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|
Attributes | |
ACN | 90386 |
Time | |
Date | 198802 |
Day | Sat |
Local Time Of Day | 0601 To 1200 |
Place | |
Locale Reference | airport : sjc |
State Reference | CA |
Altitude | msl bound lower : 2000 msl bound upper : 5000 |
Environment | |
Flight Conditions | Mixed |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | tracon : oak |
Operator | common carrier : air carrier |
Make Model Name | Widebody, Low Wing, 2 Turbojet Eng |
Navigation In Use | Other Other |
Flight Phase | climbout : intermediate altitude |
Route In Use | departure sid : sid |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 300 flight time total : 10000 flight time type : 150 |
ASRS Report | 90386 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp pilot : flight engineer |
Experience | flight time last 90 days : 45 flight time total : 9600 flight time type : 67 |
ASRS Report | 90649 |
Events | |
Anomaly | non adherence : clearance non adherence : published procedure other spatial deviation |
Independent Detector | other flight crewa |
Resolutory Action | flight crew : returned to intended course or assigned course |
Consequence | Other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
The sjc 4--runway 30L--departure is known among airline crews as a tough one, but I have made it several times and was comfortable with it, so chose to fly the departure as the first officer had only 50 hours in the aircraft and had not been out of sjc recently. The widebody transport has a moving map display for latitude navigation and while at first skeptical, I was gaining confidence in it and chose to follow it on departure (previously, I had gone to manual VOR for this departure). After departure and what seemed like enough time to fly 2 1/2 mi for the first turn, the map display still did not call for it. I brought the VOR/DME into view and found we were already 5 mi out (this turn is to be completed in 4 mi). Adding to the above problem, this was a new adv widebody transport with a third more thrust than previous models and the company procedure had called for a full power to off. This added up to greater ground speed and acceleration to 250 KTS faster than I had planned. Also a low overcast prevented any ground tracking of known reference points. But, probably the most important cause of this incident was a XA00 am get up after a fitful few hours of sleep. I've noted that most everyone starting a physical/mental task get a chance to warm up (baseball pitchers, golfers, etc--even a simulator session starts with a few steep turns). I believe the bottom line was that I wasn't mentally ready to go flying. We spend millions on hardware for safety, but the crew schedulers are still just filling the squares regardless of one's body clock! Note: I've not yet flown the departure again to watch the map display, but from reviewing it in the plan mode, it appears to be programmed in error. Supplemental information from acn 90649: my recommendations to my fellow pilots flying new, high performance aircraft: conduct a detailed pre-departure briefing with the captain when flying an unfamiliar procedure. Discuss how the procedure is to be flown, and what navigation instruments will be used. Do not be rushed before takeoff!!! Take a delay and talk it out. If in doubt, don't be afraid to turn off the FMS and go back to basic flying. Use the automation as an effective tool. When the tool does not fit the job, change tools. Know the profile you must fly for the departure. Be prepared to keep up with the performance of your aircraft.
Original NASA ASRS Text
Title: ACR WDB OVERSHOT TURN ON SID.
Narrative: THE SJC 4--RWY 30L--DEP IS KNOWN AMONG AIRLINE CREWS AS A TOUGH ONE, BUT I HAVE MADE IT SEVERAL TIMES AND WAS COMFORTABLE WITH IT, SO CHOSE TO FLY THE DEP AS THE F/O HAD ONLY 50 HRS IN THE ACFT AND HAD NOT BEEN OUT OF SJC RECENTLY. THE WDB HAS A MOVING MAP DISPLAY FOR LAT NAV AND WHILE AT FIRST SKEPTICAL, I WAS GAINING CONFIDENCE IN IT AND CHOSE TO FOLLOW IT ON DEP (PREVIOUSLY, I HAD GONE TO MANUAL VOR FOR THIS DEP). AFTER DEP AND WHAT SEEMED LIKE ENOUGH TIME TO FLY 2 1/2 MI FOR THE FIRST TURN, THE MAP DISPLAY STILL DID NOT CALL FOR IT. I BROUGHT THE VOR/DME INTO VIEW AND FOUND WE WERE ALREADY 5 MI OUT (THIS TURN IS TO BE COMPLETED IN 4 MI). ADDING TO THE ABOVE PROB, THIS WAS A NEW ADV WDB WITH A THIRD MORE THRUST THAN PREVIOUS MODELS AND THE COMPANY PROC HAD CALLED FOR A FULL PWR TO OFF. THIS ADDED UP TO GREATER GND SPD AND ACCELERATION TO 250 KTS FASTER THAN I HAD PLANNED. ALSO A LOW OVCST PREVENTED ANY GND TRACKING OF KNOWN REFERENCE POINTS. BUT, PROBABLY THE MOST IMPORTANT CAUSE OF THIS INCIDENT WAS A XA00 AM GET UP AFTER A FITFUL FEW HRS OF SLEEP. I'VE NOTED THAT MOST EVERYONE STARTING A PHYSICAL/MENTAL TASK GET A CHANCE TO WARM UP (BASEBALL PITCHERS, GOLFERS, ETC--EVEN A SIMULATOR SESSION STARTS WITH A FEW STEEP TURNS). I BELIEVE THE BOTTOM LINE WAS THAT I WASN'T MENTALLY READY TO GO FLYING. WE SPEND MILLIONS ON HARDWARE FOR SAFETY, BUT THE CREW SCHEDULERS ARE STILL JUST FILLING THE SQUARES REGARDLESS OF ONE'S BODY CLOCK! NOTE: I'VE NOT YET FLOWN THE DEP AGAIN TO WATCH THE MAP DISPLAY, BUT FROM REVIEWING IT IN THE PLAN MODE, IT APPEARS TO BE PROGRAMMED IN ERROR. SUPPLEMENTAL INFO FROM ACN 90649: MY RECOMMENDATIONS TO MY FELLOW PLTS FLYING NEW, HIGH PERFORMANCE ACFT: CONDUCT A DETAILED PRE-DEP BRIEFING WITH THE CAPT WHEN FLYING AN UNFAMILIAR PROC. DISCUSS HOW THE PROC IS TO BE FLOWN, AND WHAT NAV INSTRUMENTS WILL BE USED. DO NOT BE RUSHED BEFORE TKOF!!! TAKE A DELAY AND TALK IT OUT. IF IN DOUBT, DON'T BE AFRAID TO TURN OFF THE FMS AND GO BACK TO BASIC FLYING. USE THE AUTOMATION AS AN EFFECTIVE TOOL. WHEN THE TOOL DOES NOT FIT THE JOB, CHANGE TOOLS. KNOW THE PROFILE YOU MUST FLY FOR THE DEP. BE PREPARED TO KEEP UP WITH THE PERFORMANCE OF YOUR ACFT.
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.