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|
Attributes | |
ACN | 573494 |
Time | |
Date | 200302 |
Day | Sun |
Local Time Of Day | 1201 To 1800 |
Place | |
Altitude | msl single value : 24000 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | artcc : zhu.artcc |
Operator | common carrier : air carrier |
Make Model Name | EMB ERJ 145 ER&LR |
Operating Under FAR Part | Part 121 |
Navigation In Use | other |
Flight Phase | cruise : level |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 70 flight time total : 7000 flight time type : 1800 |
ASRS Report | 573494 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Events | |
Anomaly | aircraft equipment problem : less severe non adherence : company policies other anomaly other |
Independent Detector | aircraft equipment other aircraft equipment : eicas other flight crewa other flight crewb |
Resolutory Action | controller : issued new clearance flight crew : diverted to another airport flight crew : landed as precaution |
Consequence | other other |
Supplementary | |
Problem Areas | Flight Crew Human Performance Maintenance Human Performance Chart Or Publication Aircraft |
Primary Problem | Flight Crew Human Performance |
Narrative:
Was at FL240 in cruise direct to sbj VOR. Got EICAS message of problem (E1 fire detector failure) found in emergency checklist and ran first 3 items. Got distraction, and then turned the page. Read down to the 4TH or 5TH item, and it said 'if in-flight go to lower altitude to warm bottle, if message persists, land at nearest suitable airport.' asked ATC for FL200, and it was 10 degrees C warmer, no change in message. I asked msy operations to have maintenance call us. I told maintenance of EICAS message, and that we went down to FL200, but no change. Have they had much experience with this? I'm only 35 mi southeast of lft, and it could be our landing airport. I was put on hold, and he said 'I could just fly it to iah.' I said 'my checklist says' to land at nearest suitable airport.' at that time, going through my head was maintenance was trying to push me to come to iah. I discussed with my first officer that 'we could have an engine fire and have no indication until it fell off, I believe that's why we need to get plane on the ground (safety first). I said 'I'm going to lft and need to amend my release to have lft as my destination. Dispatch gave us direct left. Went to left and first officer landed. We parked aircraft and went back over checklist and saw that I had gone into the next checklist, which is (E1 fire bottle inoperative). Looking back a day later, several factors might have affected this situation: 1) taking time to rerun the checklist after the distraction or having the first officer run it again. 2) asking maintenance control why he felt 'we could just fly it to iah.' 3) putting maintenance control's opinion with all the other into and resources together before making final decision to divert. 4) not rushing final decision, because of lft airport getting closer and getting more input from flo.
Original NASA ASRS Text
Title: FLC OF E145 INADVERTENTLY INITIATED ONE ABNORMAL CHKLIST AND COMPLETED ANOTHER AFTER A DISTR. THIS RESULTED IN AN UNNECESSARY DIVERSION TO THE NEAREST SUITABLE ARPT.
Narrative: WAS AT FL240 IN CRUISE DIRECT TO SBJ VOR. GOT EICAS MESSAGE OF PROB (E1 FIRE DETECTOR FAILURE) FOUND IN EMER CHKLIST AND RAN FIRST 3 ITEMS. GOT DISTR, AND THEN TURNED THE PAGE. READ DOWN TO THE 4TH OR 5TH ITEM, AND IT SAID 'IF INFLT GO TO LOWER ALT TO WARM BOTTLE, IF MESSAGE PERSISTS, LAND AT NEAREST SUITABLE ARPT.' ASKED ATC FOR FL200, AND IT WAS 10 DEGS C WARMER, NO CHANGE IN MESSAGE. I ASKED MSY OPS TO HAVE MAINT CALL US. I TOLD MAINT OF EICAS MESSAGE, AND THAT WE WENT DOWN TO FL200, BUT NO CHANGE. HAVE THEY HAD MUCH EXPERIENCE WITH THIS? I'M ONLY 35 MI SE OF LFT, AND IT COULD BE OUR LNDG ARPT. I WAS PUT ON HOLD, AND HE SAID 'I COULD JUST FLY IT TO IAH.' I SAID 'MY CHKLIST SAYS' TO LAND AT NEAREST SUITABLE ARPT.' AT THAT TIME, GOING THROUGH MY HEAD WAS MAINT WAS TRYING TO PUSH ME TO COME TO IAH. I DISCUSSED WITH MY FO THAT 'WE COULD HAVE AN ENG FIRE AND HAVE NO INDICATION UNTIL IT FELL OFF, I BELIEVE THAT'S WHY WE NEED TO GET PLANE ON THE GND (SAFETY FIRST). I SAID 'I'M GOING TO LFT AND NEED TO AMEND MY RELEASE TO HAVE LFT AS MY DEST. DISPATCH GAVE US DIRECT L. WENT TO L AND FO LANDED. WE PARKED ACFT AND WENT BACK OVER CHKLIST AND SAW THAT I HAD GONE INTO THE NEXT CHKLIST, WHICH IS (E1 FIRE BOTTLE INOP). LOOKING BACK A DAY LATER, SEVERAL FACTORS MIGHT HAVE AFFECTED THIS SIT: 1) TAKING TIME TO RERUN THE CHKLIST AFTER THE DISTR OR HAVING THE FO RUN IT AGAIN. 2) ASKING MAINT CTL WHY HE FELT 'WE COULD JUST FLY IT TO IAH.' 3) PUTTING MAINT CTL'S OPINION WITH ALL THE OTHER INTO AND RESOURCES TOGETHER BEFORE MAKING FINAL DECISION TO DIVERT. 4) NOT RUSHING FINAL DECISION, BECAUSE OF LFT ARPT GETTING CLOSER AND GETTING MORE INPUT FROM FLO.
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.