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|
Attributes | |
ACN | 854525 |
Time | |
Date | 200907 |
Local Time Of Day | 1201-1800 |
Place | |
Locale Reference | ZZZZ.ARTCC |
State Reference | FO |
Environment | |
Flight Conditions | VMC |
Aircraft 1 | |
Make Model Name | B777-200 |
Operating Under FAR Part | Part 121 |
Flight Phase | Cruise |
Route In Use | Oceanic |
Flight Plan | IFR |
Component | |
Aircraft Component | Cabin Lighting |
Person 1 | |
Function | Captain Check Pilot Pilot Not Flying |
Experience | Flight Crew Last 90 Days 240 Flight Crew Total 17000 Flight Crew Type 3200 |
Events | |
Anomaly | Aircraft Equipment Problem Less Severe Deviation - Procedural Published Material / Policy Flight Deck / Cabin / Aircraft Event Smoke / Fire / Fumes / Odor |
Narrative:
I diverted with fumes in lavatory 2L; for which I filed a report. After the event and having given some thought to how the crew performed; I came to the conclusion that the divert was preventable and there were many lessons to be learned. I talked with mr. X a couple of days ago about the divert and he recommended that another report be filed as there were many factual items that could be reviewed; therefore this is an addendum to the original report. The faom (flight attendant operating manual) contains a smoke and fumes section in the emergency procedures section and it specifically addressed the problem of malfunctioning fluorescent bulbs. Following the guidance in the faom would have prevented the divert. There were 12 flight attendants on board and not one of them offered us their faom to help trouble shoot the problem. Once a pilot shows up in the cabin; the flight attendants are basically done. Flight attendants are not professional trouble shooters; pilots are. Their one day of recurrent leaves little time for trouble shooting exercises. This actual divert might be used in their recurrent training. They are totally unaware that the pilot smoke fume checklist is completely different from theirs. Most pilots are totally unaware that there are two different checklists for smoke/fire. A pilot's checklist gets the aircraft on the ground as soon as possible. The flight attendants' checklist is superior for actually troubleshooting the problem. At a check airman meeting I asked for a show of hands of who had ever looked in a faom and the response was 10-20%. I recommend on IOE's that the faom should be brought to the cockpit to be reviewed so the student is aware of content. This requirement should be in the IOE checklist. There should be a review of the faom emergency section and if there is useful info then there should be a reference in the pilot checklist to review faom info. The electrical fumes in lavatory 2L emanated from a malfunctioning mirror fluorescent light and the counter top causing the fumes. On the B777 there is a sliding switch on the door frame and its' function is to turn the mirror light on when the lavatory door is locked. On the ground all lavatory lights work irrespective of switch position. In flight the switch should be down so the lavatory mirror light extinguishes when the lavatory is empty. If the switch is in the up position the lavatory light illuminates continuously; door open or closed. On the divert the switch was in the up position which means that the light was illuminating 24 hours a day. Recommendations: in the flight attendant inspection of lavatories insert reference to moving the switch to down position on every preflight. Address this switch position in recurrent. Insert in faom. Insert in IOE cabin inspection checklist. Insert in IOE checklist light removal demo. If I had been shown how to remove light cover and light on my IOE; this divert could have been prevented.
Original NASA ASRS Text
Title: B777 Check Airman has additional comments concerning a divert due to a florescent light in the 2L lavatory. He believes that the diversion was preventable had he been aware of the information available in the Flight Attendant Operations Manual.
Narrative: I diverted with fumes in lavatory 2L; for which I filed a report. After the event and having given some thought to how the crew performed; I came to the conclusion that the divert was preventable and there were many lessons to be learned. I talked with Mr. X a couple of days ago about the divert and he recommended that another report be filed as there were many factual items that could be reviewed; therefore this is an addendum to the original report. The FAOM (Flight Attendant Operating Manual) contains a smoke and fumes section in the emergency procedures section and it specifically addressed the problem of malfunctioning fluorescent bulbs. Following the guidance in the FAOM would have prevented the divert. There were 12 Flight Attendants on board and not one of them offered us their FAOM to help trouble shoot the problem. Once a pilot shows up in the cabin; the Flight Attendants are basically done. Flight Attendants are not professional trouble shooters; pilots are. Their one day of recurrent leaves little time for trouble shooting exercises. This actual divert might be used in their recurrent training. They are totally unaware that the pilot smoke fume checklist is completely different from theirs. Most pilots are totally unaware that there are two different checklists for smoke/fire. A pilot's checklist gets the aircraft on the ground ASAP. The Flight Attendants' checklist is superior for actually troubleshooting the problem. At a Check Airman meeting I asked for a show of hands of who had ever looked in a FAOM and the response was 10-20%. I recommend on IOE's that the FAOM should be brought to the cockpit to be reviewed so the student is aware of content. This requirement should be in the IOE checklist. There should be a review of the FAOM emergency section and if there is useful info then there should be a reference in the pilot checklist to review FAOM info. The electrical fumes in lavatory 2L emanated from a malfunctioning mirror fluorescent light and the counter top causing the fumes. On the B777 there is a sliding switch on the door frame and its' function is to turn the mirror light on when the lavatory door is locked. On the ground all lavatory lights work irrespective of switch position. In flight the switch should be down so the lavatory mirror light extinguishes when the lavatory is empty. If the switch is in the up position the lavatory light illuminates continuously; door open or closed. On the divert the switch was in the up position which means that the light was illuminating 24 hours a day. Recommendations: In the flight attendant inspection of lavatories insert reference to moving the switch to down position on every preflight. Address this switch position in recurrent. Insert in FAOM. Insert in IOE cabin inspection checklist. Insert in IOE checklist light removal demo. If I had been shown how to remove light cover and light on my IOE; this divert could have been prevented.
Data retrieved from NASA's ASRS site as of April 2012 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.