37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 618099 |
Time | |
Date | 200405 |
Day | Fri |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : phx.airport |
State Reference | AZ |
Altitude | msl single value : 7000 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | tracon : p50.tracon tower : mke.tower |
Operator | common carrier : air carrier |
Make Model Name | B737-300 |
Operating Under FAR Part | Part 121 |
Flight Phase | climbout : intermediate altitude |
Route In Use | departure sid : sjn |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 85 flight time total : 14000 flight time type : 10000 |
ASRS Report | 618099 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Events | |
Anomaly | non adherence : published procedure non adherence : clearance other spatial deviation |
Independent Detector | other controllera |
Resolutory Action | controller : issued new clearance controller : issued advisory flight crew : returned to original clearance none taken : detected after the fact |
Consequence | faa : reviewed incident with flight crew |
Supplementary | |
Problem Areas | ATC Human Performance Flight Crew Human Performance |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
On departure (sjn) climbing through 7000 ft MSL, departure issued the following clearance: 'company X, climb and maintain FL210. Out of 9000 ft, turn direct forpe, then resume the sjn departure. You have VFR traffic at your 2 O'clock position at 8500 ft.' we stayed on our 260 degree heading until 12 DME, 3 mi past the depicted turn point on the SID. At 12 DME, departure wanted to now why we had not turned. We told them, 'our last clearance was to climb to 9000 ft then go direct to forpe!' we were then issued a turn to heading 360 degrees and told we were never taken off the SID procedure! This clearance was ambiguous at best! In light of the TA and the fact that we were issued a separate clearance from the SID procedure, we felt that we were now on an amended clearance from the SID. Supplemental information from acn 618506: pilot was flying wbound on the SJN3 departure. The departure indicates 'at 9 DME turn right heading 360 degrees.' I (controller) issued a clearance as follows: 'leaving 9000 ft, turn right direct forpe.' since I didn't say fly 'runway heading,' I was expecting the pilot to comply with the departure procedure and turn right to a 360 degree heading at 9 DME and then leaving 9000 ft turn right direct forpe. Pilot never turned northbound at 9 DME. My belief is that since the aircraft was cleared via the 'SJN3 departure' and I altered the clearance 'leaving 9000 ft,' therefore, the aircraft needs to adhere to all the restrs on the 'SJN3 departure' and then turn right direct to forpe. If I wanted to take the aircraft off the SJN3 departure, I would have said 'fly runway heading (or present heading), leaving 9000 ft....' since I did not say so, the pilot was last cleared via 'SJN3 departure.'
Original NASA ASRS Text
Title: A B737-300 FLT CREW FAIL TO TURN AS DEPICTED ON A SID DUE TO A CLRNC FROM THE DEP CTLR.
Narrative: ON DEP (SJN) CLBING THROUGH 7000 FT MSL, DEP ISSUED THE FOLLOWING CLRNC: 'COMPANY X, CLB AND MAINTAIN FL210. OUT OF 9000 FT, TURN DIRECT FORPE, THEN RESUME THE SJN DEP. YOU HAVE VFR TFC AT YOUR 2 O'CLOCK POS AT 8500 FT.' WE STAYED ON OUR 260 DEG HDG UNTIL 12 DME, 3 MI PAST THE DEPICTED TURN POINT ON THE SID. AT 12 DME, DEP WANTED TO NOW WHY WE HAD NOT TURNED. WE TOLD THEM, 'OUR LAST CLRNC WAS TO CLB TO 9000 FT THEN GO DIRECT TO FORPE!' WE WERE THEN ISSUED A TURN TO HDG 360 DEGS AND TOLD WE WERE NEVER TAKEN OFF THE SID PROC! THIS CLRNC WAS AMBIGUOUS AT BEST! IN LIGHT OF THE TA AND THE FACT THAT WE WERE ISSUED A SEPARATE CLRNC FROM THE SID PROC, WE FELT THAT WE WERE NOW ON AN AMENDED CLRNC FROM THE SID. SUPPLEMENTAL INFO FROM ACN 618506: PLT WAS FLYING WBOUND ON THE SJN3 DEP. THE DEP INDICATES 'AT 9 DME TURN R HDG 360 DEGS.' I (CTLR) ISSUED A CLRNC AS FOLLOWS: 'LEAVING 9000 FT, TURN R DIRECT FORPE.' SINCE I DIDN'T SAY FLY 'RWY HDG,' I WAS EXPECTING THE PLT TO COMPLY WITH THE DEP PROC AND TURN R TO A 360 DEG HDG AT 9 DME AND THEN LEAVING 9000 FT TURN R DIRECT FORPE. PLT NEVER TURNED NBOUND AT 9 DME. MY BELIEF IS THAT SINCE THE ACFT WAS CLRED VIA THE 'SJN3 DEP' AND I ALTERED THE CLRNC 'LEAVING 9000 FT,' THEREFORE, THE ACFT NEEDS TO ADHERE TO ALL THE RESTRS ON THE 'SJN3 DEP' AND THEN TURN R DIRECT TO FORPE. IF I WANTED TO TAKE THE ACFT OFF THE SJN3 DEP, I WOULD HAVE SAID 'FLY RWY HDG (OR PRESENT HDG), LEAVING 9000 FT....' SINCE I DID NOT SAY SO, THE PLT WAS LAST CLRED VIA 'SJN3 DEP.'
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.