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|
Attributes | |
ACN | 798452 |
Time | |
Date | 200807 |
Local Time Of Day | 0601 To 1200 |
Place | |
Locale Reference | airport : zzz.airport |
State Reference | US |
Altitude | agl single value : 0 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | Regional Jet 200 ER&LR |
Operating Under FAR Part | Part 121 |
Flight Phase | ground : parked |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Experience | flight time last 90 days : 200 flight time total : 2000 flight time type : 1000 |
ASRS Report | 798452 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Experience | flight time last 90 days : 200 flight time total : 7400 flight time type : 5600 |
ASRS Report | 798453 |
Events | |
Anomaly | non adherence : published procedure non adherence : far non adherence : company policies |
Independent Detector | other flight crewa other flight crewb |
Resolutory Action | none taken : detected after the fact |
Consequence | other |
Supplementary | |
Problem Areas | Flight Crew Human Performance |
Primary Problem | Flight Crew Human Performance |
Narrative:
I was ahead of the captain getting to the aircraft. I had began making my nest and had sat down in my seat. We were at the gate in ZZZ with gpu available; APU was off. I was in the process of bringing power on the aircraft and have pressed the power for ground power not realizing I had not turned the batt master on. I had just done this when the captain boarded. From that point I assumed the captain had things from there. During our attempt to switch from gpu to APU; the plane lost power and the APU shut down. Eventually we got power xfer to the APU; but had not noticed that the air-driven generator had deployed at the gate. After we found that out; we contacted maintenance control and they reset the air driven generator and associated processes. Even though the air driven generator should not have deployed; proper checklist usage and crew communication could have helped to avoid this situation. I should have ran the flight deck safety inspection checklist as a 'do' list. When the captain asked if I had done the 'fire protection;' I should have explained that I had not done the checklist so he was aware to run the list from the top. He had no reason to believe I had not run the checklist to that point; I should have communicated this. I also should have just run the whole checklist; ignored the distrs; and informed the captain that the checklist was complete. Stay on task; if you get distraction; start over and finish the process in its entirety. As much as this had taught me; I hope this air driven generator problem gets fixed because it's a scary idea what could have happened had someone been near it when it deployed. It also compliments our checklist procedures in the knowledge that even things that shouldn't happen can happen at any time and by following simple procedure; you can prevent the unthinkable. Supplemental information from acn 798453: first officer pwred up the aircraft without following the flight compartment safety inspection checklist. He merely selected 'AC external power' without turning on the battery master switch. I did not question him correctly. I asked if he had performed the fire detection test; he replied 'no; I just pushed the button.' my question should have been; 'did you perform the checklist?' first mistake on my part. I ran the rest of the checklist from the fire detection test on down; without looking at the battery master switch position. After starting the APU; I attempted to bring the APU generator on-line. There was a lot of loud banging as relays which were unpowered; suddenly were pwred; and in the process the air driven generator deployed on the ground; at the gate. Aircraft went dead; APU generator came off-line; and APU died. After re-pwring the aircraft and turning the battery master switch on and completing the rest of the checklists through starting engines (to the line); I attempted to push off the gate. The ramp agents signaled me with hand signals I did not comprehend. Another pilot radioed over the ramp frequency that our air driven generator was deployed. I set the parking brake; exited the aircraft and observed the air driven generator was deployed. I called maintenance control; wrote up the air driven generator and spoke with corp flight safety about the issue. Contributing factor -- my failure to run the entire flight deck safety inspection. Lesson learned; at the expense of a 1.25 hour delay. Henceforth; I will ensure every checklist is completed properly.
Original NASA ASRS Text
Title: A CRJ200 FO FAILED TO PERFORM THE PRESTART COCKPIT SAFETY CHECK LEAVING THE BATT OFF WHEN THE APU STARTED. THE AIR DRIVEN GEN DEPLOYED DURING THE POWER TRANSFER.
