37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 631071 |
Time | |
Date | 200409 |
Day | Wed |
Local Time Of Day | 0601 To 1200 |
Place | |
Locale Reference | airport : den.airport |
State Reference | CO |
Altitude | agl bound lower : 0 agl bound upper : 1500 |
Aircraft 1 | |
Controlling Facilities | tower : den.tower tower : elp.tower |
Operator | common carrier : air carrier |
Make Model Name | A319 |
Operating Under FAR Part | Part 121 |
Route In Use | approach : visual arrival star : quail5 |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Experience | flight time last 90 days : 227 flight time total : 9500 flight time type : 3925 |
ASRS Report | 631071 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Events | |
Anomaly | non adherence : company policies other anomaly |
Independent Detector | other flight crewa |
Resolutory Action | none taken : unable none taken : anomaly accepted |
Consequence | other |
Supplementary | |
Problem Areas | Flight Crew Human Performance |
Primary Problem | Flight Crew Human Performance |
Narrative:
Captain and first officer have never flown with each other before. Den landing runways 16L, 16R, 35L, and 35R. Sky clear, visibility 10 mi and winds 150 degrees at 6 KTS. Iad-den on quail 5 STAR to a visual approach runway 35L at 15-20-ish mi. Approximately 13-15 NM outside the OM (dymon), cleared for the visual approach: autoplt off, 10000 ft MSL and descending, 250 KTS slowing toward 210 KTS, we went direct to OM as a dogleg base to final (heading approximately 330 degrees) with 7000 ft set in the altitude window. ILS runway 35L in the FMGC's (chola 'from' point) and approach armed. Approximately 1.5 NM outside the OM, speed brakes extended, 2000 ft above ILS GS and 180 KTS. Crossing the OM, the landing gear was down, 3000 ft, managed speed and PF directed missed approach altitude 10000 ft set in the altitude window reverting the vertical mode to -1300 FPM. PF 'south' turned attempting to capture the GS. The workload spiked in a surprisingly short period of time. The single event which absolutely sealed this approach as unsalvageable (not stabilized by 500 ft AGL) occurred (I believe) just as I had finished the landing checklist, just inside the OM. The PF pulled the altitude knob for what I believe was an attempt to gain open descent which I did not see. As I looked back up, I heard the engines spooling up with climb power and the FMA's indicated 'thr climb' and 'operation climb' in the autothrust and vertical columns respectively. This caught me completely off guard. How could this be? Nevertheless, the PF pulled the power levers to the idle stop, kicking off the autothrust system, and continued the approach at 1000 ft AGL. I made the normal callout with 'except final flaps' and I verbalized (what seemed to me to be the obvious) fast, rate of descent, above PAPI GS and speed brakes were still extended. And that is as much as I said, nothing more. The captain had bent the SOP's so far that I was playing catch-up ball. I believe that my expectation was we were so far from stabilized parameters that we would definitely go around at 500 ft. Between 1000 ft and 500 ft AGL we finished configuring. I called 500 ft and the captain stated 'final flaps full' and continued the approach. I said the problem was we were far from stabilized, and he continued so I asked if he was going to go around, and he demurred, so I said, incredulously, 'you're going to land this?' to which he simply said 'yeah.' we landed an unstabilized approach. From 1500 ft to 200 ft AGL, the aircraft was above PAPI GS (all white). At 1500 ft AGL we were approximately vref +30 KTS, slowing to vref +15-20 KTS at 500 ft AGL and held vref +15-20 KTS to touchdown. We used 1300-1500 FPM rate of descent most of the way inside the OM. Speed brakes were not retracted until approximately 700 ft AGL. Engines were not spooled until approximately 350 ft AGL. In my opinion (as PNF) the unstabilized approach developed for several reason: misperceptions/preconceived notions -- we were lulled into 'this is just another easy visual approach.' in fact, with a 10-12 KT tailwind and intercepting GS from above this approach, SOP's were bent and broken. The biggest problem with breaking SOP for me is it leaves me without a good idea of what to expect next. So I was left completely reacting instead of being proactive. The PF did not articulate what actions he was taking or planning to take to remedy the situation. I failed to inquire effectively. As PNF, I let the PF down by now being more assertive. I have been trying to strike a good balance between being the back seat driver, questioning every deviation and being too flexible. The realization started for me about 3-4 NM outside the OM when I was thinking I would drop the gear now, full speed brakes, go down fast, go to managed speed once on GS. As one captain said, 'first officer's will go along with something the captain is doing until it gets to a point of discomfort which is usually after many SOP's have been busted.' this was the first leg of the identify and I was trying to get a gauge of how this captain runs his cockpit and crew. Later, at the gate, we discussed what had happened. In answer to my question of why didn't we go around he simply stated the safety of that approach to 12000 ft of runway was never in question. I said I couldn't believe we landed and that my expectation was a go around. Again, I felt he demurred. For the remainder of the identify, I stopped assuming an SOP response and clearly stated what my expectations were to clear up any misunderstanding early on. My feeling for the rest of the trip although very congenial was exceptionally guarded toward SOP deviation. I elected to go along with the captain's decision to land I believe because I felt it was safer to continue since I saw no imminent danger rather than argue or insist on a go around he clearly wasn't keen on executing. Also, I felt taking stick priority and executing a go around was not warranted and would have made the situation far worse. To be completely frank, I was befuddled when he did not initiate a go around, which is probably why I never simply said 'we are far, far from stabilized -- we must go around.' I was simply completely reactive by this point. Next time around, I will vocalize sooner starting with something like, 'I am concerned we are getting too far behind, I am uncomfortable.' I apologize to the captain for not giving him my best. I am a far better first officer and PNF than I demonstrated here. It won't happen again.
