American Airlines Sued Over Teen’s Fatal In-Flight Medical Emergency: Defibrillator Failed, Crew Didn’t Know What To Do?

Two years ago American Airlines Flight 614 was flying from San Pedro Sula, Honduras to Miami when a 14-year old passenger on board went into cardiac arrest and lost consciousness.

The flight diverted to Cancun but it was too late. The family filed suit last year against American Airlines, claiming that the onboard defibrillator that the airline is required to carry had a dead battery and could not provide the child with the necessary shock. It also claimed that flight attendants were not properly trained in how to use the machine.

According to eyewitnesses, each time the AED gave a “clear” warning for people to step back from Greenidge’s body so that a shock could be administered, a shock was not delivered. Instead, the machine simply kept advising that CPR should be continued.

The family originally sued in the Southern District of New York. The lawsuit has been moved to the Northern District of Texas where American Airlines is headquartered. The family filed its lawsuit there today.

While largely repeating the claims in the original suit, it appears to me that there are new allegations as well – that American Airlines is intentionally or negligently hiding the defibrillator. Specifically spoliation, which is the the intentional, reckless, or negligent withholding, hiding, altering, fabricating, or destroying of evidence relevant to a legal proceeding.

Flight attendants working for US-based airlines are required to be trained in CPR and in use of the automatic external defibrillator. The FAA requires simulated AED practice scenarios. And flight attendants are trained to do this even if no onboard medical personnel are available. Airlines generally consult with medical personnel on the ground.

  • In this case, two medically-trained passengers did volunteer

  • The lawsuit alleges that cabin crew did not know how to handle the situation
    At least one member of the airline personnel team was panicking and appeared to have no idea what to do during Greenidge’s medical emergency.

  • And also that they “were not trained to use the type of AED machine that was on board AA Flight 614.”

It’s a tragedy that this child lost his life. We’ll eventually learn the facts around the onboard medical equipment. Whether or not it would have made a difference we may not ever learn, but if the AED’s batter pack was indeed dead that is a black mark on the airline – and that new procedures will be put in place to better ensure onboard medical equipment is functioning properly.

Unsurprisingly, all that American Airlines would offer at this time is:

Our thoughts are with Mr. Greenridge’s loved ones. We are going to decline further comment given this matter involves pending litigation.

Aside from the sad particulars here, the suit raises important questions.

  • If the required equipment was not properly functioning, was the airline operating in contravention of its minimum equipment list? Equipment works properly until it doesn’t. How close to departure would it need to be tested? And is that foolproof guarantee that it will work properly inflight?

  • If the airline provided required training, consistent with FAA regulations, and the flight attendant failed to learn, remember, or perform what was trained is the airline liable for that?

This second question has even broader implications. Plenty of flight attendants operate for airlines despite being unable to carry out ostensibly required duties. There are crewmembers who have worked for U.S. airlines that couldn’t secure their own doors, for instance. They’ve taken and been passed through recurring training. What sort of liability is there for the airline?

It’s rarely the case that flight attendant safety training matters. Crew often speak to their first duty being to safety. But when it comes down to it, how many of them are up to that challenge? Perhaps required training is more than enough for most incidents, and for the frequency with which that training is needed. But is it actually less useful in ensuring recollection, comprehension, and deployment than many realize? Moving this case to U.S District Court for the Northern District of Texas from SDNY certainly benefits American. Other than the obvious tragedy involved, my interest though is in these broader questions.

About Gary Leff

Gary Leff is one of the foremost experts in the field of miles, points, and frequent business travel - a topic he has covered since 2002. Co-founder of frequent flyer community, emcee of the Freddie Awards, and named one of the "World's Top Travel Experts" by Conde' Nast Traveler (2010-Present) Gary has been a guest on most major news media, profiled in several top print publications, and published broadly on the topic of consumer loyalty. More About Gary »

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  1. All we hear from American and the union (and some who post on this board) is how service is cut back so safety stays in focus and as a priority. Fine, except apparently it isn’t when needed in this case. Exception? Possibly, but something tells me this wasn’t just the needle in the haystack.

  2. When my car battery dies it does so when I need it the most. I can check the battery today but tomorrow it can be dead. There is case law that says if a person is trying to give medical assistance, they cannot be held liable if the person does not live as long as they do not act recklessly flight attendant was working on a 14 year-old not an adult as she was trained on totally two different items, here, body of the 14 year-old heart is not the same as a 64 year-old white male who has a heart attack two different outcomes no matter what happens. It should be no reason for fortune year-old should go in cardiac arrest unless they are on narcotic.

  3. A very tragic situation but I have empathy for the flight crew panicking. I’ve been a AED trainer for one of the manufacturers and also ran cardiac arrest resuscitations in hospitals as an ICU nurse and watched fellow healthcare professionals panic. If the AED was not shocking when a shock was advised, that’s on the airline and their safety equipment processes. The FA is not a medical professional and shouldn’t be held to that standard. The ARD walks you through everything you have to do so a person with no experience should be able to use it.

