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Attributes | |
ACN | 529839 |
Time | |
Date | 200111 |
Day | Mon |
Local Time Of Day | 0001 To 0600 |
Place | |
Locale Reference | airport : zzz.airport |
Altitude | msl single value : 18000 |
Environment | |
Flight Conditions | Mixed |
Weather Elements | Rain |
Aircraft 1 | |
Controlling Facilities | artcc : zzz.artcc tracon : zzz.tracon tower : zzz.tower |
Operator | common carrier : air carrier |
Make Model Name | Do 328 TP (Turboprop) |
Operating Under FAR Part | Part 121 |
Navigation In Use | other |
Flight Phase | climbout : intermediate altitude climbout : takeoff cruise : level |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp pilot : cfi pilot : multi engine pilot : instrument pilot : commercial |
Experience | flight time last 90 days : 150 flight time total : 3500 flight time type : 830 |
ASRS Report | 529839 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Events | |
Anomaly | aircraft equipment problem : critical inflight encounter : weather non adherence : company policies non adherence : published procedure other anomaly other |
Independent Detector | aircraft equipment other aircraft equipment : eicas gear wng other flight crewa other flight crewb |
Resolutory Action | controller : issued new clearance none taken : unable none taken : anomaly accepted other |
Consequence | other |
Supplementary | |
Problem Areas | Flight Crew Human Performance Maintenance Human Performance Environmental Factor Aircraft Company |
Narrative:
Early morning departure from a stand-up overnight (ZZZ to ZZZ3), inadvertently flew with nose gear pin installed, preventing nose gear retraction. Aircraft: fairchild dornier 328 regional jet. I (the first officer) conducted a normal, thorough preflight inspection. I noticed the nosewheel was chocked, with the nose gear pin installed with a yellow streamer. (Per our fom we use red colored streamers for the aircraft specific set of gear pins, and yellow colored streamers for the ramp or maintenance set of gear pins.) main gear pins were not installed. All 3 red gear pins were stowed onboard. We had parked overnight on the tarmac behind an MD80 in the usual parking spot. The aircraft must have been moved overnight by tow, because in the morning a 'ramp set' yellow pin was installed in the nose gear. Seeing the nose gear pinned with a yellow streamer is a 'normal' condition, which I observe all the time. I was expecting for us to be hooked up to a tug for engine start and pushback, perhaps to move us out of the way from other mainline aircraft at the gate that had early morning departures. Upon entering the cockpit, I told the captain everything outside looks good (meaning the exterior preflight). I checked that our emergency equipment was on board, and that we had 3 red-streamered pins stowed. Conditions were as cold, dark, rainy morning as the first flight of the day. For engine start, a tow was not hooked up. The ramp area was clear so we were marshaled out with no tug. After the second engine start we both completed our first flight flows. I was 'heads down' with my eyes inside the cockpit as I was preoccupied with monitoring oil temperature and pressure limits, hydraulics, and doing my flows. The captain signaled the marshaller to pull the chocks and we taxied out. I assumed the pin was pulled when the chocks were pulled, and as my eyes were inside I didn't see the marshaller walk away. I don't know why ZZZ station operations put in a yellow pin in the nose gear and left it there if there was to be no tug. Upon gear retraction after takeoff, we got a nose red unlock light and a 'cas proxi system fail EICAS' message, and a 'proxi lock fail' on the hydraulic system synoptic page. We complied with the QRH, including operating limitations of airspeed below 200 KIAS and altitude below FL180. Maintenance control and dispatch were contacted, and all parties agreed that all was safe -- with the best course of action to proceed to ZZZ3 from our present position (in distance and time). In discussing the cas messages we deduced that a pin was left in the nose gear and realized our miscom/misassumptions about the status of the pin during start-up. The captain hadn't expected a pin to be installed, (since we were not pushed back) and I had assumed it had been removed by the marshaller and shown to the captain. The flight attendant was briefed and we landed normally, complying with the QRH. All indications were normal when the gear handle was selected to the down position. Maintenance was conferred with upon landing in ZZZ3 and the airplane was determined to be fully airworthy, the yellow-streamered gear pin was removed. I feel the following factors contributed to this event: 1) it is normal on preflight to see a yellow pin in the nose, as this is the normal confign for most pushes, ie, main gear no pins, yellow-streamered pin in the nose. 2) I had expected station operations to hook up a tow bar. 3) my being heads down, monitoring system at the instant the marshaller pulled the chocks, and not seeing him walk away (without the pin). 4) my expectation that without the tow bar operation, the marshaller would pull the streamered-pin when the chocks were pulled. 5) miscom between myself, the captain, and the marshaller. 6) WX conditions at the time were dark with pouring rain, perhaps the marshaller in his haste to get out of the rain hurried and therefore neglected to remove the pin or failed to notice the streamer. 7) the before start checklist calls for gear pins -- stowed. This language only confirms you are carrying pins to your destination, it says nothing about the status of the gear externally, and maybe contributed to the miscom.
