Air Canada refused to divert during a passenger’s medical emergency. The airline says that they followed proper procedure. The man died. Clearly they bet wrong. What obligation does an airline have to incur costs and inconvenience passengers and their operation in an uncertain medical situation?
In September, Shanu Pande and her father flew Air Canada flight 51 from Delhi to Montreal after the 83 year old man secured permanent residence in Canada. Inflight he began having chest and back pain. He was throwing up. He became immobile. His daughter begged for crew to land as they were over Europe in order to obtain medical assistance – but they continued nine hours to Montreal. He was still alive when they landed, and paramedics were waiting, but he died as they worked on him.
According to the airline,
- they aren’t responsible for the passenger’s death
- crew followed proper procedures
- and crew have unspecified disagreements about how events unfolded
The man had been medically cleared for his Canadian residency. He appeared to be in good health at the start of the trip. But his symptoms came on suddenly and he died of a myocardial infarction and he was formally pronounced dead on arrival at a hospital.
“He’s saying, ‘I’m having severe chest pain,'” Pande recounted, demonstrating how her father was clutching his chest over his heart… [Her father’s] face had drooped on one side, he had lost control of his bowels and felt extremely weak. …Pant and his daughter were moved to business class so he could lay flat.
No one came forward when crew asked for a doctor or other passenger with medical training to volunteer assistance.
On the ground, the captain spoke with third party consultant MedAire to advise the situation. They provide medical guidance to airlines around the world when inflight emergencies arise. There advice in this case appeared to be not to divert. After the fact it’s clear this was a major medical event that would have required a diversion given the risk to the passenger’s life. Crew offered aspirin, but he’s allergic to it and couldn’t take it.
Of course it’s not certain that the passenger would have lived if they’d gotten on the ground quickly in Europe.
It’s never certain just how much of an emergency a medical situation is. They rely on advice from third party experts on the ground, who also provide something of a liability shield to the airline – they did their due diligence in consulting the third party! They aren’t going to divert for every passenger complaint, but will divert for the most serious ones. But the crew in the air aren’t the ones who decide which is which.
I had an anaphylactic reaction to food on my HEL-DEL flight in June on AY. Their reaction was completely different. Even the captain came out to check on me, and since I have a history of anaphylaxis to allergens I had a battery of Epi-Pens on me. Stabbed me twice with ’em, asleep 20 minutes later. That said I’m acutely aware of the attention they provided and the concern. I found out when I stopped by to talk to the captain after landing that they were about 3 minutes from diverting to Vilnius.
Thoughts go out to the deceased as I bet you Rs. 1000 that he would have had a different outcome had they diverted and spent the extra two hours or so to offload him for medical attention.
Another reason never to fly Air Canada
I’ve long wondered if the purpose of third party medical consults like MedAire are really just to shift liability off of the airline.
Interesting. Of course, we are reading only part of the story. One can’t know what Air Canada’s rules are nor Canadian rules are but my US airline, the Captain has the final authority and can overrule the company, on board medical and ground medical advice. If, in the opinion of the captain, the patient needs to be at the nearest suitable airport, he/she will land the damned plane and our company will back up the decision. After all, those in the air can SEE what is going on in real time. If the ground support says “push on” but onboard says “we gotta land”…we’re gonna land!
This is horrible to say, but these medical services are kind of the butt of jokes amongst some airline crews and airline dispatch/operations centers. It’s long been that STAT-MD’s chief medical officer (similar service to MedAire, based out of University of Pittsburgh) who is named Dr Doyle is referred to as “Dead on Arrival Doyle.” Feeling lightheaded? Lay them down and give them some orange juice. Throwing up? Lay them down and give them some orange juice. Non responsive? Lay them down and try to give them some orange juice.
It is interesting that no one answered the call for medical assistance. I’m pretty sure there was at least one medical professional on that flight. I know it is a hassle to respond — I’ve done it several times — but I look at it as an obligation. First, I am privileged enough to have gotten the education to practice medicine. It is massively reassuring the passenger and the flight crew if they have someone else who can help. They really aren’t trained to deal with such sick people. Second, I respond because I want to give good information to the Captain and prevent an overreaction (i.e. landing when not necessary.)
