37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 774211 |
Time | |
Date | 200802 |
Place | |
Locale Reference | airport : den.airport |
State Reference | CO |
Altitude | msl single value : 13000 |
Environment | |
Flight Conditions | VMC |
Light | Dusk |
Aircraft 1 | |
Controlling Facilities | tracon : d01.tracon |
Operator | common carrier : air carrier |
Make Model Name | B737-700 |
Operating Under FAR Part | Part 121 |
Navigation In Use | other |
Flight Phase | descent : intermediate altitude |
Route In Use | arrival star : dandd |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Experience | flight time last 90 days : 191 flight time type : 4000 |
ASRS Report | 774211 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Experience | flight time last 90 days : 255 |
ASRS Report | 773896 |
Events | |
Anomaly | altitude deviation : overshoot non adherence : published procedure non adherence : clearance |
Independent Detector | other controllera |
Resolutory Action | flight crew : returned to assigned altitude |
Supplementary | |
Problem Areas | ATC Human Performance Flight Crew Human Performance |
Primary Problem | Flight Crew Human Performance |
Narrative:
We were on the dandd 5 arrival into den. Shortly before reaching FL180; ATC told us to expect runway 17R. We had briefed and expected runway 16L. As we crossed FL180; we were briefing the new runway and there was a lot of ATC congestion and communications. We missed the descent checklist and we were still set to altimeter setting 29.92. We were level at 13000 ft and ATC asked us our altitude. We read back 13000 ft and then realized that we had missed the descent checklist. The new altimeter setting put us about 400 ft low. The captain quickly corrected and we completed the descent checklist. There was no further incident. Be alert for high workloads while on arrs into congested apts. Try and brief all possible runways and expect last minute changes. The checklist should have been put on a higher priority than the briefing in this situation.supplemental information from acn 773896: too many things happening at once. I should have prioritized better. I should have switched to intercom and simply said; 'flight attendants; take seats' and let the first officer (pm) handle radios; then done descent check in accordance with fom procedures. That would have made a smoother flow; and we would not have missed setting new altimeter.
Original NASA ASRS Text
Title: A B737 OVERSHOT THEIR ASSIGNED ALTITUDE WHEN THEY FAILED TO SET LOCAL ALTIMETER DSNDING BELOW 18000 FT ON ARR TO DEN.
Narrative: WE WERE ON THE DANDD 5 ARR INTO DEN. SHORTLY BEFORE REACHING FL180; ATC TOLD US TO EXPECT RWY 17R. WE HAD BRIEFED AND EXPECTED RWY 16L. AS WE CROSSED FL180; WE WERE BRIEFING THE NEW RWY AND THERE WAS A LOT OF ATC CONGESTION AND COMS. WE MISSED THE DSCNT CHKLIST AND WE WERE STILL SET TO ALTIMETER SETTING 29.92. WE WERE LEVEL AT 13000 FT AND ATC ASKED US OUR ALTITUDE. WE READ BACK 13000 FT AND THEN REALIZED THAT WE HAD MISSED THE DSCNT CHKLIST. THE NEW ALTIMETER SETTING PUT US ABOUT 400 FT LOW. THE CAPT QUICKLY CORRECTED AND WE COMPLETED THE DSCNT CHKLIST. THERE WAS NO FURTHER INCIDENT. BE ALERT FOR HIGH WORKLOADS WHILE ON ARRS INTO CONGESTED APTS. TRY AND BRIEF ALL POSSIBLE RWYS AND EXPECT LAST MINUTE CHANGES. THE CHKLIST SHOULD HAVE BEEN PUT ON A HIGHER PRIORITY THAN THE BRIEFING IN THIS SITUATION.SUPPLEMENTAL INFO FROM ACN 773896: TOO MANY THINGS HAPPENING AT ONCE. I SHOULD HAVE PRIORITIZED BETTER. I SHOULD HAVE SWITCHED TO INTERCOM AND SIMPLY SAID; 'FLIGHT ATTENDANTS; TAKE SEATS' AND LET THE FO (PM) HANDLE RADIOS; THEN DONE DSCNT CHK IN ACCORDANCE WITH FOM PROCS. THAT WOULD HAVE MADE A SMOOTHER FLOW; AND WE WOULD NOT HAVE MISSED SETTING NEW ALTIMETER.
Data retrieved from NASA's ASRS site as of May 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.