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Attributes | |
ACN | 649424 |
Time | |
Date | 200503 |
Local Time Of Day | 0601 To 1200 |
Place | |
Locale Reference | airport : pie.airport |
State Reference | FL |
Altitude | msl single value : 25000 |
Environment | |
Flight Conditions | Mixed |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | artcc : zma.artcc |
Operator | common carrier : air carrier |
Make Model Name | B737 Undifferentiated or Other Model |
Operating Under FAR Part | Part 121 |
Flight Phase | descent : vacating altitude |
Route In Use | arrival star : n/a |
Flight Plan | IFR |
Aircraft 2 | |
Controlling Facilities | artcc : zma.artcc |
Operator | common carrier : air carrier |
Make Model Name | EMB ERJ 135 ER&LR |
Operating Under FAR Part | Part 121 |
Flight Phase | cruise : level |
Flight Plan | IFR |
Person 1 | |
Affiliation | government : faa |
Function | controller : radar |
Qualification | controller : radar |
Experience | controller limited radar : 4 controller military : 4 controller radar : 21 controller supervisory : 2 |
ASRS Report | 649424 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Events | |
Anomaly | conflict : airborne less severe non adherence : required legal separation |
Independent Detector | atc equipment : conflict alert other controllera |
Resolutory Action | controller : issued alert controller : issued new clearance |
Consequence | faa : investigated |
Miss Distance | horizontal : 19200 vertical : 400 |
Supplementary | |
Problem Areas | ATC Human Performance |
Primary Problem | ATC Human Performance |
Air Traffic Incident | Operational Error |
Narrative:
I was working fort myers high sector; R25; and I had only been there for approximately 5 mins when an error occurred. I had received a handoff from ZJX 10 mi north of pie on an air carrier X flight swbound and crossing pie at FL270. I entered an interim altitude of FL240 in the data block and flashed the aircraft to sector 07; rsw arrs sector. I was working the sector alone. I had 2 bays of strips and a national evaluator (mr X) plugged in and behind me; and observing my sector. I positioned 1/2 way between the radar position and the radar assistant position trying to manage the flight progress strips. I glanced back at the radar display knowing air carrier X would be at pie and I could descend the aircraft; but instead I had another data block with air carrier X now (the data blocks were overlapping). It was an air carrier Y flight very close to my boundary and flashing at me at FL250. I quickly took this late handoff; but I do not think I realized that the aircraft was approaching pie sebound and had the jetstream; 100+ mph from the west; pushing him with a 120 mph overtake on the air carrier X at FL270. I was talking to the evaluator; working other traffic; approximately 10 other aircraft on my display; managing the strips; 2 bays of them and more on the printer; when I issued a descent clearance to air carrier X to FL240 and xferred communications to R07. A short time later; I noticed the conflict alert (the data blocks flashing) between air carrier X approximately heading 190 degrees at FL255; and air carrier Y approximately heading 160 degrees at FL250. The 2 aircraft were 3 mi apart and diverging. I issued air carrier Y a heading of 140 degrees to increase their divergence; the pilot advised the traffic was in sight and separation was re-established. Working at a busy sector alone with the added pressure of an evaluator observing operations and receiving a late handoff from ZJX with a huge overtake not assessed due to distrs from other required duties. The evaluator had only been there for a few mins and when he first plugged in my headset would not transmit. After a failed transmission; I had to quickly change headset jacks and verify my equipment was ok. I also was in the process of changing my map at the sector so I could show the evaluator the state of florida and what airspace I was working. The strips at this sector are out of control and unmanageable. We do not use uret (automated strips); but ZJX does so we get even more strips than usual; increasing the workload at this sector. I believe all these things diverted my attention from the radar scope -- a dangerous move on my part! What can be done: 1) the radar controller should not have to manage flight progress strips and divert his attention from the radar display. This sector had 2 full bays of strips and even more printing; and on the printer. 2) when a national evaluator monitors a sector; a supervisor should also plug in to assist by explaining sector operation; nuances and procedures -- not the radar controller. 3) uret (automated strips) miami uret training has not been scheduled despite the installation of the equipment and software at the facility. I believe ZMA is the only non-uret center in the country! Our paper strips are inefficient and costly. 4) staffing needs to improve. Human performance consideration: with 25+ yrs (21 of those with the FAA) of ATC experience; it is easy to trust your own judgements. I had perceived the air carrier X and air carrier Y were similar type aircraft and performance. The jetstream rarely visits us this far south and usually only affects our sequencing of eastbound traffic. I had seen this situation many times; but that perception was wrong. These aircraft were tracking in such a way that one was slowed by the extreme winds of the jetstream and the other was sped up by it; even though they were on very similar rtes after pie. Once I was aware of the conflict; which was too late; I quickly determined the aircraft were becoming more separated by divergence. Another factor affecting the quality on my human performance was the national evaluator being present. Although there was not an overwhelming physical distraction; national evaluations are a big deal at a facility and employees are expected to perform their best. That was one reason I diverted my attention to the strips; to ensure there were no duplicates or deadwood the evaluator would see. I am positive if the evaluator were not there; I would have been more focused on the radar instead of the 'whole' sector.
