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decision-making on the part of individuals or organizations that
contributed to mishaps. Here is a sampling of relevant reports from
cabin and cockpit crew members.
Down the Hatch
A B747 Purser reports that a Maintenance Technician failed
to comply with communication and procedural requirements
before entering an E/E (Electrical and Electronic) hatch in the
passenger cabin.
n …Prior to boarding passengers, a Mechanic entered the E/E
Hatch located near Row 4 on our B747-400. The Mechanic did not
warn any Flight Attendant (nor me as the Purser) that he would be
opening the hatch; nor did he install the safety barrier strap which is
required per our procedures. As a result, a Flight Attendant fell into
the fully opened hatch and was able to catch herself after injuring
her foot and badly bruising her knee. Both her shoes fell to the floor
below in the cargo well. The Mechanic then attempted to close the
hatch, but did not do so properly and another Flight Attendant came
along and tripped on the partially opened hatch [and was injured].
Call Light Conundrum
Aircraft passenger call lights are both a safety and security feature.
Flight Attendants in larger aircraft may not be able to see the
entire cabin from their duty stations. If a passenger crisis occurs,
it may be some time before they know about it unless call lights
are activated. However, the call light system may be legally
placarded inoperative by Maintenance, as was the case with a
B767’s passenger call system. Here’s what happened shortly after
departure (according to a Flight Attendant’s ASRS report):
n Passenger upon climbout suffered from a seizure. Passenger call
lights were not working at time of departure and we were aware
of this, but call lights were placarded and we departed. Purser
questioned the decision in the event of an emergency with having no
working call lights. Twenty minutes after takeoff passenger’s mom
was screaming because of daughter who went into seizure…Purser
ASRS Injury and
Incapacitation
Incidents
Number 366 June 2010
It’s time for another “interactive” issue of
CALLBACK! All of this month’s reports involve the
same type of incident – a real or apparent equipment
problem that occurs in IMC or other adverse weather
conditions. On the front page you will find “the first
half of the story,” report excerpts followed by several
plausible action choices. On the back page, you
will find “the rest of the story,” the actions actually
taken by reporters to resolve their situations. Each
incident will give you a chance to draw on your
aviation decision-making experience to anticipate
what you would have done in the same situation.
The First Half of the Story
Situation #1: A TRU Dilemma
(CRJ-900 First Officer’s Report)
Editor’s Note: A Transformer Rectifier Unit (TRU) is a
device for converting alternating current (AC) input into
direct current (DC) output.
n While en route…I as the Pilot Not Flying /Pilot
Monitoring, noticed a message that said TRU2 on my PFD
[Primary Flight Display] and on my MFD [Multi-Function
Display]. I looked over to my Captain’s side, the Pilot
Flying, and saw his [display] said TRU1. I knew this was
not normal so I asked him about it. Both the Captain and
I thought that it was referring to the Transformer Rectifier
Units (TRU) in the electrical system. We brought up the
electrical page to monitor TRU1 and TRU2. Both looked fine.
We got out our POM [Pilot Operating Manual] and contacted
Dispatch and Maintenance Control to see if we could find
out what it means, as neither of us had seen that displayed
before. The plane seemed to be acting fine so we continued
toward our destination. While on approach we noticed
the TRU1 and the TRU2 message was blinking. When
we switched from the FMS to ILS, we noticed a difference
in course and also in heading...We were in IMC and in
mountainous terrain….
What would you have done?
• Break off the approach and wait for additional
Maintenance input
• Cross-check ILS indications with the magnetic
compass and continue the approach
• Proceed to an alternate airport
• ? ? ?
Situation #2: Partial Panel in IMC
(C182 Pilot’s Report)
n My attitude indicator failed in-flight, in IMC,
approximately 70 miles southwest of my destination.
Weather was reported in the area as 2,900 BKN and 4,000
OVC with 7 miles visibility which should have allowed
for a visual approach. After determining weather from 2
　
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