISPATCHING AN ACFT. EACH DEPT SEEMED MYOPICALLY CONCERNED WITH THEIR OWN AGENDAS WITH ONLY THE FLC CONCERNED WITH SAFETY.
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.