Original NASA ASRS Text
Title: A DO-328 IS SUFFERED TO FLY TO DEST ARPT WITH THE NOSE GEAR EXTENDED AFTER GND MAINT PERSONNEL HAD FORGOTTEN TO REMOVE THEIR YELLOW FLAGGED PIN PRIOR TO TAXI AT ZZZ, US.
Narrative: EARLY MORNING DEP FROM A STAND-UP OVERNIGHT (ZZZ TO ZZZ3), INADVERTENTLY FLEW WITH NOSE GEAR PIN INSTALLED, PREVENTING NOSE GEAR RETRACTION. ACFT: FAIRCHILD DORNIER 328 REGIONAL JET. I (THE FO) CONDUCTED A NORMAL, THOROUGH PREFLT INSPECTION. I NOTICED THE NOSEWHEEL WAS CHOCKED, WITH THE NOSE GEAR PIN INSTALLED WITH A YELLOW STREAMER. (PER OUR FOM WE USE RED COLORED STREAMERS FOR THE ACFT SPECIFIC SET OF GEAR PINS, AND YELLOW COLORED STREAMERS FOR THE RAMP OR MAINT SET OF GEAR PINS.) MAIN GEAR PINS WERE NOT INSTALLED. ALL 3 RED GEAR PINS WERE STOWED ONBOARD. WE HAD PARKED OVERNIGHT ON THE TARMAC BEHIND AN MD80 IN THE USUAL PARKING SPOT. THE ACFT MUST HAVE BEEN MOVED OVERNIGHT BY TOW, BECAUSE IN THE MORNING A 'RAMP SET' YELLOW PIN WAS INSTALLED IN THE NOSE GEAR. SEEING THE NOSE GEAR PINNED WITH A YELLOW STREAMER IS A 'NORMAL' CONDITION, WHICH I OBSERVE ALL THE TIME. I WAS EXPECTING FOR US TO BE HOOKED UP TO A TUG FOR ENG START AND PUSHBACK, PERHAPS TO MOVE US OUT OF THE WAY FROM OTHER MAINLINE ACFT AT THE GATE THAT HAD EARLY MORNING DEPS. UPON ENTERING THE COCKPIT, I TOLD THE CAPT EVERYTHING OUTSIDE LOOKS GOOD (MEANING THE EXTERIOR PREFLT). I CHKED THAT OUR EMER EQUIP WAS ON BOARD, AND THAT WE HAD 3 RED-STREAMERED PINS STOWED. CONDITIONS WERE AS COLD, DARK, RAINY MORNING AS THE FIRST FLT OF THE DAY. FOR ENG START, A TOW WAS NOT HOOKED UP. THE RAMP AREA WAS CLR SO WE WERE MARSHALED OUT WITH NO TUG. AFTER THE SECOND ENG START WE BOTH COMPLETED OUR FIRST FLT FLOWS. I WAS 'HEADS DOWN' WITH MY EYES INSIDE THE COCKPIT AS I WAS PREOCCUPIED WITH MONITORING OIL TEMP AND PRESSURE LIMITS, HYDS, AND DOING MY FLOWS. THE CAPT SIGNALED THE MARSHALLER TO PULL THE CHOCKS AND WE TAXIED OUT. I ASSUMED THE PIN WAS PULLED WHEN THE CHOCKS WERE PULLED, AND AS MY EYES WERE INSIDE I DIDN'T SEE THE MARSHALLER WALK AWAY. I DON'T KNOW WHY ZZZ STATION OPS PUT IN A YELLOW PIN IN THE NOSE GEAR AND LEFT IT THERE IF THERE