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|
Attributes | |
ACN | 816282 |
Time | |
Date | 200812 |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : zzz.airport |
State Reference | US |
Altitude | msl single value : 34000 |
Environment | |
Flight Conditions | IMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | artcc : zzz.artcc |
Operator | other |
Make Model Name | MD-80 Series (DC-9-80) Undifferentiated or Other Model |
Operating Under FAR Part | Part 121 |
Flight Phase | cruise : level |
Flight Plan | IFR |
Person 1 | |
Affiliation | government : military |
Function | flight crew : first officer |
Qualification | pilot : instrument pilot : commercial |
Experience | flight time last 90 days : 70 flight time total : 2900 flight time type : 160 |
ASRS Report | 816282 |
Events | |
Anomaly | aircraft equipment problem : less severe altitude deviation : excursion from assigned altitude |
Independent Detector | other flight crewa |
Resolutory Action | aircraft : equipment problem dissipated flight crew : returned to assigned altitude |
Consequence | other |
Supplementary | |
Problem Areas | Aircraft Flight Crew Human Performance |
Primary Problem | Aircraft |
Narrative:
At FL340; in the vicinity of ZZZ VORTAC. Aircraft commander left cockpit momentarily for lavatory use. Copilot was monitoring instruments when 2 minutes later GPWS system was activated; stating 'terrain; terrain; terrain; pull up; pull up; pull up.' copilot instinctively performed immediate action steps for GPWS activation then realized that it was a faulty system failure. Copilot immediately initiated recovery back to assigned altitude and heading. Aircraft deviated 800 ft above assigned altitude. Aircraft commander relayed to ATC deviation of altitude and return back to assigned altitude and heading. No other instructions were provided by ATC. C-9B natops states that GPWS alarm needs to be acted upon with immediate action steps which pilots are trained to respond to immediately. However; copilot's situational awareness was focused more on immediate execution of action items instead of realizing that aircraft was at FL340 and; therefore; only a system failure. Copilot affected by human factors to include shift in circadian rhythm; multiple time zone changes in 5 days; and emphasis on action versus careful evaluation of alarm with corresponding emergency steps. Had copilot paused for a minute and recognized that no such terrain is possible at FL340; no action would have been taken. However; due to intensive simulated training in emergency procedures; immediate action steps of GPWS alarm warning were performed automatically and in accordance with natops flight manual. Had steps been performed during a final approach in IMC near actual terrain; CFIT would have been avoided.
Original NASA ASRS Text
Title: First Officer of C-9b (military DC-9-30) reacts inappropriately to false GPWS Terrain Warning while in cruise at FL340. Reporter cites fatigue and diurnal desynchronosis for the loss of situational awareness.
Narrative: At FL340; in the vicinity of ZZZ VORTAC. Aircraft Commander left cockpit momentarily for lavatory use. Copilot was monitoring instruments when 2 minutes later GPWS system was activated; stating 'Terrain; Terrain; Terrain; Pull Up; Pull Up; Pull Up.' Copilot instinctively performed immediate action steps for GPWS activation then realized that it was a faulty system failure. Copilot immediately initiated recovery back to assigned altitude and heading. Aircraft deviated 800 FT above assigned altitude. Aircraft Commander relayed to ATC deviation of altitude and return back to assigned altitude and heading. No other instructions were provided by ATC. C-9B NATOPS states that GPWS alarm needs to be acted upon with immediate action steps which pilots are trained to respond to immediately. However; Copilot's situational awareness was focused more on immediate execution of action items instead of realizing that aircraft was at FL340 and; therefore; only a system failure. Copilot affected by human factors to include shift in circadian rhythm; multiple time zone changes in 5 days; and emphasis on action versus careful evaluation of alarm with corresponding emergency steps. Had Copilot paused for a minute and recognized that no such terrain is possible at FL340; no action would have been taken. However; due to intensive simulated training in emergency procedures; immediate action steps of GPWS alarm warning were performed automatically and in accordance with NATOPS Flight Manual. Had steps been performed during a final approach in IMC near actual terrain; CFIT would have been avoided.
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.