Kmkmd, I was thinking the same thing. It’s almost statistically impossible on a TATL long haul not to have a nurse or a paramedic at the very least. Likely some people didn’t want to volunteer. Which is a shame. Even if not your area of expertise you likely have better knowledge and instincts than a flight attendant and can still try to help even if you’re aware of your limitations. Flip side, my wife is a physician and once offered help on a TATL and the FA wouldn’t let her help because she wasn’t carrying a copy of her license. Of course there was another doctor onboard who was, so they went with him. But it wasn’t a life or death emergency.
I hope Shanu Pande sues and is awarded millions, enough to get Air Canada to change procedure in such situations.
I am an ER doc and used to always respond on-board when there was an ask for medical personnel…until on TATL flight.
There was call for assistance. I initially did not respond because I had had two drinks already and am very careful about that sort of thing. There was a repeat request for help, and then a third, so I made my way back. Disclosed to the passenger that I was doctor, had already consumed two drinks and asked if I had their permission to assist them with that understanding. Of course they said yes.
I was very concerned the person might be having a heart attack. I asked our location and was told we were still over the Canadian maritimes, so I recommended we divert and evacuate the passenger. Without an EKG machine and access to a clinical lab I cannot be sure whether or not the passenger is indeed having a heart attack. To me the calculus is easy: inconvenience 250 people for an hour or so if it means saving the life of someone.
Unfortunately, what I did not know what that Captain was in communication not only with me, but with a physician sitting on a radio in Pittsburgh…1,500 miles away who was NOT looking at the passenger. That physician advised the Captain it was acceptable to proceed for the remaining 6 hours of the flight without diversion.
I went back to my seat and sent some positive thoughts out into the universe for the passenger. After that incident I have never volunteered to help again. I do not see the benefit if I my professional judgement, with more information than the physician on the radio or the captain, is going to be dismissed. I know airlines what procedures for things like this, but procedures need to be adaptable to the moment.
If not, this is what can happen….we policy and procedure oursevlves into a bad outcome.
When the health of anyone is at risk, airlines must divert.
He was dying for an upgrade.
It’s horrifying enough to be confronted with a heart emergency when you’re on the ground. No one knows how much time you have. I know I’ve been there with my spouse.
SOBE ER DOC:
My PCP recently called me after a flight where a request was made for medical assistance, and the crew was in contact with a ground-located doctor or nurse. While my Dr had some ideas and recommendations, they basically only cared about him taking vitals. He called me to ask about airline procedures, about the service on the ground, etc. A lot of it is in place for liability reasons to the airline – their physician of care, who they can verify credentials, is the one on the other end of the radio/phone call. I may joke about Dr Dead-On-Arrival Doyle in Pittsburgh, but you see where that can have basis in reality….
I can easily see where the presence of a medical person on the plane could have influenced the pilot’s decision. Without any substantive information about the patient, it then becomes a matter of protocol based upon some doctor on the ground. I find it difficult to believe that a pilot would ignore a medical person on the plane and the airline surely knows they then have an emergency qualifying for a diversion.
Then, one has to consider where do they want the body to land. If death is imminent or if I am 83 years old, I might just want to land in the most convenient location rather than having to repatriate my remains with a ton of governmental paperwork. This person has already created a less than ideal situation for all of those on board.
Never Fly AirCanada Worst Airlines. They literally left him to die.
Please do not forget to sign the petition https://chng.it/khQmc9Z8YF to support. It is to save precious lives and tell airlines that passengers are not money-making machines .
https://youtu.be/R9XGlDgBdww?feature=shared
Wow! Those are some serious symptoms! Why wouldn’t the airline lean towards the side of caution? The airline should be liable.
SCREW AIR CANADA !!! #GangsterCapitalists
I will NEVER set foot on this carrier ever again.
Full stop.
As a firefighter and paramedic, I am used to providing emergency in-flight medical care. On one flight, a medical emergency happened while Alaska Airlines was flying over the middle of the Pacific Ocean between Hawaii and Seattle. This flight was the third in-flight medical emergency I responded to while flying on Alaska Airlines.
