37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 90363 |
Time | |
Date | 198807 |
Day | Mon |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : ord |
State Reference | IL |
Altitude | agl bound lower : 0 agl bound upper : 0 |
Environment | |
Light | Daylight |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | Medium Large Transport, Low Wing, 2 Turbojet Eng |
Flight Phase | ground : preflight |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 120 flight time total : 8000 |
ASRS Report | 90363 |
Person 2 | |
Affiliation | company : air carrier |
Function | other personnel other |
Qualification | other other : other |
Events | |
Anomaly | aircraft equipment problem : less severe |
Independent Detector | other other : unspecified |
Resolutory Action | none taken : detected after the fact |
Consequence | Other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | other |
Narrative:
The APU of this medium large transport was only able to supply pneumatics so that ground power was plugged in and used at the gate. The mechanic and I discussed whether to start 1 engine or both engines at the gate and he preferred starting both. He mentioned that after engine generators were on line that he would remove ground power. Since we were both concerned with on time departures, the sooner we could get ground power removed the sooner we could get ramp clearance for pushback. We started both engines after completing the before start and before pushback/taxi checklists. As previously discussed with the mechanic, I got both generators on the line and checked them for output and then, evidently, turned on both 'a' hydraulic pumps. Normally the 'a' pumps are turned on immediately after the generators are selected and checked. I told the mechanic that he was clear to disconnect the ground power. We got pushback clearance from the ramp and we pushed back about 20' at which time a distinct noise was heard under us. The mechanic then pulled us back into the gate. The tow bar shear bolts were removed and replaced since they had sheared because the 'a' system was pressurized. No other damage occurred to the aircraft and no injury resulted. The incident occurred by using normal 'flow pattern' procedures during an abnormal condition. There is no written procedure in our manual for the APU elec inoperative start. The first officer was in his first month in that seat. I suggest that during any abnormal condition, where switches are positioned differently from normal, that applicable checklists be repeated as necessary. Had I called for the before pushback checklist after the engines were started and the generators switched (and 'a' pumps turned on), I would have caught the problem.
Original NASA ASRS Text
Title: ACR MLG TOW BAR DAMAGED BECAUSE ACFT HYDRAULIC SYSTEM WAS PRESSURIZED DURING PUSHBACK.
Narrative: THE APU OF THIS MLG WAS ONLY ABLE TO SUPPLY PNEUMATICS SO THAT GND PWR WAS PLUGGED IN AND USED AT THE GATE. THE MECHANIC AND I DISCUSSED WHETHER TO START 1 ENG OR BOTH ENGS AT THE GATE AND HE PREFERRED STARTING BOTH. HE MENTIONED THAT AFTER ENG GENERATORS WERE ON LINE THAT HE WOULD REMOVE GND PWR. SINCE WE WERE BOTH CONCERNED WITH ON TIME DEPS, THE SOONER WE COULD GET GND PWR REMOVED THE SOONER WE COULD GET RAMP CLRNC FOR PUSHBACK. WE STARTED BOTH ENGS AFTER COMPLETING THE BEFORE START AND BEFORE PUSHBACK/TAXI CHKLISTS. AS PREVIOUSLY DISCUSSED WITH THE MECH, I GOT BOTH GENERATORS ON THE LINE AND CHKED THEM FOR OUTPUT AND THEN, EVIDENTLY, TURNED ON BOTH 'A' HYD PUMPS. NORMALLY THE 'A' PUMPS ARE TURNED ON IMMEDIATELY AFTER THE GENERATORS ARE SELECTED AND CHKED. I TOLD THE MECH THAT HE WAS CLEAR TO DISCONNECT THE GND PWR. WE GOT PUSHBACK CLRNC FROM THE RAMP AND WE PUSHED BACK ABOUT 20' AT WHICH TIME A DISTINCT NOISE WAS HEARD UNDER US. THE MECH THEN PULLED US BACK INTO THE GATE. THE TOW BAR SHEAR BOLTS WERE REMOVED AND REPLACED SINCE THEY HAD SHEARED BECAUSE THE 'A' SYS WAS PRESSURIZED. NO OTHER DAMAGE OCCURRED TO THE ACFT AND NO INJURY RESULTED. THE INCIDENT OCCURRED BY USING NORMAL 'FLOW PATTERN' PROCS DURING AN ABNORMAL CONDITION. THERE IS NO WRITTEN PROC IN OUR MANUAL FOR THE APU ELEC INOP START. THE F/O WAS IN HIS FIRST MONTH IN THAT SEAT. I SUGGEST THAT DURING ANY ABNORMAL CONDITION, WHERE SWITCHES ARE POSITIONED DIFFERENTLY FROM NORMAL, THAT APPLICABLE CHKLISTS BE REPEATED AS NECESSARY. HAD I CALLED FOR THE BEFORE PUSHBACK CHKLIST AFTER THE ENGS WERE STARTED AND THE GENERATORS SWITCHED (AND 'A' PUMPS TURNED ON), I WOULD HAVE CAUGHT THE PROB.
Data retrieved from NASA's ASRS site as of August 2007 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.