Original NASA ASRS Text
Title: ZMA CTLR EXPERIENCED OPERROR AT FL250 DISTR BY AN EVALUATOR'S PRESENCE AND STRIP DATA BLOCK MGMNT.
Narrative: I WAS WORKING FORT MYERS HIGH SECTOR; R25; AND I HAD ONLY BEEN THERE FOR APPROX 5 MINS WHEN AN ERROR OCCURRED. I HAD RECEIVED A HDOF FROM ZJX 10 MI N OF PIE ON AN ACR X FLT SWBOUND AND XING PIE AT FL270. I ENTERED AN INTERIM ALT OF FL240 IN THE DATA BLOCK AND FLASHED THE ACFT TO SECTOR 07; RSW ARRS SECTOR. I WAS WORKING THE SECTOR ALONE. I HAD 2 BAYS OF STRIPS AND A NATL EVALUATOR (MR X) PLUGGED IN AND BEHIND ME; AND OBSERVING MY SECTOR. I POSITIONED 1/2 WAY BTWN THE RADAR POS AND THE RADAR ASSISTANT POS TRYING TO MANAGE THE FLT PROGRESS STRIPS. I GLANCED BACK AT THE RADAR DISPLAY KNOWING ACR X WOULD BE AT PIE AND I COULD DSND THE ACFT; BUT INSTEAD I HAD ANOTHER DATA BLOCK WITH ACR X NOW (THE DATA BLOCKS WERE OVERLAPPING). IT WAS AN ACR Y FLT VERY CLOSE TO MY BOUNDARY AND FLASHING AT ME AT FL250. I QUICKLY TOOK THIS LATE HDOF; BUT I DO NOT THINK I REALIZED THAT THE ACFT WAS APCHING PIE SEBOUND AND HAD THE JETSTREAM; 100+ MPH FROM THE W; PUSHING HIM WITH A 120 MPH OVERTAKE ON THE ACR X AT FL270. I WAS TALKING TO THE EVALUATOR; WORKING OTHER TFC; APPROX 10 OTHER ACFT ON MY DISPLAY; MANAGING THE STRIPS; 2 BAYS OF THEM AND MORE ON THE PRINTER; WHEN I ISSUED A DSCNT CLRNC TO ACR X TO FL240 AND XFERRED COMS TO R07. A SHORT TIME LATER; I NOTICED THE CONFLICT ALERT (THE DATA BLOCKS FLASHING) BTWN ACR X APPROX HDG 190 DEGS AT FL255; AND ACR Y APPROX HDG 160 DEGS AT FL250. THE 2 ACFT WERE 3 MI APART AND DIVERGING. I ISSUED ACR Y A HDG OF 140 DEGS TO INCREASE THEIR DIVERGENCE; THE PLT ADVISED THE TFC WAS IN SIGHT AND SEPARATION WAS RE-ESTABLISHED. WORKING AT A BUSY SECTOR ALONE WITH THE ADDED PRESSURE OF AN EVALUATOR OBSERVING OPS AND RECEIVING A LATE HDOF FROM ZJX WITH A HUGE OVERTAKE NOT ASSESSED DUE TO DISTRS FROM OTHER REQUIRED DUTIES. THE EVALUATOR HAD ONLY BEEN THERE FOR A FEW MINS AND WHEN HE FIRST PLUGGED IN MY HEADSET WOULD NOT XMIT. AFTER A FAILED XMISSION; I HAD TO QUICKLY CHANGE HEADSET JACKS AND VERIFY MY EQUIP WAS OK. I ALSO WAS IN THE PROCESS OF CHANGING MY MAP AT THE SECTOR SO I COULD SHOW THE EVALUATOR THE STATE OF FLORIDA AND WHAT