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Attributes | |
ACN | 99813 |
Time | |
Date | 198812 |
Day | Sat |
Local Time Of Day | 0601 To 1200 |
Place | |
Locale Reference | atc facility : mgw |
State Reference | WV |
Altitude | msl bound lower : 11000 msl bound upper : 25000 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | tracon : iad |
Operator | common carrier : air carrier |
Make Model Name | Medium Large Transport, Low Wing, 2 Turbojet Eng |
Flight Phase | descent other |
Route In Use | arrival star : star |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp pilot : instrument pilot : commercial |
Experience | flight time last 90 days : 180 flight time total : 14300 flight time type : 9480 |
ASRS Report | 99813 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : commercial pilot : instrument |
Events | |
Anomaly | altitude deviation : crossing restriction not met non adherence : published procedure other spatial deviation |
Independent Detector | other flight crewa |
Resolutory Action | controller : issued new clearance none taken : detected after the fact |
Consequence | faa : reviewed incident with flight crew |
Supplementary | |
Primary Problem | Chart Or Publication |
Air Traffic Incident | other |
Narrative:
Contributing factors: 2 different arrival routes into the washington dc area with the same name, moderate radio congestion and strong tailwind/high ground speed. Narrative: we had been cleared from dtw to iad via V103 to phish, direct aco, J something to air, and then the aml 1 arrival to dulles. Approximately 50 NM west of air we were cleared direct to mgw. At that point I opened my manual to the armel 1 arrival. As luck would have it, I had opened my manual to the armel 1 into washington national. I did notice that the airport name was washington national, but assumed the arrival route just served both iad and dca, a situation I had run across at other airports. (Also, the arrival did go right over armel VOR which is located on dulles airport.) since there was no routing depicted after mgw my presumption was that we would be receiving vectors for, or to, the arrival route. Another common practice used by ATC to create desired aircraft spacing. However, as we approached to within 8 NM of mgw with no further instructions, I began the attempt to contact ATC (I believe we were on dulles approach at this point). Due to the usual radio traffic and a very strong tailwind (280 at 120 KTS at our cruise altitude, tapering off to 90 KTS at 18000') we were probably about 10 mi past mgw when I got through to ask for a vector. ATC didn't recognize my problem at this time and cleared us to cross mumsy intersection at 11000'. Not finding mumsy on the armel (dca) routing, I was thoroughly confused and told ATC I did not have that intersection or any routing out of mgw on my armel arrival chart. At this point my first officer, who had been off ATC frequency getting the ATIS, got back in the loop and realized I had the wrong armel 1 arrival. Having realized my mistake I suggested to ATC that the different arrival routes should have different names, to which they replied that they had been trying to get them changed, but so far had been unsuccessful. I turned to about a 45 degree intercept heading (for the proper course out of mgw) but was almost immediately cleared direct to armel with a crossing restriction of 11000' at 45 mi. Even though we started an immediate and steep descent, it was soon clear we could not make the restriction and advised ATC so. They amended the restriction to cross 40 DME at 11000', which was still not enough room to get down. I told the first officer to tell them we still could not make the restriction. Instead of making the call, he replied to me, 'oh, sure we'll make it.' he was entirely correct in that we were rapidly approaching 11000' and still had a few mi to go. However, what he did not realize was that in all the confusion of getting the routing straightened out and the desperate descent with a strong tailwind, that the target altitude of 11000' had escaped my mind and I was now shooting for the more common 10000' level off. Therefore his reply to my request was totally unexpected and just added further to the confusion. It is my custom to start level offs from steep dscnts at 2000' above the target altitude. We did pass through 11000' at a much reduced descent rate, and fortunately, almost simultaneously, ATC cleared us to 5000'. As I glanced at the altitude reminder to be sure it was reset to 5000' I saw the 11000' and realized what had happened. The rest of the flight to dulles was uneventful and routine. I did call the supervisor at dulles approach control to see if there were any problems concerning our flight (answer: no) and did get the distinct impression that this had happened before (although I did not ask for any details as I was somewhat embarrassed). Factors affecting human performance: once this chain of events started at mgw, the primary factor was confusion, compounded by lack of immediate access to ATC due to moderate radio congestion, first officer being out of the loop while he was getting the ATIS, and very little time due to strong tail winds and high ground speeds. Conclusion: although this flight did not result in an accident or incident, I feel that the current route names will probably continue to confuse pilots and at some point could unnecessarily cause, or contribute to, an avoidable incident or accident. Corrective actions: they primary factor that started this chain of events was the existence of 2 different arrs into the washington, dc area of the same name (armel 1 arrival). To me this defies common sense and rational logic. Clearly, one of the arrs should be renamed.
