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Attributes | |
ACN | 719385 |
Time | |
Date | 200612 |
Local Time Of Day | 1801 To 2400 |
Place | |
Locale Reference | airport : dfw.airport |
State Reference | TX |
Altitude | agl single value : 1000 |
Environment | |
Flight Conditions | VMC |
Light | Night |
Aircraft 1 | |
Controlling Facilities | tracon : d10.tracon |
Operator | common carrier : air carrier |
Make Model Name | MD-80 Series (DC-9-80) Undifferentiated or Other Model |
Operating Under FAR Part | Part 121 |
Navigation In Use | other |
Flight Phase | climbout : initial |
Flight Plan | IFR |
Aircraft 2 | |
Controlling Facilities | tracon : d10.tracon |
Operator | common carrier : air carrier |
Make Model Name | Any Unknown or Unlisted Aircraft Manufacturer |
Operating Under FAR Part | Part 121 |
Flight Phase | climbout : initial |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
ASRS Report | 719385 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
ASRS Report | 719405 |
Events | |
Anomaly | aircraft equipment problem : critical conflict : airborne less severe non adherence : required legal separation non adherence : clearance non adherence : published procedure other spatial deviation |
Independent Detector | other controllera |
Resolutory Action | controller : issued new clearance controller : issued advisory |
Consequence | faa : reviewed incident with flight crew |
Supplementary | |
Problem Areas | Environmental Factor Flight Crew Human Performance Aircraft Chart Or Publication |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
We departed dfw runway 36R with runway 35L incorrectly loaded in the FMS. Following a normal rotation and gear retraction; the navigation mode was selected at 400 ft AGL. The v-bars commanded approximately 3 degrees right angle of bank. I; the PF; followed them precisely. As the first officer and I observed the position of an aircraft 2.5 NM ahead at 1 O'clock position; we both realized our error. I executed an immediate left turn to correct and intercept the appropriate departure course. Departure queried us and we advised that we were correcting our course. My first officer requested 'direct hazkl' and departure granted the request. As we were visually preoccupied with the aircraft ahead; apparently loss of separation occurred with an aircraft behind us -- according to a later conversation with an ATC supervisor via phone after the flight. The supervisor asked for my personal information -- which I provided. I have no excuse for this error. The first officer didn't update the FMS departure runway and I failed to follow up. I would like to submit what might be a considered contributing factor to this error and one suggestion for improvement in standard procedures. We had experienced 2 ATC flow control delays prior to departure. Just as we practice during deicing delays; we should have revisited the mechanical checklist item 'flight instruments and bugs' as well as all other mechanical checklist items. My navigation display was set at 5 NM to confirm correct tracking of the RNAV course; but that prevented me from seeing the waypoints of the entire RNAV procedure which would have alerted me to the incorrect FMS programming. This was our first leg of a 3-DAY sequence together. This was my 4TH of 6 straight days of flying. I had been awake for 12 hours and had been through 3 hours of ATC delays. Actual departure time; now XA00; was much later than planned. I should have 'tweaked' up my awareness level a few notches knowing that these factors might contribute to mistakes. As more and more stations adopt RNAV departure procedures; the possibility of this error occurring in the future will only increase.
Original NASA ASRS Text
Title: FATIGUED MD80 FLT CREW; AFTER A LENGTHY GND DELAY; FAILS TO UPDATE DEP RWY WHILE FLYING RNAV SID FROM DFW. TRACK DEV ENSUES.
Narrative: WE DEPARTED DFW RWY 36R WITH RWY 35L INCORRECTLY LOADED IN THE FMS. FOLLOWING A NORMAL ROTATION AND GEAR RETRACTION; THE NAV MODE WAS SELECTED AT 400 FT AGL. THE V-BARS COMMANDED APPROX 3 DEGS R ANGLE OF BANK. I; THE PF; FOLLOWED THEM PRECISELY. AS THE FO AND I OBSERVED THE POS OF AN ACFT 2.5 NM AHEAD AT 1 O'CLOCK POS; WE BOTH REALIZED OUR ERROR. I EXECUTED AN IMMEDIATE L TURN TO CORRECT AND INTERCEPT THE APPROPRIATE DEP COURSE. DEP QUERIED US AND WE ADVISED THAT WE WERE CORRECTING OUR COURSE. MY FO REQUESTED 'DIRECT HAZKL' AND DEP GRANTED THE REQUEST. AS WE WERE VISUALLY PREOCCUPIED WITH THE ACFT AHEAD; APPARENTLY LOSS OF SEPARATION OCCURRED WITH AN ACFT BEHIND US -- ACCORDING TO A LATER CONVERSATION WITH AN ATC SUPVR VIA PHONE AFTER THE FLT. THE SUPVR ASKED FOR MY PERSONAL INFO -- WHICH I PROVIDED. I HAVE NO EXCUSE FOR THIS ERROR. THE FO DIDN'T UPDATE THE FMS DEP RWY AND I FAILED TO FOLLOW UP. I WOULD LIKE TO SUBMIT WHAT MIGHT BE A CONSIDERED CONTRIBUTING FACTOR TO THIS ERROR AND ONE SUGGESTION FOR IMPROVEMENT IN STANDARD PROCS. WE HAD EXPERIENCED 2 ATC FLOW CTL DELAYS PRIOR TO DEP. JUST AS WE PRACTICE DURING DEICING DELAYS; WE SHOULD HAVE REVISITED THE MECHANICAL CHKLIST ITEM 'FLT INSTS AND BUGS' AS WELL AS ALL OTHER MECHANICAL CHKLIST ITEMS. MY NAV DISPLAY WAS SET AT 5 NM TO CONFIRM CORRECT TRACKING OF THE RNAV COURSE; BUT THAT PREVENTED ME FROM SEEING THE WAYPOINTS OF THE ENTIRE RNAV PROC WHICH WOULD HAVE ALERTED ME TO THE INCORRECT FMS PROGRAMMING. THIS WAS OUR FIRST LEG OF A 3-DAY SEQUENCE TOGETHER. THIS WAS MY 4TH OF 6 STRAIGHT DAYS OF FLYING. I HAD BEEN AWAKE FOR 12 HRS AND HAD BEEN THROUGH 3 HRS OF ATC DELAYS. ACTUAL DEP TIME; NOW XA00; WAS MUCH LATER THAN PLANNED. I SHOULD HAVE 'TWEAKED' UP MY AWARENESS LEVEL A FEW NOTCHES KNOWING THAT THESE FACTORS MIGHT CONTRIBUTE TO MISTAKES. AS MORE AND MORE STATIONS ADOPT RNAV DEP PROCS; THE POSSIBILITY OF THIS ERROR OCCURRING IN THE FUTURE WILL ONLY INCREASE.
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.