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An air carrier metropolitan III SA227 captain moved an ignition switch without reading the switch label. Error admitted.
| Attributes | |
| ACN | 342427 |
| Time | |
| Date | 199607 |
| Day | Sun |
| Local Time Of Day | 0601 To 1200 |
| Place | |
| Locale Reference | atc facility : ena |
| State Reference | AK |
| Altitude | msl bound lower : 18000 msl bound upper : 20000 |
| Environment | |
| Flight Conditions | Mixed |
| Light | Daylight |
| Aircraft 1 | |
| Controlling Facilities | artcc : zan |
| Operator | common carrier : air carrier |
| Make Model Name | SA-227 AC Metro III |
| Operating Under FAR Part | Part 135 |
| Flight Phase | descent other |
| Route In Use | enroute airway : zan |
| Flight Plan | IFR |
| Person 1 | |
| Affiliation | company : air carrier |
| Function | flight crew : captain oversight : pic |
| Qualification | pilot : atp |
| Experience | flight time last 90 days : 400 flight time total : 5000 flight time type : 1000 |
| ASRS Report | 342427 |
| Person 2 | |
| Affiliation | company : air carrier |
| Function | flight crew : first officer |
| Qualification | pilot : commercial pilot : instrument |
| Events | |
| Anomaly | aircraft equipment problem : less severe non adherence : published procedure other anomaly other |
| Independent Detector | aircraft equipment other aircraft equipment : unspecified other flight crewa |
| Resolutory Action | flight crew : overcame equipment problem |
| Consequence | Other |
| Supplementary | |
| Primary Problem | Aircraft |
| Air Traffic Incident | Pilot Deviation |
Narrative:
Level at FL200 on J-115 about 80 NM southwest of ena. The cloud tops slowly began to come up and before long we were just skimming the tops. We had gotten a light dusting of ice in the tops, so I requested that the first officer request 18000 ft to get blow the layer of clouds. He did so and I started the descent. I moved the igniter switches to the 'center' position and turned the left engine heat on. I looked out the window to see if the ice was starting to melt yet when the left engine quit. At that instant I realized what had happened. We went through the procedure of feathering and using the checklist to restart. The engine started normally and the flight was continued normally. The error was that I allowed myself to get into a mindset of habit. On this particular flight, we were in the only airplane in the fleet that has the normal-con-override ignition system and out of habit, I just put the igniter switches in the center position (instead of override). I was just so used to the rest of the fleet where the center position gives you 'cont' or 'on.'
Original NASA ASRS Text
Title: AN ACR METRO III SA227 CAPT MOVED AN IGNITION SWITCH WITHOUT READING THE SWITCH LABEL. ERROR ADMITTED.
Narrative: LEVEL AT FL200 ON J-115 ABOUT 80 NM SW OF ENA. THE CLOUD TOPS SLOWLY BEGAN TO COME UP AND BEFORE LONG WE WERE JUST SKIMMING THE TOPS. WE HAD GOTTEN A LIGHT DUSTING OF ICE IN THE TOPS, SO I REQUESTED THAT THE FO REQUEST 18000 FT TO GET BLOW THE LAYER OF CLOUDS. HE DID SO AND I STARTED THE DSCNT. I MOVED THE IGNITER SWITCHES TO THE 'CTR' POS AND TURNED THE L ENG HEAT ON. I LOOKED OUT THE WINDOW TO SEE IF THE ICE WAS STARTING TO MELT YET WHEN THE L ENG QUIT. AT THAT INSTANT I REALIZED WHAT HAD HAPPENED. WE WENT THROUGH THE PROC OF FEATHERING AND USING THE CHKLIST TO RESTART. THE ENG STARTED NORMALLY AND THE FLT WAS CONTINUED NORMALLY. THE ERROR WAS THAT I ALLOWED MYSELF TO GET INTO A MINDSET OF HABIT. ON THIS PARTICULAR FLT, WE WERE IN THE ONLY AIRPLANE IN THE FLEET THAT HAS THE NORMAL-CON-OVERRIDE IGNITION SYS AND OUT OF HABIT, I JUST PUT THE IGNITER SWITCHES IN THE CTR POS (INSTEAD OF OVERRIDE). I WAS JUST SO USED TO THE REST OF THE FLEET WHERE THE CTR POS GIVES YOU 'CONT' OR 'ON.'
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.