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|
Attributes | |
ACN | 983251 |
Time | |
Date | 201112 |
Local Time Of Day | 0001-0600 |
Place | |
Locale Reference | ZZZ.Airport |
State Reference | US |
Aircraft 1 | |
Make Model Name | Regional Jet 700 ER/LR (CRJ700) |
Operating Under FAR Part | Part 121 |
Flight Phase | Taxi |
Route In Use | None |
Flight Plan | IFR |
Aircraft 2 | |
Make Model Name | MD-82 |
Operating Under FAR Part | Part 121 |
Flight Phase | Taxi Takeoff |
Flight Plan | IFR |
Person 1 | |
Function | Local |
Qualification | Air Traffic Control Fully Certified |
Events | |
Anomaly | ATC Issue All Types Conflict Ground Conflict Less Severe |
Narrative:
After beginning a mid shift; and less than 30 minutes after assuming responsibility for all east tower local and ground positions combined; I cleared a CRJ7 to land on runway 17C. Almost simultaneously; I taxied a MD82 to runway 17R; an action which would require a release from the west tower due to his SID. Another crj had landed prior to the CRJ7 and I had routed the other crj via taxiway's M and em with instructions to hold short runway 17R before I eventually crossed him and taxied him to the ramp. The CRJ7 touched down on runway 17C; exited at M3 high-speed and I instructed him to cross runway 17R at K8; then turn left on lima and remain on local east-1 frequency. Immediately afterwards; the MD82 reached runway 17R and I obtained a departure release from the west tower. I cleared the MD82 for take off with instructions to proceed to the first RNAV fix on his SID. I observed the CRJ7 turning westbound on K8 and remembered that I had given him permission to cross runway 17R. I immediately queried the MD82 as to whether or not they had crossed the hold-short line and when they responded in the affirmative I immediately canceled their take off clearance with instructions to 'taxi onto the runway' only. I then queried the CRJ7 as to whether he was still short of the runway 17R hold-short line and when he answered in the affirmative; I instructed him to 'hold short of runway 17R' which he acknowledged. I then re-cleared the MD82 for takeoff and when airborne; I instructed the CRJ7 to cross runway 17R and to remain on tower frequency. Honestly; this incident occurred largely due to fatigue from lack of sleep between my day shift and mid shift. For whatever reason; it was the previous crj's 'hold short' instruction and routing which my mind transposed over that which I had given to the CRJ7! In the future; I will utilize alertness aids such as caffeinated drinks or more rest between shifts to reduce the possibility of significant errors in judgment. While upset and shaken upon realizing this mistake; I do believe that my actions were timely in recognizing and correcting my mistake and prevented a loss of separation or runway incursion. As a rule; I don't believe that I fully grasped how physically and intellectually fatigued I was following my day shift. This incident; frankly; was terrifying to me and maximum alertness ensued immediately thereafter!
Original NASA ASRS Text
Title: Tower Controller described a near conflict event when issuing conflicting runway occupancy clearances; the reporter listing fatigue resulting from a quick turn from the day to mid shift as a causal factor.
Narrative: After beginning a mid shift; and less than 30 minutes after assuming responsibility for all East Tower Local and Ground positions combined; I cleared a CRJ7 to land on Runway 17C. Almost simultaneously; I taxied a MD82 to Runway 17R; an action which would require a release from the West Tower due to his SID. Another CRJ had landed prior to the CRJ7 and I had routed the other CRJ via Taxiway's M and EM with instructions to hold short Runway 17R before I eventually crossed him and taxied him to the ramp. The CRJ7 touched down on Runway 17C; exited at M3 high-speed and I instructed him to cross Runway 17R at K8; then turn left on Lima and remain on Local East-1 frequency. Immediately afterwards; the MD82 reached Runway 17R and I obtained a departure release from the West Tower. I cleared the MD82 for take off with instructions to proceed to the first RNAV fix on his SID. I observed the CRJ7 turning westbound on K8 and remembered that I had given him permission to cross Runway 17R. I immediately queried the MD82 as to whether or not they had crossed the hold-short line and when they responded in the affirmative I immediately canceled their take off clearance with instructions to 'taxi onto the runway' only. I then queried the CRJ7 as to whether he was still short of the Runway 17R hold-short line and when he answered in the affirmative; I instructed him to 'hold short of Runway 17R' which he acknowledged. I then re-cleared the MD82 for takeoff and when airborne; I instructed the CRJ7 to cross Runway 17R and to remain on Tower frequency. Honestly; this incident occurred largely due to fatigue from lack of sleep between my day shift and mid shift. For whatever reason; it was the previous CRJ's 'hold short' instruction and routing which my mind transposed over that which I had given to the CRJ7! In the future; I will utilize alertness aids such as caffeinated drinks or more rest between shifts to reduce the possibility of significant errors in judgment. While upset and shaken upon realizing this mistake; I do believe that my actions were timely in recognizing and correcting my mistake and prevented a loss of separation or runway incursion. As a rule; I don't believe that I fully grasped how physically and intellectually fatigued I was following my day shift. This incident; frankly; was terrifying to me and maximum alertness ensued immediately thereafter!
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.