37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 700855 |
Time | |
Date | 200606 |
Local Time Of Day | 0601 To 1200 |
Place | |
Locale Reference | navaid : stv.vortac |
State Reference | TX |
Altitude | msl bound lower : 6000 msl bound upper : 6400 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | tracon : sat.tracon tower : ord.tower |
Operator | general aviation : personal |
Make Model Name | Baron 58/58TC |
Operating Under FAR Part | Part 91 |
Navigation In Use | other |
Flight Phase | cruise : level |
Flight Plan | IFR |
Person 1 | |
Affiliation | other |
Function | flight crew : single pilot |
Experience | flight time last 90 days : 210 flight time total : 10000 flight time type : 1500 |
ASRS Report | 700855 |
Events | |
Anomaly | aircraft equipment problem : critical altitude deviation : excursion from assigned altitude non adherence : clearance |
Independent Detector | other flight crewa |
Resolutory Action | flight crew : returned to assigned altitude flight crew : overcame equipment problem |
Supplementary | |
Problem Areas | Flight Crew Human Performance Aircraft |
Primary Problem | Aircraft |
Air Traffic Incident | Pilot Deviation |
Narrative:
I had just gone missed approach at horseshoe bay; tx. NDB 17 (due to low clouds) and exited holding for a direct to sat. While preparing the GPS; finding approach plates; and changing from center frequency to sat approach; the autoplt altitude hold disconnected. I did not catch the error until 6400 ft (400 ft off altitude). My autoplt (kfc 200) has only a blinking light for a disconnect and no warning for a single mode disconnect (like altitude hold). It was a very busy phase of flight (single pilot IFR) in the deviation and I did not catch the error due to a slow crosschk. The only solution is to be more aware of distractions at this busy point and to use a faster crosschk even with the autoplt.
Original NASA ASRS Text
Title: BE58 SINGLE PLT; DISTRACTED BY REROUTE ACTIVITIES FOLLOWING A MISSED APCH; EXPERIENCES AN ALT DEV WHEN THE ALT HOLD FUNCTION OF THE AUTOPLT FAILED; WITH NO CLR WARNING INDICATION.
Narrative: I HAD JUST GONE MISSED APCH AT HORSESHOE BAY; TX. NDB 17 (DUE TO LOW CLOUDS) AND EXITED HOLDING FOR A DIRECT TO SAT. WHILE PREPARING THE GPS; FINDING APCH PLATES; AND CHANGING FROM CTR FREQ TO SAT APCH; THE AUTOPLT ALT HOLD DISCONNECTED. I DID NOT CATCH THE ERROR UNTIL 6400 FT (400 FT OFF ALT). MY AUTOPLT (KFC 200) HAS ONLY A BLINKING LIGHT FOR A DISCONNECT AND NO WARNING FOR A SINGLE MODE DISCONNECT (LIKE ALT HOLD). IT WAS A VERY BUSY PHASE OF FLT (SINGLE PLT IFR) IN THE DEV AND I DID NOT CATCH THE ERROR DUE TO A SLOW CROSSCHK. THE ONLY SOLUTION IS TO BE MORE AWARE OF DISTRACTIONS AT THIS BUSY POINT AND TO USE A FASTER CROSSCHK EVEN WITH THE AUTOPLT.
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.