Original NASA ASRS Text
Title: CLRED FOR A VISUAL APCH TO RWY 35L AT DEN, AN A319 CREW FLIES AN APCH THAT WAS NOT WITHIN THE STABILIZED APCH CRITERIA OF THEIR COMPANY.
Narrative: CAPT AND FO HAVE NEVER FLOWN WITH EACH OTHER BEFORE. DEN LNDG RWYS 16L, 16R, 35L, AND 35R. SKY CLR, VISIBILITY 10 MI AND WINDS 150 DEGS AT 6 KTS. IAD-DEN ON QUAIL 5 STAR TO A VISUAL APCH RWY 35L AT 15-20-ISH MI. APPROX 13-15 NM OUTSIDE THE OM (DYMON), CLRED FOR THE VISUAL APCH: AUTOPLT OFF, 10000 FT MSL AND DSNDING, 250 KTS SLOWING TOWARD 210 KTS, WE WENT DIRECT TO OM AS A DOGLEG BASE TO FINAL (HDG APPROX 330 DEGS) WITH 7000 FT SET IN THE ALT WINDOW. ILS RWY 35L IN THE FMGC'S (CHOLA 'FROM' POINT) AND APCH ARMED. APPROX 1.5 NM OUTSIDE THE OM, SPD BRAKES EXTENDED, 2000 FT ABOVE ILS GS AND 180 KTS. XING THE OM, THE LNDG GEAR WAS DOWN, 3000 FT, MANAGED SPD AND PF DIRECTED MISSED APCH ALT 10000 FT SET IN THE ALT WINDOW REVERTING THE VERT MODE TO -1300 FPM. PF 'S' TURNED ATTEMPTING TO CAPTURE THE GS. THE WORKLOAD SPIKED IN A SURPRISINGLY SHORT PERIOD OF TIME. THE SINGLE EVENT WHICH ABSOLUTELY SEALED THIS APCH AS UNSALVAGEABLE (NOT STABILIZED BY 500 FT AGL) OCCURRED (I BELIEVE) JUST AS I HAD FINISHED THE LNDG CHKLIST, JUST INSIDE THE OM. THE PF PULLED THE ALT KNOB FOR WHAT I BELIEVE WAS AN ATTEMPT TO GAIN OPEN DSCNT WHICH I DID NOT SEE. AS I LOOKED BACK UP, I HEARD THE ENGS SPOOLING UP WITH CLB PWR AND THE FMA'S INDICATED 'THR CLB' AND 'OP CLB' IN THE AUTOTHRUST AND VERT COLUMNS RESPECTIVELY. THIS CAUGHT ME COMPLETELY OFF GUARD. HOW COULD THIS BE? NEVERTHELESS, THE PF PULLED THE PWR LEVERS TO THE IDLE STOP, KICKING OFF THE AUTOTHRUST SYS, AND CONTINUED THE APCH AT 1000 FT AGL. I MADE THE NORMAL CALLOUT WITH 'EXCEPT FINAL FLAPS' AND I VERBALIZED (WHAT SEEMED TO ME TO BE THE OBVIOUS) FAST, RATE OF DSCNT, ABOVE PAPI GS AND SPD BRAKES WERE STILL EXTENDED. AND THAT IS AS MUCH AS I SAID, NOTHING MORE. THE CAPT HAD BENT THE SOP'S SO FAR THAT I WAS PLAYING CATCH-UP BALL. I BELIEVE THAT MY EXPECTATION WAS WE WERE SO FAR FROM STABILIZED PARAMETERS THAT WE WOULD DEFINITELY GO AROUND AT 500 FT. BTWN 1000 FT AND 500 FT AGL WE FINISHED CONFIGURING. I CALLED 500 FT AND THE CAPT STATED 'FINAL FLAPS FULL' AND CONTINUED THE APCH. I SAID THE PROB WAS WE WERE FAR FROM STABILIZED, AND HE CONTINUED SO I ASKED IF HE WAS GOING TO GO AROUND, AND HE DEMURRED, SO I SAID, INCREDULOUSLY, 'YOU'RE GOING TO LAND THIS?' TO WHICH HE SIMPLY SAID 'YEAH.' WE LANDED AN UNSTABILIZED APCH. FROM 1500 FT TO 200 FT AGL, THE ACFT WAS ABOVE PAPI GS (ALL WHITE). AT 1500 FT AGL WE WERE APPROX VREF +30 KTS, SLOWING TO VREF +15-20 KTS AT 500 FT AGL AND HELD VREF +15-20 KTS TO TOUCHDOWN. WE USED 1300-1500 FPM RATE OF DSCNT MOST OF THE