AIRSPACE I WAS WORKING. THE STRIPS AT THIS SECTOR ARE OUT OF CTL AND UNMANAGEABLE. WE DO NOT USE URET (AUTOMATED STRIPS); BUT ZJX DOES SO WE GET EVEN MORE STRIPS THAN USUAL; INCREASING THE WORKLOAD AT THIS SECTOR. I BELIEVE ALL THESE THINGS DIVERTED MY ATTN FROM THE RADAR SCOPE -- A DANGEROUS MOVE ON MY PART! WHAT CAN BE DONE: 1) THE RADAR CTLR SHOULD NOT HAVE TO MANAGE FLT PROGRESS STRIPS AND DIVERT HIS ATTN FROM THE RADAR DISPLAY. THIS SECTOR HAD 2 FULL BAYS OF STRIPS AND EVEN MORE PRINTING; AND ON THE PRINTER. 2) WHEN A NATL EVALUATOR MONITORS A SECTOR; A SUPVR SHOULD ALSO PLUG IN TO ASSIST BY EXPLAINING SECTOR OP; NUANCES AND PROCS -- NOT THE RADAR CTLR. 3) URET (AUTOMATED STRIPS) MIAMI URET TRAINING HAS NOT BEEN SCHEDULED DESPITE THE INSTALLATION OF THE EQUIP AND SOFTWARE AT THE FACILITY. I BELIEVE ZMA IS THE ONLY NON-URET CTR IN THE COUNTRY! OUR PAPER STRIPS ARE INEFFICIENT AND COSTLY. 4) STAFFING NEEDS TO IMPROVE. HUMAN PERFORMANCE CONSIDERATION: WITH 25+ YRS (21 OF THOSE WITH THE FAA) OF ATC EXPERIENCE; IT IS EASY TO TRUST YOUR OWN JUDGEMENTS. I HAD PERCEIVED THE ACR X AND ACR Y WERE SIMILAR TYPE ACFT AND PERFORMANCE. THE JETSTREAM RARELY VISITS US THIS FAR S AND USUALLY ONLY AFFECTS OUR SEQUENCING OF EBOUND TFC. I HAD SEEN THIS SIT MANY TIMES; BUT THAT PERCEPTION WAS WRONG. THESE ACFT WERE TRACKING IN SUCH A WAY THAT ONE WAS SLOWED BY THE EXTREME WINDS OF THE JETSTREAM AND THE OTHER WAS SPED UP BY IT; EVEN THOUGH THEY WERE ON VERY SIMILAR RTES AFTER PIE. ONCE I WAS AWARE OF THE CONFLICT; WHICH WAS TOO LATE; I QUICKLY DETERMINED THE ACFT WERE BECOMING MORE SEPARATED BY DIVERGENCE. ANOTHER FACTOR AFFECTING THE QUALITY ON MY HUMAN PERFORMANCE WAS THE NATL EVALUATOR BEING PRESENT. ALTHOUGH THERE WAS NOT AN OVERWHELMING PHYSICAL DISTR; NATL EVALUATIONS ARE A BIG DEAL AT A FACILITY AND EMPLOYEES ARE EXPECTED TO PERFORM THEIR BEST. THAT WAS ONE REASON I DIVERTED MY ATTN TO THE STRIPS; TO ENSURE THERE WERE NO DUPLICATES OR DEADWOOD THE EVALUATOR WOULD SEE. I AM POSITIVE IF THE EVALUATOR WERE NOT THERE; I WOULD HAVE BEEN MORE FOCUSED ON THE RADAR INSTEAD OF THE 'WHOLE' SECTOR.
Data retrieved from NASA's ASRS site as of January 2009 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.