Original NASA ASRS Text
Title: 2 STAR ARR CHARTS NAMED ARMEL SERVING BOTH IAD AND DCA. PICKED WRONG CHART FOR DESCENT INTO IAD.
Narrative: CONTRIBUTING FACTORS: 2 DIFFERENT ARR ROUTES INTO THE WASHINGTON DC AREA WITH THE SAME NAME, MODERATE RADIO CONGESTION AND STRONG TAILWIND/HIGH GND SPD. NARRATIVE: WE HAD BEEN CLRED FROM DTW TO IAD VIA V103 TO PHISH, DIRECT ACO, J SOMETHING TO AIR, AND THEN THE AML 1 ARR TO DULLES. APPROX 50 NM W OF AIR WE WERE CLRED DIRECT TO MGW. AT THAT POINT I OPENED MY MANUAL TO THE ARMEL 1 ARR. AS LUCK WOULD HAVE IT, I HAD OPENED MY MANUAL TO THE ARMEL 1 INTO WASHINGTON NATL. I DID NOTICE THAT THE ARPT NAME WAS WASHINGTON NATL, BUT ASSUMED THE ARR ROUTE JUST SERVED BOTH IAD AND DCA, A SITUATION I HAD RUN ACROSS AT OTHER ARPTS. (ALSO, THE ARR DID GO RIGHT OVER ARMEL VOR WHICH IS LOCATED ON DULLES ARPT.) SINCE THERE WAS NO ROUTING DEPICTED AFTER MGW MY PRESUMPTION WAS THAT WE WOULD BE RECEIVING VECTORS FOR, OR TO, THE ARR ROUTE. ANOTHER COMMON PRACTICE USED BY ATC TO CREATE DESIRED ACFT SPACING. HOWEVER, AS WE APCHED TO WITHIN 8 NM OF MGW WITH NO FURTHER INSTRUCTIONS, I BEGAN THE ATTEMPT TO CONTACT ATC (I BELIEVE WE WERE ON DULLES APCH AT THIS POINT). DUE TO THE USUAL RADIO TFC AND A VERY STRONG TAILWIND (280 AT 120 KTS AT OUR CRUISE ALT, TAPERING OFF TO 90 KTS AT 18000') WE WERE PROBABLY ABOUT 10 MI PAST MGW WHEN I GOT THROUGH TO ASK FOR A VECTOR. ATC DIDN'T RECOGNIZE MY PROB AT THIS TIME AND CLRED US TO CROSS MUMSY INTXN AT 11000'. NOT FINDING MUMSY ON THE ARMEL (DCA) ROUTING, I WAS THOROUGHLY CONFUSED AND TOLD ATC I DID NOT HAVE THAT INTXN OR ANY ROUTING OUT OF MGW ON MY ARMEL ARR CHART. AT THIS POINT MY F/O, WHO HAD BEEN OFF ATC FREQ GETTING THE ATIS, GOT BACK IN THE LOOP AND REALIZED I HAD THE WRONG ARMEL 1 ARR. HAVING REALIZED MY MISTAKE I SUGGESTED TO ATC THAT THE DIFFERENT ARR ROUTES SHOULD HAVE DIFFERENT NAMES, TO WHICH THEY REPLIED THAT THEY HAD BEEN TRYING TO GET THEM CHANGED, BUT SO FAR HAD BEEN UNSUCCESSFUL. I TURNED TO ABOUT A 45 DEG INTERCEPT HDG (FOR THE PROPER COURSE OUT OF MGW) BUT WAS ALMOST IMMEDIATELY CLRED DIRECT TO ARMEL WITH A XING RESTRICTION OF 11000' AT 45 MI. EVEN THOUGH WE STARTED AN IMMEDIATE AND STEEP DSCNT, IT WAS SOON CLR WE COULD NOT MAKE