WAY INSIDE THE OM. SPD BRAKES WERE NOT RETRACTED UNTIL APPROX 700 FT AGL. ENGS WERE NOT SPOOLED UNTIL APPROX 350 FT AGL. IN MY OPINION (AS PNF) THE UNSTABILIZED APCH DEVELOPED FOR SEVERAL REASON: MISPERCEPTIONS/PRECONCEIVED NOTIONS -- WE WERE LULLED INTO 'THIS IS JUST ANOTHER EASY VISUAL APCH.' IN FACT, WITH A 10-12 KT TAILWIND AND INTERCEPTING GS FROM ABOVE THIS APCH, SOP'S WERE BENT AND BROKEN. THE BIGGEST PROB WITH BREAKING SOP FOR ME IS IT LEAVES ME WITHOUT A GOOD IDEA OF WHAT TO EXPECT NEXT. SO I WAS LEFT COMPLETELY REACTING INSTEAD OF BEING PROACTIVE. THE PF DID NOT ARTICULATE WHAT ACTIONS HE WAS TAKING OR PLANNING TO TAKE TO REMEDY THE SIT. I FAILED TO INQUIRE EFFECTIVELY. AS PNF, I LET THE PF DOWN BY NOW BEING MORE ASSERTIVE. I HAVE BEEN TRYING TO STRIKE A GOOD BAL BTWN BEING THE BACK SEAT DRIVER, QUESTIONING EVERY DEV AND BEING TOO FLEXIBLE. THE REALIZATION STARTED FOR ME ABOUT 3-4 NM OUTSIDE THE OM WHEN I WAS THINKING I WOULD DROP THE GEAR NOW, FULL SPD BRAKES, GO DOWN FAST, GO TO MANAGED SPD ONCE ON GS. AS ONE CAPT SAID, 'FO'S WILL GO ALONG WITH SOMETHING THE CAPT IS DOING UNTIL IT GETS TO A POINT OF DISCOMFORT WHICH IS USUALLY AFTER MANY SOP'S HAVE BEEN BUSTED.' THIS WAS THE FIRST LEG OF THE IDENT AND I WAS TRYING TO GET A GAUGE OF HOW THIS CAPT RUNS HIS COCKPIT AND CREW. LATER, AT THE GATE, WE DISCUSSED WHAT HAD HAPPENED. IN ANSWER TO MY QUESTION OF WHY DIDN'T WE GO AROUND HE SIMPLY STATED THE SAFETY OF THAT APCH TO 12000 FT OF RWY WAS NEVER IN QUESTION. I SAID I COULDN'T BELIEVE WE LANDED AND THAT MY EXPECTATION WAS A GAR. AGAIN, I FELT HE DEMURRED. FOR THE REMAINDER OF THE IDENT, I STOPPED ASSUMING AN SOP RESPONSE AND CLRLY STATED WHAT MY EXPECTATIONS WERE TO CLR UP ANY MISUNDERSTANDING EARLY ON. MY FEELING FOR THE REST OF THE TRIP ALTHOUGH VERY CONGENIAL WAS EXCEPTIONALLY GUARDED TOWARD SOP DEV. I ELECTED TO GO ALONG WITH THE CAPT'S DECISION TO LAND I BELIEVE BECAUSE I FELT IT WAS SAFER TO CONTINUE SINCE I SAW NO IMMINENT DANGER RATHER THAN ARGUE OR INSIST ON A GAR HE CLRLY WASN'T KEEN ON EXECUTING. ALSO, I FELT TAKING STICK PRIORITY AND EXECUTING A GAR WAS NOT WARRANTED AND WOULD HAVE MADE THE SIT FAR WORSE. TO BE COMPLETELY FRANK, I WAS BEFUDDLED WHEN HE DID NOT INITIATE A GAR, WHICH IS PROBABLY WHY I NEVER SIMPLY SAID 'WE ARE FAR, FAR FROM STABILIZED -- WE MUST GO AROUND.' I WAS SIMPLY COMPLETELY REACTIVE BY THIS POINT. NEXT TIME AROUND, I WILL VOCALIZE SOONER STARTING WITH SOMETHING LIKE, 'I AM CONCERNED WE ARE GETTING TOO FAR BEHIND, I AM UNCOMFORTABLE.' I APOLOGIZE TO THE CAPT FOR NOT GIVING HIM MY BEST. I AM A FAR BETTER FO AND PNF THAN I DEMONSTRATED HERE. IT WON'T HAPPEN AGAIN.
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.