37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 782378 |
Time | |
Date | 200804 |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : zzz.airport |
State Reference | US |
Altitude | msl single value : 37000 |
Aircraft 1 | |
Controlling Facilities | artcc : zla.artcc |
Operator | common carrier : air carrier |
Make Model Name | B767-300 and 300 ER |
Operating Under FAR Part | Part 121 |
Navigation In Use | other other other |
Flight Phase | cruise : level |
Route In Use | enroute : pacific |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
ASRS Report | 782378 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
ASRS Report | 782377 |
Events | |
Anomaly | non adherence : far non adherence : published procedure non adherence : company policies |
Independent Detector | other flight crewa other flight crewb |
Resolutory Action | none taken : detected after the fact |
Supplementary | |
Problem Areas | Flight Crew Human Performance |
Primary Problem | Flight Crew Human Performance |
Narrative:
After takeoff when we received our final clearance; I noticed that the final clearance waypoints didn't match our flight plan and FMC waypoints. We manually entered waypoints and did bearing and distance checks; FMC versus chart and flight plan and proceeded on to ZZZ. When trying to determine what had caused this; my operating experience captain said that during our legs check he had responded to my glass to paper check and had seen but not corrected the waypoint names that were not correct. It was his first leg international. He misinterped my waypoints challenge and had not questioned his misunderstanding. Further confusing the issue was the fact that we had both mentally transposed the wrong UTC time date and had not updated the navigation database. The other twist being the fact that maintenance had not installed the new navigation database. There were no deviations from our planned route or ATC procedures. We all learned a lot and it was a classic series of minor mistakes that could have caused a navigation error. A suggestion to avoid this error in the future would be to attach a note to our flight plan on flts that might be affected by a database changes.
Original NASA ASRS Text
Title: B767-300 FLT CREW DISCOVERED DURING CRUISE THAT THEY FAILED TO UPDATE THE NAV DATABASE PRIOR TO DEP.
Narrative: AFTER TKOF WHEN WE RECEIVED OUR FINAL CLRNC; I NOTICED THAT THE FINAL CLRNC WAYPOINTS DIDN'T MATCH OUR FLT PLAN AND FMC WAYPOINTS. WE MANUALLY ENTERED WAYPOINTS AND DID BEARING AND DISTANCE CHKS; FMC VERSUS CHART AND FLT PLAN AND PROCEEDED ON TO ZZZ. WHEN TRYING TO DETERMINE WHAT HAD CAUSED THIS; MY OPERATING EXPERIENCE CAPT SAID THAT DURING OUR LEGS CHK HE HAD RESPONDED TO MY GLASS TO PAPER CHK AND HAD SEEN BUT NOT CORRECTED THE WAYPOINT NAMES THAT WERE NOT CORRECT. IT WAS HIS FIRST LEG INTL. HE MISINTERPED MY WAYPOINTS CHALLENGE AND HAD NOT QUESTIONED HIS MISUNDERSTANDING. FURTHER CONFUSING THE ISSUE WAS THE FACT THAT WE HAD BOTH MENTALLY TRANSPOSED THE WRONG UTC TIME DATE AND HAD NOT UPDATED THE NAV DATABASE. THE OTHER TWIST BEING THE FACT THAT MAINT HAD NOT INSTALLED THE NEW NAV DATABASE. THERE WERE NO DEVS FROM OUR PLANNED RTE OR ATC PROCS. WE ALL LEARNED A LOT AND IT WAS A CLASSIC SERIES OF MINOR MISTAKES THAT COULD HAVE CAUSED A NAV ERROR. A SUGGESTION TO AVOID THIS ERROR IN THE FUTURE WOULD BE TO ATTACH A NOTE TO OUR FLT PLAN ON FLTS THAT MIGHT BE AFFECTED BY A DATABASE CHANGES.
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.