Narrative: I WAS AHEAD OF THE CAPT GETTING TO THE ACFT. I HAD BEGAN MAKING MY NEST AND HAD SAT DOWN IN MY SEAT. WE WERE AT THE GATE IN ZZZ WITH GPU AVAILABLE; APU WAS OFF. I WAS IN THE PROCESS OF BRINGING PWR ON THE ACFT AND HAVE PRESSED THE PWR FOR GND PWR NOT REALIZING I HAD NOT TURNED THE BATT MASTER ON. I HAD JUST DONE THIS WHEN THE CAPT BOARDED. FROM THAT POINT I ASSUMED THE CAPT HAD THINGS FROM THERE. DURING OUR ATTEMPT TO SWITCH FROM GPU TO APU; THE PLANE LOST PWR AND THE APU SHUT DOWN. EVENTUALLY WE GOT PWR XFER TO THE APU; BUT HAD NOT NOTICED THAT THE AIR-DRIVEN GENERATOR HAD DEPLOYED AT THE GATE. AFTER WE FOUND THAT OUT; WE CONTACTED MAINT CTL AND THEY RESET THE AIR DRIVEN GENERATOR AND ASSOCIATED PROCESSES. EVEN THOUGH THE AIR DRIVEN GENERATOR SHOULD NOT HAVE DEPLOYED; PROPER CHKLIST USAGE AND CREW COM COULD HAVE HELPED TO AVOID THIS SITUATION. I SHOULD HAVE RAN THE FLT DECK SAFETY INSPECTION CHKLIST AS A 'DO' LIST. WHEN THE CAPT ASKED IF I HAD DONE THE 'FIRE PROTECTION;' I SHOULD HAVE EXPLAINED THAT I HAD NOT DONE THE CHKLIST SO HE WAS AWARE TO RUN THE LIST FROM THE TOP. HE HAD NO REASON TO BELIEVE I HAD NOT RUN THE CHKLIST TO THAT POINT; I SHOULD HAVE COMMUNICATED THIS. I ALSO SHOULD HAVE JUST RUN THE WHOLE CHKLIST; IGNORED THE DISTRS; AND INFORMED THE CAPT THAT THE CHKLIST WAS COMPLETE. STAY ON TASK; IF YOU GET DISTR; START OVER AND FINISH THE PROCESS IN ITS ENTIRETY. AS MUCH AS THIS HAD TAUGHT ME; I HOPE THIS AIR DRIVEN GENERATOR PROB GETS FIXED BECAUSE IT'S A SCARY IDEA WHAT COULD HAVE HAPPENED HAD SOMEONE BEEN NEAR IT WHEN IT DEPLOYED. IT ALSO COMPLIMENTS OUR CHKLIST PROCS IN THE KNOWLEDGE THAT EVEN THINGS THAT SHOULDN'T HAPPEN CAN HAPPEN AT ANY TIME AND BY FOLLOWING SIMPLE PROC; YOU CAN PREVENT THE UNTHINKABLE. SUPPLEMENTAL INFO FROM ACN 798453: FO PWRED UP THE ACFT WITHOUT FOLLOWING THE FLT COMPARTMENT SAFETY INSPECTION CHKLIST. HE MERELY SELECTED 'AC EXTERNAL PWR' WITHOUT TURNING ON THE BATTERY MASTER SWITCH. I DID NOT QUESTION HIM CORRECTLY. I ASKED IF HE HAD PERFORMED THE FIRE DETECTION TEST; HE REPLIED 'NO; I JUST PUSHED THE BUTTON.' MY QUESTION SHOULD HAVE BEEN; 'DID YOU PERFORM THE CHKLIST?' FIRST MISTAKE ON MY PART. I RAN THE REST OF THE CHKLIST FROM THE FIRE DETECTION TEST ON DOWN; WITHOUT LOOKING AT THE BATTERY MASTER SWITCH POS. AFTER STARTING THE APU; I ATTEMPTED TO BRING THE APU GENERATOR ON-LINE. THERE WAS A LOT OF LOUD BANGING AS RELAYS WHICH WERE UNPOWERED; SUDDENLY WERE PWRED; AND IN THE PROCESS THE AIR DRIVEN GENERATOR DEPLOYED ON THE GND; AT THE GATE. ACFT WENT DEAD; APU GENERATOR CAME OFF-LINE; AND APU DIED. AFTER RE-PWRING THE ACFT AND TURNING THE BATTERY MASTER SWITCH ON AND COMPLETING THE REST OF THE CHKLISTS THROUGH STARTING ENGS (TO THE LINE); I ATTEMPTED TO PUSH OFF THE GATE. THE RAMP AGENTS SIGNALED ME WITH HAND SIGNALS I DID NOT COMPREHEND. ANOTHER PLT RADIOED OVER THE RAMP FREQ THAT OUR AIR DRIVEN GENERATOR WAS DEPLOYED. I SET THE PARKING BRAKE; EXITED THE ACFT AND OBSERVED THE AIR DRIVEN GENERATOR WAS DEPLOYED. I CALLED MAINT CTL; WROTE UP THE AIR DRIVEN GENERATOR AND SPOKE WITH CORP FLT SAFETY ABOUT THE ISSUE. CONTRIBUTING FACTOR -- MY FAILURE TO RUN THE ENTIRE FLT DECK SAFETY INSPECTION. LESSON LEARNED; AT THE EXPENSE OF A 1.25 HR DELAY. HENCEFORTH; I WILL ENSURE EVERY CHKLIST IS COMPLETED PROPERLY.
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.