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|
Attributes | |
ACN | 595875 |
Time | |
Date | 200310 |
Day | Wed |
Local Time Of Day | 1801 To 2400 |
Place | |
Locale Reference | airport : hou.airport |
State Reference | TX |
Altitude | msl bound lower : 46 msl bound upper : 5000 |
Environment | |
Flight Conditions | IMC |
Weather Elements | Rain Thunderstorm |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | tracon : i90.tracon |
Operator | general aviation : corporate |
Make Model Name | Learjet 55 |
Operating Under FAR Part | Part 121 |
Flight Phase | climbout : initial climbout : intermediate altitude |
Route In Use | departure : on vectors |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : corporate |
Function | flight crew : first officer |
Qualification | pilot : atp pilot : multi engine |
Experience | flight time last 90 days : 75 flight time total : 9500 flight time type : 4100 |
ASRS Report | 595875 |
Person 2 | |
Affiliation | company : corporate |
Function | flight crew : captain oversight : pic |
Events | |
Anomaly | altitude deviation : overshoot cabin event other non adherence : published procedure non adherence : clearance other spatial deviation |
Independent Detector | other controllerb |
Resolutory Action | controller : issued advisory flight crew : became reoriented flight crew : returned to intended or assigned course flight crew : returned to original clearance flight crew : overcame equipment problem |
Consequence | Other |
Supplementary | |
Problem Areas | Company Aircraft Flight Crew Human Performance |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
The WX was light to moderate rain with thunderstorm moving through the area. When the boss arrived, it was raining lightly so he parked by the plane and got on board. I went and parked his car while the captain started the right engine and got ready to go. When I got to the plane, he started the other engine and started taxiing to the runway, which was a short distance, while I ran the checklist. The linemen had moved the plane while it was parked and the directional gyros were precessed about 100 degrees. We were in a hurry and missed this on the taxi checks. The tower cleared us to take off on runway 22 and turn left to heading of 200 degrees. Our directional gyros showed a heading of about 150 degrees not 220 degrees, which we should have noticed was wrong. Due to dealing with the WX and radar we missed it. After takeoff, we started to make a turn all the way around to 200 degrees. They told us we were supposed to fly a heading of 200 degrees and I said we're turning to it now. They said to keep it tight and continue the turn to 190 degrees. When we stopped the turn, they said they showed us on a heading of 330 degrees and to turn left to 180 degrees. This is when we figured that our directional gyros were wrong and proceeded to correct them. While doing this the captain busted his altitude by 1000 ft and we had to descend back to 5000 ft. After we completed the flight, we discussed the events, to figure why everything went wrong. We decided that in the future we would not start engines or taxi until both pilots are seated and ready to perform their duties. Cutting corners and playing catch up caused an overload which caused us to miss items on the checklist and things snowballed from there. Supplemental information from acn 595921: tower assigned an initial heading of 210 degrees, which should have been only a 10 degree left turn from runway alignment. Both pilots failed to mentally compute this. Both pilot and copilot directional gyros indicated the aircraft needed approximately 90 degree left turn to achieve the assigned heading. The immediate cause of this event was the pilots allowed the situation to become rushed. Cpr pilots are subjected to many pressures that do not pertain to the safety of flight, ie, passenger needs, passenger schedule, passenger moods, passenger destination schedule and needs, etc. It is very easy to allow these pressures to effect flight decisions. Our immediate response to this incident is to put procedures into place to ensure certain checklist items are complete before crew continues to next flight phase. Educate passenger on some of the pressures that can effect the flight crew.
Original NASA ASRS Text
Title: NON STANDARD PROCS RESULT IN A TKOF WITHOUT DIRECTIONAL GYROS PROPERLY SET LEADING TO A TRACK DEV CAUSING FURTHER DISTR THAT LED TO AN ALT OVERSHOOT DEPARTING HOU IN A LEAR 55.