The flight attendants immediately retrieved the supplies I requested from the Enhanced Emergency Medical Kit (EEMK), including a communications headset. This headset plugs into a connector in the cabin so I can simultaneously communicate with the flight deck and ground medical support from MedAire (an international SOS company) while delivering emergency medical treatment to the patient. On every flight, the Alaska Airlines flight crews were outstanding and helpful.
Would the on-board defibrillator have helped in this situation?
Air Canada doing Air Canada things. I don’t care if Porter uses the airplane equivalent of rickshaws, they actually treat passengers well, so I’ll fly with them every time
Doctors on a flight from Dehli?
Gary, I’m curious. What does the term of service say?
DOT regulations?
Or is an airlines responsibility just to get you from A to B dead or alive? Surely some lawyers have thought this out?
Stop flying this garbage airline!
Many of my long-haul flights out of Delhi to the UK and North America seem to have one or more doctor aboard — which shouldn’t be surprising given how many Indian-origin doctors there are in the US, non-Quebec parts of Canada and UK who happen to maintain close ties to India. But I also know some of them don’t jump to respond to calls for medical assistance on the flights if they can avoid doing so unless the calls for assistance are repeated. And of those who responded over the years, the airlines are no longer as appreciative of the in-flight assistance by a medically-trained passengers as they used to be and can be rather dismissive of the contribution when their contracted advisory service partner on the ground remotely clears the passenger for continued travel.
Lufthansa used to have a program for passengers who are doctors to register with the airline as doctors who could be called for assistance on flights, and maybe it still has that around. We had a bunch of doctors register for the program and get some miles out of it.
You made it clear: In the event of a heart attack assault the nearest flight attendant.
If the crew in the air doesn’t get to decide if it’s appropriate to land for medical emergencies then the crew should also not be allowed to decide who flies with them for other matters as well.
The ground advisors are murderers. The flight crew is guilty of negligent homicide at the very least.
Many Physical Exams are FIXED in India! I deal with a lot of people migrating to USA, So far no one has Failed Physical Exam, that includes Hundreds that take the Wheel Chairs.and several that are 85 plus years old.
“No one came forward when crew asked for a doctor or other passenger with medical training to volunteer assistance.”
I wouldn’t have heeded the call either. Who wants to spend a night in Lubbock at a Motel 6 with a $15 gift card from Cinnabon. I’m sure he would be fine.
I flew for short and long haul passenger airlines for almost 30 years, in three countries, and will say that company responses to medical emergencies has certainly changed. It is a universal regulation which states that the “pilot in command is the final authority as to (and is directly responsible for) the operation of the aircraft.” Everyone else in the company, and all contractors who give advice, are subordinate to the captain, who is expected to consider the situation and direct the flight appropriately. It is permissible to act contrary to any regulations or orders as necessary to meet the needs or manage an emergency.
Now, it appears that Air Canada has neutered its captains. Evidence is not only flight this 51, but also flight 1506, on August. 26, from Las Vegas to Montreal, where two passengers were kicked off for refusing to accept vomit covered seats.
I’ve had some medical emergencies and other disturbances happen inflight and always acted in the interest of safety first and then doing right by the people who bought tickets. In one case, we even got help ATC to exceed the 250 knot speed limit, to get a heart attack victim quickly onto an airport where paramedics were waiting. Our medical advisory service was called MedLink; they advised us to get the patient to a hospital ASAP. We found out that she died, but at least we did our best to help.
I noted that things were changing more recently, when a passenger died enroute to Honolulu, where my crew and I were waiting to work the return flight to the mainland USA. The passenger died enroute, but the company wanted her declared dead on the jetway, not on the aircraft. That person’s body was laid out on the floor, under a sheet, for nearly a half hour, just outside the cabin door. Screw the dignity, flights gotta move.
