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37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
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| Attributes | |
| ACN | 333630 |
| Time | |
| Date | 199604 |
| Day | Wed |
| Local Time Of Day | 1201 To 1800 |
| Place | |
| Locale Reference | atc facility : zny |
| State Reference | NY |
| Altitude | msl bound lower : 14000 msl bound upper : 14000 |
| Environment | |
| Flight Conditions | VMC |
| Light | Daylight |
| Aircraft 1 | |
| Controlling Facilities | artcc : zny |
| Operator | common carrier : air carrier |
| Make Model Name | Commercial Fixed Wing |
| Operating Under FAR Part | Part 121 |
| Navigation In Use | Other Other |
| Flight Phase | climbout : intermediate altitude |
| Route In Use | enroute airway : zny |
| Flight Plan | IFR |
| Person 1 | |
| Affiliation | company : air carrier |
| Function | flight crew : captain oversight : pic |
| Qualification | pilot : atp pilot : commercial pilot : flight engineer pilot : instrument |
| Experience | flight time last 90 days : 250 flight time total : 19000 flight time type : 4000 |
| ASRS Report | 333630 |
| Person 2 | |
| Affiliation | company : air carrier |
| Function | flight crew : first officer |
| Qualification | pilot : commercial pilot : instrument |
| Events | |
| Anomaly | non adherence : published procedure non adherence : far other anomaly other |
| 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 | Pilot Deviation |
Narrative:
Climbing through approximately 14000 ft, the 'a' flight attendant called and asked if we knew the seatbelt sign was not on. Yes, indeed, it was not on -- how could that be? We had run the checklist. 'Seatbelt switch -- on' is a response on the before start checklist and we had run the list, so how was it missed? I usually physically touch the switch when challenged. Apparently this time I didn't and either did not check it or looked over the top of my bifocal sunglasses and thought it was in the 'on' position. Either way, it was not on. I asked the 'a' flight attendant when she noticed it and her response was, 'on taxi out.' I asked why didn't you say something? She said, 'I didn't want to bother you.' I try to give a very complete crew briefing prior to the trip and emphasize the importance of working as a team. This will have to be re-emphasized in later briefings. I will admit the entire crew was tired at this point. This was day 2 of 3. Day 1 was 12 hours plus and 8 hours flying time, minimum crew rest, 9 hours + 45 mins. Day 2 was 11 hours plus and I think the entire crew just wanted to get to the hotel and get some sleep. I know I slept 10 1/2 hours that night. The moral: fatigue, not paying enough attention to a checklist item (or not seeing what I thought I saw), and a breakdown in CRM caused an error -- a small one, but nevertheless an error. Attention and good CRM techniques should be the order of the day -- every day.
Original NASA ASRS Text
Title: MLG FLC NOTIFIED DURING CLB BY FLT ATTENDANT THE SEAT BELT SIGN WAS NOT ON FOR TKOF.
Narrative: CLBING THROUGH APPROX 14000 FT, THE 'A' FLT ATTENDANT CALLED AND ASKED IF WE KNEW THE SEATBELT SIGN WAS NOT ON. YES, INDEED, IT WAS NOT ON -- HOW COULD THAT BE? WE HAD RUN THE CHKLIST. 'SEATBELT SWITCH -- ON' IS A RESPONSE ON THE BEFORE START CHKLIST AND WE HAD RUN THE LIST, SO HOW WAS IT MISSED? I USUALLY PHYSICALLY TOUCH THE SWITCH WHEN CHALLENGED. APPARENTLY THIS TIME I DIDN'T AND EITHER DID NOT CHK IT OR LOOKED OVER THE TOP OF MY BIFOCAL SUNGLASSES AND THOUGHT IT WAS IN THE 'ON' POS. EITHER WAY, IT WAS NOT ON. I ASKED THE 'A' FLT ATTENDANT WHEN SHE NOTICED IT AND HER RESPONSE WAS, 'ON TAXI OUT.' I ASKED WHY DIDN'T YOU SAY SOMETHING? SHE SAID, 'I DIDN'T WANT TO BOTHER YOU.' I TRY TO GIVE A VERY COMPLETE CREW BRIEFING PRIOR TO THE TRIP AND EMPHASIZE THE IMPORTANCE OF WORKING AS A TEAM. THIS WILL HAVE TO BE RE-EMPHASIZED IN LATER BRIEFINGS. I WILL ADMIT THE ENTIRE CREW WAS TIRED AT THIS POINT. THIS WAS DAY 2 OF 3. DAY 1 WAS 12 HRS PLUS AND 8 HRS FLYING TIME, MINIMUM CREW REST, 9 HRS + 45 MINS. DAY 2 WAS 11 HRS PLUS AND I THINK THE ENTIRE CREW JUST WANTED TO GET TO THE HOTEL AND GET SOME SLEEP. I KNOW I SLEPT 10 1/2 HRS THAT NIGHT. THE MORAL: FATIGUE, NOT PAYING ENOUGH ATTN TO A CHKLIST ITEM (OR NOT SEEING WHAT I THOUGHT I SAW), AND A BREAKDOWN IN CRM CAUSED AN ERROR -- A SMALL ONE, BUT NEVERTHELESS AN ERROR. ATTN AND GOOD CRM TECHNIQUES SHOULD BE THE ORDER OF THE DAY -- EVERY DAY.
Data retrieved from NASA's ASRS site as of July 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.