Narrative: THE WX WAS LIGHT TO MODERATE RAIN WITH TSTM MOVING THROUGH THE AREA. WHEN THE BOSS ARRIVED, IT WAS RAINING LIGHTLY SO HE PARKED BY THE PLANE AND GOT ON BOARD. I WENT AND PARKED HIS CAR WHILE THE CAPT STARTED THE R ENG AND GOT READY TO GO. WHEN I GOT TO THE PLANE, HE STARTED THE OTHER ENG AND STARTED TAXIING TO THE RWY, WHICH WAS A SHORT DISTANCE, WHILE I RAN THE CHKLIST. THE LINEMEN HAD MOVED THE PLANE WHILE IT WAS PARKED AND THE DIRECTIONAL GYROS WERE PRECESSED ABOUT 100 DEGS. WE WERE IN A HURRY AND MISSED THIS ON THE TAXI CHKS. THE TWR CLRED US TO TAKE OFF ON RWY 22 AND TURN L TO HEADING OF 200 DEGS. OUR DIRECTIONAL GYROS SHOWED A HEADING OF ABOUT 150 DEGS NOT 220 DEGS, WHICH WE SHOULD HAVE NOTICED WAS WRONG. DUE TO DEALING WITH THE WX AND RADAR WE MISSED IT. AFTER TKOF, WE STARTED TO MAKE A TURN ALL THE WAY AROUND TO 200 DEGS. THEY TOLD US WE WERE SUPPOSED TO FLY A HEADING OF 200 DEGS AND I SAID WE'RE TURNING TO IT NOW. THEY SAID TO KEEP IT TIGHT AND CONTINUE THE TURN TO 190 DEGS. WHEN WE STOPPED THE TURN, THEY SAID THEY SHOWED US ON A HEADING OF 330 DEGS AND TO TURN L TO 180 DEGS. THIS IS WHEN WE FIGURED THAT OUR DIRECTIONAL GYROS WERE WRONG AND PROCEEDED TO CORRECT THEM. WHILE DOING THIS THE CAPT BUSTED HIS ALT BY 1000 FT AND WE HAD TO DSND BACK TO 5000 FT. AFTER WE COMPLETED THE FLT, WE DISCUSSED THE EVENTS, TO FIGURE WHY EVERYTHING WENT WRONG. WE DECIDED THAT IN THE FUTURE WE WOULD NOT START ENGS OR TAXI UNTIL BOTH PLTS ARE SEATED AND READY TO PERFORM THEIR DUTIES. CUTTING CORNERS AND PLAYING CATCH UP CAUSED AN OVERLOAD WHICH CAUSED US TO MISS ITEMS ON THE CHKLIST AND THINGS SNOWBALLED FROM THERE. SUPPLEMENTAL INFO FROM ACN 595921: TWR ASSIGNED AN INITIAL HEADING OF 210 DEGS, WHICH SHOULD HAVE BEEN ONLY A 10 DEG L TURN FROM RWY ALIGNMENT. BOTH PLTS FAILED TO MENTALLY COMPUTE THIS. BOTH PLT AND COPLT DIRECTIONAL GYROS INDICATED THE ACFT NEEDED APPROX 90 DEG L TURN TO ACHIEVE THE ASSIGNED HEADING. THE IMMEDIATE CAUSE OF THIS EVENT WAS THE PLTS ALLOWED THE SIT TO BECOME RUSHED. CPR PLTS ARE SUBJECTED TO MANY PRESSURES THAT DO NOT PERTAIN TO THE SAFETY OF FLT, IE, PAX NEEDS, PAX SCHEDULE, PAX MOODS, PAX DEST SCHEDULE AND NEEDS, ETC. IT IS VERY EASY TO ALLOW THESE PRESSURES TO EFFECT FLT DECISIONS. OUR IMMEDIATE RESPONSE TO THIS INCIDENT IS TO PUT PROCS INTO PLACE TO ENSURE CERTAIN CHKLIST ITEMS ARE COMPLETE BEFORE CREW CONTINUES TO NEXT FLT PHASE. EDUCATE PAX ON SOME OF THE PRESSURES THAT CAN EFFECT THE FLT CREW.
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.