Being in a hurry, and trying to beat a turn-around time limit, the Honolulu employees insisted that we board the return flight quickly, and tell enplaning passengers to “step around the body.” I raised hell and told them, “Nobody boards this plane until the deceased person is taken off of the jetway – no one is stepping around the body. What if that was your mother laying there?”
More recently, in another company, a good friend and colleague had a passenger who “became unresponsive” on a long haul flight, and they were advised to continue. The destination was about as far away, in time, as the nearest alternate. Also, a diversion would adversely impact company operations. That is code for, “delays and extra costs.”
• Your customer experience is weighed against profits, fines, lawsuits and insurance.
• If they can get away with letting you suffer or die, they will.
• They will help you only if it is the cheaper option.
• Maintenance and crew fatigue issues are similarly weighed.
• If you can avoid flying, avoid it.
Good luck; stay on the ground if you can.
Sounds like a big lawsuit. That being said I was on a Cathay flight from SF to HK a few years back. I developed food poisoning from eating day old food in the Cathay SF Lounge. A Cathay RN was on board. She attended to me called a doctor via satellite phone and he prescribed medication that they had on board. I was impressed. I was already feeling better by the time we landed. Some of the larger international airlines have an RN on board and keep a supply of emergency meds. I suppose this is mainly on the bigger aircraft ie. A380, 757, 767, A350,
This is such bloody hypocrisy. If a flight attendant doesn’t like the attitude of a passenger they have no problem diverting, landing or turning the plane around. But, God forbid, you inconvenience them with a heart attack or some other minor thing.
And yet – we keep giving them money and accepting this sh!te
Air Canada? Not surprised at all. The worst NA airline ever, behind Spirit and Frontier!
@NedsKid and
@SOBE ER DOC I have worked EMS in the area around Pittsburgh for many years. I even covered Pittsburgh International Airport for EMS working with Allegheny County Airport Fire. STAT med comm itself is fine, but the in air medical command has an unofficial bad reputation. I imagine that most physicians or experienced EMS providers knew the limitations of care in air. EMS protocol does state that ASA can be administered, even with an allergy because the benefit ususally outweighs the risk. The story is just one side, but I don’t doubt there was some miscommunication. A trained medical provider could have made a better case for diversion. If I felt that I didn’t like my consult, I would have known whom to ask for, but that’s the benefit of working with one of 2 major health systems in Pittsburgh. Sadly, a man lost his life. I hope that some change comes to STAT air command with this recent loss.
How come no one is talking about an AED here? According to their website, Air Canada states all flights have an AED on board and all cabin personnel are trained to use it. Just about every airline carries these life-saving, diagnostic tools, especially long-haul flights. Something doesn’t seem right.
Had a similar situation from LHR to ATL. We stopped in Ireland; all were told to stay in their seats; EMS came aboard and removed the person in question. We were back in the air within an hour.
Sad situation all around. Let me explain to those of you not in the industry and not informed on how the proper procedures work regarding medical events. First and foremost there is a clear chain of command, with specifically trained procedures that should be followed. The Flight Attendants utilize their medical training, and may or may not request assistance from a medically trained passenger onboard, however, that passenger offering assistance is their to ASSIST and offer advice but ultimately the crew owns the situation. THEY communicate with the ground medical personnel and confer the situation with the flight deck who ultimately has the authority to divert. FA-Stat MD-Captian is the chain of command. The reason for this is ultimately the Captain has the final authority and the medical event must be handled from start to finish by the crew. While medical assistance from a passenger is often helpful and appreciated is is not always needed and is never required or depended on. As an example, as the purser on an international flight, I had a passenger faint some years back, and a new hire flight attendant automatically paged for a doctor. The ‘doctor’ that offered assistance glanced over the passenger and claimed we had to immediately divert. However I followed our proper training procedures, performed an initial medical survey of the passenger, collected their vitals and contacted ground med support and the flight deck. The passenger was fine and we quickly realized she took an ambien mixed with a glass of wine. The flight obviously continued to its destination without incident and the passenger slept it off. As I thanked the doctor for their assistance I asked them what area of medicine they practiced, his response: I’m a podiatrist. The point of this is to emphasize that airlines have very specific policies and procedures to follow regarding medical events, and as long as Air Canada followed theirs, they aren’t at any fault for this unfortunate event. The armchair Flight Attendants and Pilots/ armchair doctors/ and wannabe airline experts should sit this one out.
