A DC9 cargo crew overshoots their assigned altitude by 1000 ft. Crew failed to set their altimeter to the correct local setting, misreading and missetting them 1000 ft low or 1 inch off near day, oh.

Home

Browse by month

Random

Latest

About

Contact

Attributes
ACN	472000
Time
Date	200005
Day	Mon
Local Time Of Day	1801 To 2400
Place
State Reference	OH
Altitude	msl bound lower : 8000 msl bound upper : 9000
Environment
Flight Conditions	IMC
Light	Night
Aircraft 1
Controlling Facilities	tracon : cvg.tracon tower : dfw.tower
Operator	common carrier : air carrier
Make Model Name	DC-9 Undifferentiated or Other Model
Operating Under FAR Part	Part 121
Flight Phase	climbout : intermediate altitude
Route In Use	departure : on vectors
Flight Plan	IFR
Person 1
Affiliation	company : air carrier
Function	flight crew : first officer
Qualification	pilot : atp
Experience	flight time last 90 days : 46 flight time total : 2270 flight time type : 46
ASRS Report	472000
Person 2
Affiliation	company : air carrier
Function	flight crew : captain oversight : pic
Qualification	pilot : multi engine pilot : instrument pilot : atp
Experience	flight time last 90 days : 100 flight time total : 11000 flight time type : 6500
ASRS Report	471867
Events
Anomaly	altitude deviation : overshoot non adherence : clearance non adherence : published procedure
Independent Detector	atc equipment other atc equipment : radar other controllera
Resolutory Action	controller : issued advisory controller : issued new clearance flight crew : returned to assigned altitude
Supplementary
Problem Areas	ATC Human Performance Flight Crew Human Performance Maintenance Human Performance Aircraft
Primary Problem	Flight Crew Human Performance
Air Traffic Incident	Pilot Deviation

Narrative:

On climb out from iln, ATC reported a 1000 ft altitude difference between the radar and transponder/pilot check-in altitudes. The controller asked us to verify the altimeter setting. While troubleshooting, the opposite altimeter was selected as the 'reporting' altimeter for the transponder. It was then discovered both altimeters had been separately set to a setting which was off by 1 inch or 1000 ft. Maintenance records show the pitot static system had been previously worked on and set to sea level elevation. On preflight, both pilots separately made the same mistake of adjusting the altimeter setting by a few digits rather than an inch and a few digits. Supplemental information from acn 471867: shortly thereafter, I took yet another look at the altimeter setting and finally noticed that I had 28.92 set on my altimeter, and the first officer had made the same mistake on his side and on the standby unit. In our complacency, we made the small adjustment to the altimeters that is normally required and we both saw what we expected to see. It would also be a great help if the backgnd color behind them would be of a different color at unusually high and low barometric settings.

Original NASA ASRS Text

Title: A DC9 CARGO CREW OVERSHOOTS THEIR ASSIGNED ALT BY 1000 FT. CREW FAILED TO SET THEIR ALTIMETER TO THE CORRECT LCL SETTING, MISREADING AND MISSETTING THEM 1000 FT LOW OR 1 INCH OFF NEAR DAY, OH.

Narrative: ON CLBOUT FROM ILN, ATC RPTED A 1000 FT ALT DIFFERENCE BTWN THE RADAR AND XPONDER/PLT CHK-IN ALTS. THE CTLR ASKED US TO VERIFY THE ALTIMETER SETTING. WHILE TROUBLESHOOTING, THE OPPOSITE ALTIMETER WAS SELECTED AS THE 'RPTING' ALTIMETER FOR THE XPONDER. IT WAS THEN DISCOVERED BOTH ALTIMETERS HAD BEEN SEPARATELY SET TO A SETTING WHICH WAS OFF BY 1 INCH OR 1000 FT. MAINT RECORDS SHOW THE PITOT STATIC SYS HAD BEEN PREVIOUSLY WORKED ON AND SET TO SEA LEVEL ELEVATION. ON PREFLT, BOTH PLTS SEPARATELY MADE THE SAME MISTAKE OF ADJUSTING THE ALTIMETER SETTING BY A FEW DIGITS RATHER THAN AN INCH AND A FEW DIGITS. SUPPLEMENTAL INFO FROM ACN 471867: SHORTLY THEREAFTER, I TOOK YET ANOTHER LOOK AT THE ALTIMETER SETTING AND FINALLY NOTICED THAT I HAD 28.92 SET ON MY ALTIMETER, AND THE FO HAD MADE THE SAME MISTAKE ON HIS SIDE AND ON THE STANDBY UNIT. IN OUR COMPLACENCY, WE MADE THE SMALL ADJUSTMENT TO THE ALTIMETERS THAT IS NORMALLY REQUIRED AND WE BOTH SAW WHAT WE EXPECTED TO SEE. IT WOULD ALSO BE A GREAT HELP IF THE BACKGND COLOR BEHIND THEM WOULD BE OF A DIFFERENT COLOR AT UNUSUALLY HIGH AND LOW BAROMETRIC SETTINGS.

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.