  4. Just a little background on Automated External Defibrillators. They can’t bring a person back to life. They have a very narrow range of heart rithyms that they will shock for. If the device was saying “clear” it was most likely analyzing the patients heart rithyms to determine if a shock is possible. If the battery was dead, it would not do this. If a shockable rithym is not detected, it will instruct to continue CPR.
    Training is great but it really does not determine how someone will react when faced with an actual emergency. Having been a firefighter/emt and police officer I know this first hand. If a doctor or nurse approaches a crash or similar incident they are often not useful as they are not familiar with emergency scenes. Even though they may be excellent health care providers.

  5. I am currently attending the Google University School of Medicine while doing a residency at the Bing University Hospital. ha ha. Dr. Google, that is. So take this with a grain of salt.

    The AED did not have a dead battery because it gave a “continue CPR message”. Also note that the heart is not like a car battery. Dr. Google says if there is asystole, meaning the heart has stopped, do NOT give shocks. Dr. Google also says that if there is ventricular fibrillation, then shock. The shocking is supposed to convert some kinds of abnormal rhythms to normal. The shocking is not supposed to convert a non-beating heart to beating, despite what is shown on dramatic TV episodes.

    I also stayed at a Holiday Inn Express before.

  6. The crew member likely appeared “panicked” because there was a teen with no heartbeat laying on the floor of the airplane. It’s not shocking that someone would appear panicked or distraught in that situation. That’s not something to blame the FA for.

    It’s also very likely that their heart was stopped so there was no shock advised by the machine, but that’s not a failure of the AED. That’s the programming of the AED.

  7. This is such a sad story. My heart goes out to the family. The AED has clear simple steps in easy to read instructions. Remembering how the flight attendant certification allowed four attempts for passing, I hope this was not the case here.

  8. I was trained on use of AEDs and had yearly refreshers up until I retired almost seven years ago. I was also trained on CPR. I was not a medical professional but the training indicated that there were situations when a shock would not be delivered. Nothing of this article indicates that the machine was malfunctioning or had a dead battery. A question that will be answered during the trial is how quickly did the flight attendants respond to the emergency. Also, how long was it before the uncle tried to summon the flight attendants? I am curious as to what the autopsy indicated as the cause of death.

  9. Ah yes, medical emergencies are not for the faint of heart. Unless you’ve given chest compressions on another human being, applied a tourniquet to stop splurting arterial bleeding, etc. then you may freak out in same manner. It happens. The only ways to overcome this is through realistic training scenarios where all hell is breaking loose, or routine review of the reaction drills in the manual where things become muscle memory or you’re actually performing life saving steps in a real world scenario to where it becomes muscle memory.

  10. A tragedy that the child died. A shame that the family seeks to make money on the death. Pathetic.

  11. AA does not provide sufficient training for safety and service. Both needs to be improved drastically.

  12. If the AED says “No shock advised”, the patient either has a pulse, or is in asystole, and cannot be shocked back into a normal rhythm. The dead battery message is different. This is meritless on the face of it.

    An actual doctor

  13. aircraft are not hospitals and flight attendants are not doctors.
    But relative to the AED, the unit and battery should be checked as soon as the senior F/A is on board. Should be a no go if the unit is not 100% working. A spare AED unit/battery should be at the terminal in case a replacement is needed.

  14. There seems to be an expectation that everyone around them should be ready to save them at every turn. If there isn’t every means available, they are at fault for your predisposing factors and actions that contribute to the situation or death. Assuming every intervention could have saved that person. (We will never know).

    I wonder if FAs are required to provide aid under the law at all. I’m not sure what thier duties are.

    Most people are not required (although ethically compelled) to intervene or render aid.

    In Mexico, most don’t intervene as if they don’t provide perfect aid. They can be sued. Where in the USA you have laws protecting the bystander to provide aid.

    I suspect that this lawsuit will most likely be dismissed.

    It sounds like the AED did function. And as noted. It won’t shock unless specific conditions exist. Doesn’t mean it broken if it didn’t shock.

    This is the family trying to get a pay day.

  15. Sorry but the parents of this teen are a piece of shit. One shouldn’t have the expectation of ER level service on a plane. Hopefully jury awards them nothing.

  16. Not a good situation when you need someone who lives below the poverty line to resuscitate you.

  17. @ Glenn E. Pickard. True. But ask any flight attendant who’s standing behind their seatbelt barrier, one they built around the galley to avoid as much contact as possible, and they will tell you they are trained as Emergency Responders and that they are there solely for your safety. Which we all know in FA speak means …”We are lazy and looking for any excuse to do absolutely nothing.”

