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|
Attributes | |
ACN | 489894 |
Time | |
Date | 200010 |
Day | Tue |
Local Time Of Day | 0001 To 0600 |
Place | |
Locale Reference | airport : zzz.airport |
State Reference | US |
Altitude | agl single value : 0 |
Environment | |
Light | Dawn |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | B737-200 |
Operating Under FAR Part | Part 121 |
Flight Phase | ground : parked ground : holding |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | oversight : supervisor |
Qualification | technician : powerplant technician : airframe |
Experience | maintenance supervisor : 10 maintenance technician : 5 |
ASRS Report | 489894 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Events | |
Anomaly | aircraft equipment problem : critical maintenance problem : non compliance with mel non adherence : far non adherence : published procedure |
Independent Detector | other other : person 1 |
Resolutory Action | none taken : detected after the fact |
Consequence | other |
Factors | |
Maintenance | contributing factor : schedule pressure contributing factor : manuals performance deficiency : non compliance with legal requirements performance deficiency : inspection performance deficiency : logbook entry |
Supplementary | |
Problem Areas | Maintenance Human Performance Chart Or Publication Aircraft Flight Crew Human Performance |
Primary Problem | Maintenance Human Performance |
Narrative:
After several unsuccessful attempts, flight dispatch contacted maintenance control. I was working the B727/A320 desk but assisted in helping out my fellow controller who was busy on another call. It was a flight that was off the block in XXX. The flight crew indicated that upon #1 engine start, the generator had not come on-line and showed no frequencys, volts, oil pressure or temperature. After requesting the crew to verify all circuit breakers were in, including the circuit breaker on the gcu, with the captain's and dispatcher's concurrence, all were in agreement to continue on with the #1 generator inoperative. Hence I authority/authorized deferral with the #1 generator inoperative per MEL. What I didn't do was review the requirements for the MEL, which required that the CSD and APU oil level to be checked. By the time I realized my error, the flight was in the air. The flight landed without incident and maintenance in ZZZ reset the CSD and checked the oil, and subsequent engine run verified that the generator was operable.
Original NASA ASRS Text
Title: A B737-200 WAS DISPATCHED IN NON COMPLIANCE WITH #1 GENERATOR DEFERRED INOP, PER THE MEL, BUT A CHK OF THE CSD OIL LEVEL WAS NOT ACCOMPLISHED.
Narrative: AFTER SEVERAL UNSUCCESSFUL ATTEMPTS, FLT DISPATCH CONTACTED MAINT CTL. I WAS WORKING THE B727/A320 DESK BUT ASSISTED IN HELPING OUT MY FELLOW CTLR WHO WAS BUSY ON ANOTHER CALL. IT WAS A FLT THAT WAS OFF THE BLOCK IN XXX. THE FLC INDICATED THAT UPON #1 ENG START, THE GENERATOR HAD NOT COME ON-LINE AND SHOWED NO FREQS, VOLTS, OIL PRESSURE OR TEMP. AFTER REQUESTING THE CREW TO VERIFY ALL CIRCUIT BREAKERS WERE IN, INCLUDING THE CIRCUIT BREAKER ON THE GCU, WITH THE CAPT'S AND DISPATCHER'S CONCURRENCE, ALL WERE IN AGREEMENT TO CONTINUE ON WITH THE #1 GENERATOR INOP. HENCE I AUTH DEFERRAL WITH THE #1 GENERATOR INOP PER MEL. WHAT I DIDN'T DO WAS REVIEW THE REQUIREMENTS FOR THE MEL, WHICH REQUIRED THAT THE CSD AND APU OIL LEVEL TO BE CHKED. BY THE TIME I REALIZED MY ERROR, THE FLT WAS IN THE AIR. THE FLT LANDED WITHOUT INCIDENT AND MAINT IN ZZZ RESET THE CSD AND CHKED THE OIL, AND SUBSEQUENT ENG RUN VERIFIED THAT THE GENERATOR WAS OPERABLE.
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.