<< >> NASA ASRS Report 688318, February 2006

B757 flight crew after being released from guidance after pushback; aircraft rolls forward during engine start.

Attributes
ACN	688318
Time
Date	200602
Local Time Of Day	0601 To 1200
Place
Locale Reference	airport : den.airport
State Reference	CO
Altitude	agl single value : 0
Aircraft 1
Operator	common carrier : air carrier
Make Model Name	B757-200
Operating Under FAR Part	Part 121
Flight Phase	ground : pushback
Flight Plan	IFR
Person 1
Affiliation	company : air carrier
Function	flight crew : captain oversight : pic
Experience	flight time last 90 days : 210 flight time total : 17000 flight time type : 420
ASRS Report	688318
Events
Anomaly	non adherence : published procedure non adherence : company policies other anomaly other
Independent Detector	other flight crewa
Resolutory Action	none taken : anomaly accepted
Supplementary
Problem Areas	Flight Crew Human Performance
Primary Problem	Flight Crew Human Performance

Narrative:

During push from gate at den; command given to set parking brake. I reported brake set/pressure normal; followed by the normal tow bar disconnected/cleared to disconnect SOP. As #1 engine came up to speed; observed aircraft start rolling slowly forward; applied brakes. After estimate 1 ft of movement; ground crew plugged back in. Apologized to them after asking if they were ok; continued normal wave-off procedure and flight to iad. In retrospect; it was difficult to determine how the brake handle got out of the detent. Did I not have it fully in the detent to begin? Did I somehow apply brake pedal pressure with my feet thus releasing the lever? I can't determine. I know that I am extremely happy that no one was injured or any damage took place. I know that I will be more vigilant during what; heretofore was considered a routine event -- setting the brakes.

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Original NASA ASRS Text

Title: B757 FLT CREW AFTER BEING RELEASED FROM GUIDANCE AFTER PUSHBACK; ACFT ROLLS FORWARD DURING ENG START.

Narrative: DURING PUSH FROM GATE AT DEN; COMMAND GIVEN TO SET PARKING BRAKE. I RPTED BRAKE SET/PRESSURE NORMAL; FOLLOWED BY THE NORMAL TOW BAR DISCONNECTED/CLRED TO DISCONNECT SOP. AS #1 ENG CAME UP TO SPD; OBSERVED ACFT START ROLLING SLOWLY FORWARD; APPLIED BRAKES. AFTER ESTIMATE 1 FT OF MOVEMENT; GND CREW PLUGGED BACK IN. APOLOGIZED TO THEM AFTER ASKING IF THEY WERE OK; CONTINUED NORMAL WAVE-OFF PROC AND FLT TO IAD. IN RETROSPECT; IT WAS DIFFICULT TO DETERMINE HOW THE BRAKE HANDLE GOT OUT OF THE DETENT. DID I NOT HAVE IT FULLY IN THE DETENT TO BEGIN? DID I SOMEHOW APPLY BRAKE PEDAL PRESSURE WITH MY FEET THUS RELEASING THE LEVER? I CAN'T DETERMINE. I KNOW THAT I AM EXTREMELY HAPPY THAT NO ONE WAS INJURED OR ANY DAMAGE TOOK PLACE. I KNOW THAT I WILL BE MORE VIGILANT DURING WHAT; HERETOFORE WAS CONSIDERED A ROUTINE EVENT -- SETTING THE BRAKES.

Data retrieved from NASA's ASRS site as of January 2009 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.