  18. a trained professional, (presumably) cannot spell rhythm?
    Sorry, that is terrifying. What has happened to airline safely standards? I am a layman with some limited safely/medical/first aid training along the way. I would probably have been terrified but I hope I would have recalled safety standards/requirements…

  19. All else aside. it seems to me a 14 yr old who goes into total cardiac arrest was probably very unwell when they set foot on the plane. Surely this poor boy was being treated for something prior to his final journey.
    I wonder if we’ll ever hear the the the true and total story.

  20. As others have said, this case is sad but without merit

    AEDs are specifically made so that you can use one without medical training. It tells you exactly what to do. It says loudly “put this sticker here. Put the other sticker there. Clear!” (Analyzing). Then a shock if appropriate.

    AEDs only work for certain rhythm abnormalities like Ventricular Fibrillation and Ventricular tachycardia.

    Sudden cardiac events are extremely rare in teens and children. When they do happen, it’s almost never VF or VT. More often it’s a reentrant arrhythmia like Wolf Parkinson White , a supraventricular tachycardia, or a complication from a congenital heart disease. Either way an AED won’t help these

    It’s not even clear that this child had a cardiac event. It may instead have been a different issue that lead to secondary cardiac arrest such as stroke, Covid or pulmonary infection, illicit drug (fentanyl, cocaine, etc) or a Pulmonary embolism from a DVT. (This is highly possible given that they were in a plane).

    Nonetheless, the machine was working. It analyzed the rhythm and understood that a shock won’t help, so didn’t deliver a shock. It then advised continued CPR. But that was never going to be enough to save this boy. He was dead the second he passed out in an airplane.

    Source: Ex Peds ICU doc

  21. 40yr paramedic and 30yr pilot here. When an AED says “continue CPR” it is telling the rescuers that a shock IS NOT NEEDED, and it does not charge up for the shock. The device will then coach the responders to continue CPR. Contrary to popular belief, a defibrillator does not “jump start” the heart. It actually does the opposed – it terminates all uncoordinated electrical activity in the heart, in hopes that coordinated activity will resume. A patient with “flat-line” despite what is often shown on medical drama TV shoes, doesn’t need a shock. They need CPR and rescue medications if they are available. Now given this, there is an expectation that the cabin crew would be able to properly operate the device, and to do CPR. It appears the writer may be confusing the “No Shock – Continue CPR” message, with a dead battery. If the device was saying No Shock Advised – Continue CPR (some only say “Continue CPR” the battery was certainly not dead.

  22. Wow, where is Andy and his crew. Clearly DEI was at the root of this child’s death, unless the FAs were clearly identified as being white males. Please Andy respond.

  23. They are not waiters and waitresses. No. These jobs are so much more complicated than serving food and drink, reading from a script, and then sitting down for the remaining 2/3 of the flight. That’s right, they are there mainly for our safety.

  24. I read the lawsuit. The battery was not depleted as far as I can tell as there are several different “low battery” warnings on most portable machines. The only indications for delivering a shock are two specific ventricular arythmias, fibrillation and tachycardia. The machine was working and was delivering instructions appropriately. The boy did not apparently have a cardiac rhythm treatable by DC counterclockwise.

    No mention is made of any results of a post-mortem exam assuming there was one.

  25. Not a doc but I will add to the crowd: no failure here.

    CPR works in a lot more cases than a shock does. Shocks are only for the purpose of **stopping** the heart when it’s beating **ineffectively**. They’re a very good tool for a narrow range of cases, they are not by any means a cure-all.

    CPR doesn’t care why the heart isn’t beating, it just pushes blood (assuming there’s blood to push) anyway–it doesn’t fix anything, just buys a bit of time for the actual issue to be addressed. And, unlike what Hollywood shows, it has a low probability of success (10% live to discharge, only half of those neurologically intact.) You only get a save when the underlying problem can be addressed fast enough, or when the workload can be taken over quickly enough (ECMO, they’re doing trials with mobile ECMO equipment that races towards the incoming ambulance.)

  26. Once again the author of this article is putting out information without doing any additional research. If an AED does not advise a shock that means it’s either not needed or the patient is already dead, besides CPR nothing can be done. The flight crew cannot do anything else besides continue CPR. Gary should not be able to post these lazy and ignorant articles. Do some research idiot.

  27. AED audibly prompting? The battery is fine, otherwise won’t pass self-check and never get that far. The battery dead is a ridiculous, uniformed speculation. Ken A above is right, the AED is in working order. He too probably uses one professionally.

    Not all electrical rhythms are shockable, no matter what the author picked up from watching TV, where poeple convert from asystole regularly.

    Really disappointed on this article. A basic CPR course might be a good place to start.

  28. 14 year old with a heart failure? Awfully young. I’m curious to know if the parents had medical clearance from a Doctor for the child to travel if it was a known health condition. Expecting a flight attendant to have the same skill set as a trauma nurse or paramedic is asking a lot.

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