Heading track deviation during task saturation with abnormal SOP's B737-200 in ZNY airspace.

Attributes
ACN	452569
Time
Date	199910
Day	Sun
Local Time Of Day	0601 To 1200
Place
Locale Reference	navaid : rbv.vortac
State Reference	NJ
Altitude	msl single value : 26000
Environment
Flight Conditions	VMC
Light	Daylight
Aircraft 1
Controlling Facilities	artcc : zny.artcc
Operator	common carrier : air carrier
Make Model Name	B737-200
Operating Under FAR Part	Part 121
Flight Phase	climbout : vacating altitude
Flight Plan	IFR
Person 1
Affiliation	company : air carrier
Function	flight crew : captain oversight : pic
Qualification	pilot : atp
Experience	flight time last 90 days : 200 flight time total : 5000 flight time type : 1800
ASRS Report	452569
Person 2
Affiliation	company : air carrier
Function	flight crew : first officer
Qualification	pilot : multi engine pilot : instrument pilot : commercial
Events
Anomaly	aircraft equipment problem : less severe non adherence : far non adherence : clearance other spatial deviation
Independent Detector	atc equipment other atc equipment : radar aircraft equipment other aircraft equipment : master caution other controllera other flight crewa
Resolutory Action	controller : issued new clearance controller : issued advisory flight crew : returned to original clearance
Consequence	faa : reviewed incident with flight crew other
Supplementary
Problem Areas	Aircraft Flight Crew Human Performance
Primary Problem	Ambiguous

Narrative:

Air carrier B737 departed isp, filed routing was 'isp direct sbj J75 gso direct irq....' flight plan clearance 'isp direct beads direct rbj J230 J75 gso direct irq...long island 3 departure. While flying direct to rbv VOR and climbing through approximately FL240, we got a master caution light and a 'mach trim fail light.' following briefed procedures, the first officer (PF) assumed control of ATC communications while the captain (PNF) referenced aircraft manuals to resolve aircraft abnormal procedure. Navigation deviation error resulted from first officer tracking the 230 degree radial off of rbv rather than J230 off of rbv. The captain (PNF) was first to recognize the deviation but crew was unable to correct before ZNY (frequency 125.32) queried and subsequently issued a vector (310 degrees I think) to join J230. Contributing factors/chain of events: demanding northeast corridor. Intensive workload on ground operations (1/4 mi visibility at takeoff). Clearance routing different than filed. Jet route to jet route clearance. Poorly marked en route chart (J230 3 inches west of rbv, 3 intxns away). Aircraft abnormal mach trim fail. First officer failure to xref his navigation with captain's (captain's outbound dialed in correctly). Captain failure to monitor first officer while following abnormal procedure. Human factors: 'let down' in performance after intensive ground operations. Focusing on aircraft abnormal procedure without attention to navigation. Very experienced first officer causing captain to let down his guard.

Original NASA ASRS Text

Title: HDG TRACK DEV DURING TASK SATURATION WITH ABNORMAL SOP'S B737-200 IN ZNY AIRSPACE.

Narrative: ACR B737 DEPARTED ISP, FILED ROUTING WAS 'ISP DIRECT SBJ J75 GSO DIRECT IRQ....' FLT PLAN CLRNC 'ISP DIRECT BEADS DIRECT RBJ J230 J75 GSO DIRECT IRQ...LONG ISLAND 3 DEP. WHILE FLYING DIRECT TO RBV VOR AND CLBING THROUGH APPROX FL240, WE GOT A MASTER CAUTION LIGHT AND A 'MACH TRIM FAIL LIGHT.' FOLLOWING BRIEFED PROCS, THE FO (PF) ASSUMED CTL OF ATC COMS WHILE THE CAPT (PNF) REFED ACFT MANUALS TO RESOLVE ACFT ABNORMAL PROC. NAV DEV ERROR RESULTED FROM FO TRACKING THE 230 DEG RADIAL OFF OF RBV RATHER THAN J230 OFF OF RBV. THE CAPT (PNF) WAS FIRST TO RECOGNIZE THE DEV BUT CREW WAS UNABLE TO CORRECT BEFORE ZNY (FREQ 125.32) QUERIED AND SUBSEQUENTLY ISSUED A VECTOR (310 DEGS I THINK) TO JOIN J230. CONTRIBUTING FACTORS/CHAIN OF EVENTS: DEMANDING NE CORRIDOR. INTENSIVE WORKLOAD ON GND OPS (1/4 MI VISIBILITY AT TKOF). CLRNC ROUTING DIFFERENT THAN FILED. JET RTE TO JET RTE CLRNC. POORLY MARKED ENRTE CHART (J230 3 INCHES W OF RBV, 3 INTXNS AWAY). ACFT ABNORMAL MACH TRIM FAIL. FO FAILURE TO XREF HIS NAV WITH CAPT'S (CAPT'S OUTBOUND DIALED IN CORRECTLY). CAPT FAILURE TO MONITOR FO WHILE FOLLOWING ABNORMAL PROC. HUMAN FACTORS: 'LET DOWN' IN PERFORMANCE AFTER INTENSIVE GND OPS. FOCUSING ON ACFT ABNORMAL PROC WITHOUT ATTN TO NAV. VERY EXPERIENCED FO CAUSING CAPT TO LET DOWN HIS GUARD.

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.