WAS TO BE NO TUG. UPON GEAR RETRACTION AFTER TKOF, WE GOT A NOSE RED UNLOCK LIGHT AND A 'CAS PROXI SYS FAIL EICAS' MESSAGE, AND A 'PROXI LOCK FAIL' ON THE HYD SYS SYNOPTIC PAGE. WE COMPLIED WITH THE QRH, INCLUDING OPERATING LIMITATIONS OF AIRSPD BELOW 200 KIAS AND ALT BELOW FL180. MAINT CTL AND DISPATCH WERE CONTACTED, AND ALL PARTIES AGREED THAT ALL WAS SAFE -- WITH THE BEST COURSE OF ACTION TO PROCEED TO ZZZ3 FROM OUR PRESENT POS (IN DISTANCE AND TIME). IN DISCUSSING THE CAS MESSAGES WE DEDUCED THAT A PIN WAS LEFT IN THE NOSE GEAR AND REALIZED OUR MISCOM/MISASSUMPTIONS ABOUT THE STATUS OF THE PIN DURING START-UP. THE CAPT HADN'T EXPECTED A PIN TO BE INSTALLED, (SINCE WE WERE NOT PUSHED BACK) AND I HAD ASSUMED IT HAD BEEN REMOVED BY THE MARSHALLER AND SHOWN TO THE CAPT. THE FLT ATTENDANT WAS BRIEFED AND WE LANDED NORMALLY, COMPLYING WITH THE QRH. ALL INDICATIONS WERE NORMAL WHEN THE GEAR HANDLE WAS SELECTED TO THE DOWN POS. MAINT WAS CONFERRED WITH UPON LNDG IN ZZZ3 AND THE AIRPLANE WAS DETERMINED TO BE FULLY AIRWORTHY, THE YELLOW-STREAMERED GEAR PIN WAS REMOVED. I FEEL THE FOLLOWING FACTORS CONTRIBUTED TO THIS EVENT: 1) IT IS NORMAL ON PREFLT TO SEE A YELLOW PIN IN THE NOSE, AS THIS IS THE NORMAL CONFIGN FOR MOST PUSHES, IE, MAIN GEAR NO PINS, YELLOW-STREAMERED PIN IN THE NOSE. 2) I HAD EXPECTED STATION OPS TO HOOK UP A TOW BAR. 3) MY BEING HEADS DOWN, MONITORING SYS AT THE INSTANT THE MARSHALLER PULLED THE CHOCKS, AND NOT SEEING HIM WALK AWAY (WITHOUT THE PIN). 4) MY EXPECTATION THAT WITHOUT THE TOW BAR OP, THE MARSHALLER WOULD PULL THE STREAMERED-PIN WHEN THE CHOCKS WERE PULLED. 5) MISCOM BTWN MYSELF, THE CAPT, AND THE MARSHALLER. 6) WX CONDITIONS AT THE TIME WERE DARK WITH POURING RAIN, PERHAPS THE MARSHALLER IN HIS HASTE TO GET OUT OF THE RAIN HURRIED AND THEREFORE NEGLECTED TO REMOVE THE PIN OR FAILED TO NOTICE THE STREAMER. 7) THE BEFORE START CHKLIST CALLS FOR GEAR PINS -- STOWED. THIS LANGUAGE ONLY CONFIRMS YOU ARE CARRYING PINS TO YOUR DEST, IT SAYS NOTHING ABOUT THE STATUS OF THE GEAR EXTERNALLY, AND MAYBE CONTRIBUTED TO THE MISCOM.
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.