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A BA146 on takeoff climb at 3000 ft diverted due to tower report the aft cargo door was open caused by poor dispatch and preflight inspection.
| Attributes | |
| ACN | 491249 |
| Time | |
| Date | 200011 |
| Day | Fri |
| Local Time Of Day | 0601 To 1200 |
| Place | |
| Locale Reference | airport : grb.airport |
| State Reference | WI |
| Altitude | agl bound lower : 0 agl bound upper : 3000 |
| Environment | |
| Flight Conditions | VMC |
| Light | Daylight |
| Aircraft 1 | |
| Controlling Facilities | tower : grb.tower |
| Operator | common carrier : air carrier |
| Make Model Name | BAe 146 Undifferentiated or Other Model |
| Operating Under FAR Part | Part 121 |
| Navigation In Use | other |
| Flight Phase | climbout : initial |
| Flight Plan | IFR |
| Person 1 | |
| Affiliation | company : air carrier |
| Function | flight crew : first officer |
| Qualification | pilot : atp |
| Experience | flight time last 90 days : 120 flight time total : 2600 flight time type : 120 |
| ASRS Report | 491249 |
| Person 2 | |
| Affiliation | company : air carrier |
| Function | flight crew : captain oversight : pic |
| Qualification | pilot : atp |
| Events | |
| Anomaly | aircraft equipment problem : critical maintenance problem : improper maintenance non adherence : published procedure non adherence : far |
| Independent Detector | other other : person 3 |
| Resolutory Action | flight crew : landed as precaution |
| Consequence | other |
| Factors | |
| Maintenance | contributing factor : schedule pressure performance deficiency : non compliance with legal requirements performance deficiency : inspection |
| Supplementary | |
| Problem Areas | Maintenance Human Performance Aircraft Flight Crew Human Performance |
| Primary Problem | Maintenance Human Performance |
Narrative:
We departed with the rear cargo door open. I was instructed by the captain to perform the interior check. When he returned we went over it together as dictated in our manual. All system were normal, including the test of the lights on the master warning system panel. The items on the before start, starting, after start and before takeoff checks were performed per the manual and all checks were normal. After takeoff the tower advised that the rear cargo door may be open. Our cabin vsi indicated pressurization of the cabin was not taking place and then the captain pressed the light test on the master warning system. The rear cargo light was not functioning. We returned for landing. The light had burned out sometime between the interior check and the starting check where the door lights are to be checked closed (not lit), there are 2 bulbs behind each warning caption. The aircraft system could not be improved.
Original NASA ASRS Text
Title: A BA146 ON TKOF CLB AT 3000 FT DIVERTED DUE TO TWR RPT THE AFT CARGO DOOR WAS OPEN CAUSED BY POOR DISPATCH AND PREFLT INSPECTION.
Narrative: WE DEPARTED WITH THE REAR CARGO DOOR OPEN. I WAS INSTRUCTED BY THE CAPT TO PERFORM THE INTERIOR CHK. WHEN HE RETURNED WE WENT OVER IT TOGETHER AS DICTATED IN OUR MANUAL. ALL SYS WERE NORMAL, INCLUDING THE TEST OF THE LIGHTS ON THE MASTER WARNING SYS PANEL. THE ITEMS ON THE BEFORE START, STARTING, AFTER START AND BEFORE TKOF CHKS WERE PERFORMED PER THE MANUAL AND ALL CHKS WERE NORMAL. AFTER TKOF THE TWR ADVISED THAT THE REAR CARGO DOOR MAY BE OPEN. OUR CABIN VSI INDICATED PRESSURIZATION OF THE CABIN WAS NOT TAKING PLACE AND THEN THE CAPT PRESSED THE LIGHT TEST ON THE MASTER WARNING SYS. THE REAR CARGO LIGHT WAS NOT FUNCTIONING. WE RETURNED FOR LNDG. THE LIGHT HAD BURNED OUT SOMETIME BTWN THE INTERIOR CHK AND THE STARTING CHK WHERE THE DOOR LIGHTS ARE TO BE CHKED CLOSED (NOT LIT), THERE ARE 2 BULBS BEHIND EACH WARNING CAPTION. THE ACFT SYS COULD NOT BE IMPROVED.
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.