Back in 2000, I was flying first class on American Airlines. I specifically asked if there was mushrooms in the omelet as I am deathly allergic to them, and was informed no. Of course I bit into the omelet and had an immediate anaphylactic reaction to it and luckily there was a doctor on board. For some reason the Epi-pen did not get the matter under control. When this occurred we were flying right over MCI and they would not divert. Needless to say they carried on to ORD, where an ambulance met the aircraft and I was taken to Resurrection Hospital, Ended up being there a week and was intubated. The doctor checked on me, but nothing from AA. No, I did not pursue the issues as I did not have the money or time, but I never flew AA again (even when I was a Flight Dispatcher for another airlines, I would not jumpseat on theirs)
@crew well, your problem is you didn’t ask for a medical doctor. Podiatrists don’t got to med school. You may have well have asked for a dentist. Medical doctors have far more training than you do, and, while there surely are plenty of profit driven medical doctors, they generally set that aside when helping people, unlike airlines. What you just described is putting the airline over the person, and then handwaving it by saying “well the handbook says it’s okay, so we’re not at fault”
If this ever happens on your flight and it’s your family member AND they refuse to divert, start punching a flight attendant, if they refuse to divert then, claim you have a bomb and you are willing to detonate it if they do not land the plane immediately, do WHATEVER you can possibly think you can do to get the plane diverted. Could you have it on your conscience to have your family member die the rest of your life because you did nothing and an airline is being an absolute a$$? Screw the consequences. Screw what the airline’s policy is. Don’t actually do an actual unethical crime (actually hurt someone else) but don’t let them make the life or death decision for you either just so THEY can save THEIR bottom line. It is readily that apparent all airlines care about is money. You can sort out the consequences on the ground. Claim temporary insanity due to the impending death of your family member. Or claim the action was is self defense as the airline was purposely putting you in danger. Whatever it takes. This article makes me sick. F- Air Canada for allowing this to happen!!!
As much as a i hate AC…..for a whole bunch of reasons in the air and on the ground.
I want to see the full facts here. Its completely 1 sided and i refuse to think that the captain is going to refuse to divert if it was that serious when over LHR!) I feel they do have a bit of empathy.
Again there are other factors on exactly where they were. Passengers seem to think they know, but dont….heck they dont even know the type of aircraft let alone seeing the flight map…..
Not saying they souldnt divert…but lets get the agreed timeline of facts. When did the call to medical advice happen? I refuse to accept that FAs and service directors ignored their calls for help delaying that advice call. I have never seen AC flight crews THAT indifferent…..id say the TATL inflight crews are some of thier better FAs in the system….
I would have to give a little criticism to the passenger….again i know these medicals are completely faked in most cases…seen it ….50 bucks and you are in better health than a 20 year old. But also realize personally…you are 83 and susceptible to sudden health emergencies and the mercy of circumstance. If they were over the atlantic…..turning around isnt an option generally, and if they were over labrador/northern QC….the nearest alternate isnt much better than continuing on to YYZ. (its YOUR risk to get on a plane for 12 hours with NO access to emergency medical care! Perhaps medical transport should have been better option…but you took the $$$ and took that risk…heck even a J class seat would have been better for less clotting and DVT chances but it was Y class on AC!) I suspect this was a “final trip” home as they probably knew they were on the serious decline….these trips happen all the time. If there was a lawdsuit against AC….thier medical records would be fair game for review….if the medical indications signal they shouldnt have traveled…..they would lose and pay AC for the legals costs (this isn america!). I think they are doing media as that would allow the best route to $$$ versus an actual facts based lawsuit….will we ever get the headline from CBC that “oh the person we highlighted as a victim was a complete liar and risked the family members life and tried to blame AC?!?” – NO!
Again AC definitely appears to have some compassionate faults here too…but again give us the exact timeline for the call for help…facts do matter but the public and media doesnt care about that either!