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the yoke to try and climb. I took control of the airplane
and while I was doing so, my student reduced both
throttles to idle in an attempt to abort! I reapplied full
power and lowered the nose to normal climb attitude. In
discussing this with the student after the fact, he was at
a total loss as to why he did what he did. It is because of
incidents exactly like this one that I do not do touch-andgo
landings.
Instructors need to watch where students put their
hands. Visual verification of the control being moved is
paramount in a cockpit full of levers, knobs and
switches.
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A Monthly Safety Bulletin
from
The Office of the NASA
Aviation Safety Reporting
System,
P.O. Box 189,
Moffett Field, CA
94035-0189
February 1996 Report Intake
Air Carrier Pilots 1774
General Aviation Pilots 658
Controllers 84
Cabin/Mechanics/Military/Other 34
TOTAL 2550
Check…then Double-Check ✔✔
Many accidents and incidents have been attributed in
part to misuse or non-use of cockpit checklists. An air
carrier Captain reports on a minor checklist omission
that, fortunately, did not cause a major incident.
■ The aircraft was ready for pushback and the ground
crew called on the interphone saying that they were ready.
I announced to the ground crew, “Brakes off, door lights
out, cleared to push.” Just after pushback began, the tug
operator brought the aircraft to an abrupt stop, and said
there was still an agent in the rear cargo bin. I looked up
and saw the aft cargo light illuminated. Apparently the
First Officer and myself both failed to see the illuminated
aft cargo light on the overhead panel. Both pilots should
check items on the checklist, and confirm that the proper
response and action have been taken.
Many pilots respond to checklist items with a simple
“Check,” “Set,” or “OK.” Our reporter echoes a suggestion
made in research studies of checklist usage: a safer
response is a value (“N1 reading 97.5%” or “Altimeter set
29.88”) or a status (“Fuel valve open” or “Hydraulic
warning light out”) for the item identified.
Pilots who are accustomed to flying a particular aircraft
develop habit patterns specific for that aircraft. A
problem can occur when old habits are used with a new
aircraft, as our next reporter points out:
■ After a hiatus from flying, I got checked out to rent an
aircraft. On aircraft I used in the past, the transponder
had only an OFF/ON setting. When turned on, the Mode
C was automatic. In this aircraft, the transponder had
STBY/ON/ALT settings, the “ALT” being Mode C. I
should have made a note of this.
I took off on my second flight since the checkout. I turned
the knob on the transponder and noted the yellow return
light. About half-way through the flight, I noted the
transponder was only set on “STBY.” I immediately set it
to “ON,” then remembered I needed “ALT” setting for the
encoder.
During preflight I used a generic checklist. I have now
made my own checklist, and have highlighted
“transponder check” and added a note about checking the
“ALT” setting. When switching aircraft, I need to be extra
alert about differences in equipment.
Checklists often need to be customized. Even among
same make and model aircraft, slight equipment
variations and different cockpit layouts can lead to
overlooking crucial items if a generic checklist is used.
Landing Checks
Some pilots have cockpit rituals to help remind them of
an item to monitor or action to be accomplished. A longstanding
landing ritual proved to be somewhat less than
foolproof, according to the next reporter, an air carrier
Captain.
■ The copilot suspected we may not have switched to
Tower during the IMC approach, and may not have had a
landing clearance. We do not have a checklist procedure to
confirm landing clearance. I usually turn on the taxi light
when we are cleared to land and then do a scan of lights
and switches at 500 feet AGL. I either did not do this scan
or missed the switch position due to the workload. Now I
plan to brief the Flight Engineer to confirm landing
clearance before sliding the last tab on the mechanical
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