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Attributes | |
ACN | 813442 |
Time | |
Date | 200811 |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : zzz.airport |
State Reference | US |
Altitude | agl single value : 0 |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | B737-500 |
Operating Under FAR Part | Part 121 |
Flight Phase | ground : parked ground : preflight ground : maintenance |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Experience | flight time last 90 days : 126 |
ASRS Report | 813442 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Experience | flight time last 90 days : 203 flight time type : 5500 |
ASRS Report | 813445 |
Events | |
Anomaly | aircraft equipment problem : critical non adherence : company policies non adherence : published procedure |
Independent Detector | aircraft equipment other aircraft equipment : engine instruments other flight crewa other flight crewb |
Resolutory Action | flight crew : took evasive action other |
Consequence | other other |
Supplementary | |
Problem Areas | Flight Crew Human Performance Aircraft |
Primary Problem | Flight Crew Human Performance |
Narrative:
During engine #2 start all was normal until I (captain) responded to the first officer calling starter cutout by saying start engine #1. I took my attention away from #2 egt (I really do try to note the peak egt) gauge to note N2 rotation on #1 engine at which I did not see any N2 rotation. I heard the first officer say; 'we're losing #2 engine;' while I was quickly scanning pack and bleed switches; anything to cause zero N2 rotation on #1. The first officer stated engine #2 was spooling down so I looked to engine #2 instruments and noted egt rapidly rising toward the top of the green band and I quickly moved the start lever to cutout at which time the egt kept climbing to peak out at approximately 910 and immediately started dropping. I then called for QRH aborted engine start checklist which we then accomplished. I talked to the passenger while the first officer called operations and maintenance. We returned to the gate; I wrote up the event in the logbook; called dispatch; and explained to the mechanic what happened. We changed aircraft and continued our trip. Both of us have tried to figure out and I still do not understand what caused no N2 rotation on engine #1 or what caused engine #2 to spool down. I do know that I could have prevented engine #2 over-temperature by not letting myself be distraction. I should have stayed with engine #2 until rollback; then try to take care of engine #1. Possible procedure is to not call for second engine start until rollback on the first engine is verified. Supplemental information from acn 813445: looking back; the communication on the engine failure could have been clrer; prompting captain to initiate the aborted engine start before the rapid rise in egt. We also let the no rotation on engine #1 distract us from the more serious problem on engine #2.
Original NASA ASRS Text
Title: A B737-500'S NUMBER 2 ENG STALLED ON START WHILE ATTEMPTING TO START NUMBER ONE ENG THAT WAS NOT ROTATING AND DISTRACTING THE CREW. THE NUMBER TWO ENG SUBSEQUENTLY OVER-TEMPED.
Narrative: DURING ENG #2 START ALL WAS NORMAL UNTIL I (CAPT) RESPONDED TO THE FO CALLING STARTER CUTOUT BY SAYING START ENG #1. I TOOK MY ATTN AWAY FROM #2 EGT (I REALLY DO TRY TO NOTE THE PEAK EGT) GAUGE TO NOTE N2 ROTATION ON #1 ENG AT WHICH I DID NOT SEE ANY N2 ROTATION. I HEARD THE FO SAY; 'WE'RE LOSING #2 ENG;' WHILE I WAS QUICKLY SCANNING PACK AND BLEED SWITCHES; ANYTHING TO CAUSE ZERO N2 ROTATION ON #1. THE FO STATED ENG #2 WAS SPOOLING DOWN SO I LOOKED TO ENG #2 INSTS AND NOTED EGT RAPIDLY RISING TOWARD THE TOP OF THE GREEN BAND AND I QUICKLY MOVED THE START LEVER TO CUTOUT AT WHICH TIME THE EGT KEPT CLBING TO PEAK OUT AT APPROX 910 AND IMMEDIATELY STARTED DROPPING. I THEN CALLED FOR QRH ABORTED ENG START CHKLIST WHICH WE THEN ACCOMPLISHED. I TALKED TO THE PAX WHILE THE FO CALLED OPS AND MAINT. WE RETURNED TO THE GATE; I WROTE UP THE EVENT IN THE LOGBOOK; CALLED DISPATCH; AND EXPLAINED TO THE MECH WHAT HAPPENED. WE CHANGED ACFT AND CONTINUED OUR TRIP. BOTH OF US HAVE TRIED TO FIGURE OUT AND I STILL DO NOT UNDERSTAND WHAT CAUSED NO N2 ROTATION ON ENG #1 OR WHAT CAUSED ENG #2 TO SPOOL DOWN. I DO KNOW THAT I COULD HAVE PREVENTED ENG #2 OVER-TEMP BY NOT LETTING MYSELF BE DISTR. I SHOULD HAVE STAYED WITH ENG #2 UNTIL ROLLBACK; THEN TRY TO TAKE CARE OF ENG #1. POSSIBLE PROC IS TO NOT CALL FOR SECOND ENG START UNTIL ROLLBACK ON THE FIRST ENG IS VERIFIED. SUPPLEMENTAL INFO FROM ACN 813445: LOOKING BACK; THE COM ON THE ENG FAILURE COULD HAVE BEEN CLRER; PROMPTING CAPT TO INITIATE THE ABORTED ENG START BEFORE THE RAPID RISE IN EGT. WE ALSO LET THE NO ROTATION ON ENG #1 DISTRACT US FROM THE MORE SERIOUS PROB ON ENG #2.
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.