THE RESTRICTION AND ADVISED ATC SO. THEY AMENDED THE RESTRICTION TO CROSS 40 DME AT 11000', WHICH WAS STILL NOT ENOUGH ROOM TO GET DOWN. I TOLD THE F/O TO TELL THEM WE STILL COULD NOT MAKE THE RESTRICTION. INSTEAD OF MAKING THE CALL, HE REPLIED TO ME, 'OH, SURE WE'LL MAKE IT.' HE WAS ENTIRELY CORRECT IN THAT WE WERE RAPIDLY APCHING 11000' AND STILL HAD A FEW MI TO GO. HOWEVER, WHAT HE DID NOT REALIZE WAS THAT IN ALL THE CONFUSION OF GETTING THE ROUTING STRAIGHTENED OUT AND THE DESPERATE DSCNT WITH A STRONG TAILWIND, THAT THE TARGET ALT OF 11000' HAD ESCAPED MY MIND AND I WAS NOW SHOOTING FOR THE MORE COMMON 10000' LEVEL OFF. THEREFORE HIS REPLY TO MY REQUEST WAS TOTALLY UNEXPECTED AND JUST ADDED FURTHER TO THE CONFUSION. IT IS MY CUSTOM TO START LEVEL OFFS FROM STEEP DSCNTS AT 2000' ABOVE THE TARGET ALT. WE DID PASS THROUGH 11000' AT A MUCH REDUCED DSCNT RATE, AND FORTUNATELY, ALMOST SIMULTANEOUSLY, ATC CLRED US TO 5000'. AS I GLANCED AT THE ALT REMINDER TO BE SURE IT WAS RESET TO 5000' I SAW THE 11000' AND REALIZED WHAT HAD HAPPENED. THE REST OF THE FLT TO DULLES WAS UNEVENTFUL AND ROUTINE. I DID CALL THE SUPVR AT DULLES APCH CTL TO SEE IF THERE WERE ANY PROBS CONCERNING OUR FLT (ANSWER: NO) AND DID GET THE DISTINCT IMPRESSION THAT THIS HAD HAPPENED BEFORE (ALTHOUGH I DID NOT ASK FOR ANY DETAILS AS I WAS SOMEWHAT EMBARRASSED). FACTORS AFFECTING HUMAN PERFORMANCE: ONCE THIS CHAIN OF EVENTS STARTED AT MGW, THE PRIMARY FACTOR WAS CONFUSION, COMPOUNDED BY LACK OF IMMEDIATE ACCESS TO ATC DUE TO MODERATE RADIO CONGESTION, F/O BEING OUT OF THE LOOP WHILE HE WAS GETTING THE ATIS, AND VERY LITTLE TIME DUE TO STRONG TAIL WINDS AND HIGH GND SPDS. CONCLUSION: ALTHOUGH THIS FLT DID NOT RESULT IN AN ACCIDENT OR INCIDENT, I FEEL THAT THE CURRENT ROUTE NAMES WILL PROBABLY CONTINUE TO CONFUSE PLTS AND AT SOME POINT COULD UNNECESSARILY CAUSE, OR CONTRIBUTE TO, AN AVOIDABLE INCIDENT OR ACCIDENT. CORRECTIVE ACTIONS: THEY PRIMARY FACTOR THAT STARTED THIS CHAIN OF EVENTS WAS THE EXISTENCE OF 2 DIFFERENT ARRS INTO THE WASHINGTON, DC AREA OF THE SAME NAME (ARMEL 1 ARR). TO ME THIS DEFIES COMMON SENSE AND RATIONAL LOGIC. CLEARLY, ONE OF THE ARRS SHOULD BE RENAMED.
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.