HISTORY
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PERSONAL HISTORY
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PHYSICAL EXAMINATION
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DOCUMENTATION
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OPINION
Mr McKenzie was a well-groomed, intelligent man, who presented his case in a very simple and unembellished fashion. It was Mr McKenzie whobrought his health status to the attention of CASA and it does appear that CASA has overreacted, although it has gone to the length of contacting Professor Mark Stoodley for an independent opinion and has reviewed the literature.
The report from Professor Stoodley is a typical response in an area that is essentially an evidence vacuum. The opinions provided, and also those relied upon by CASA, are based on very small sample studies and do nothing to look for bias or scientific rigour.
The risks that are posed by Mr McKenzie were serious and significant, prior to intervention and, subsequent to intervention all the available material, would indicate complete resolution of the problem. This does not negate the potential for recurrence but it must be accepted that what Mr McKenzie presents was asymptomatic, in the first place, and it is unclear how many other pilots have similar issues that are asymptomatic and diagnosed coincidentally. It is also questionable how many other pilots would show as much integrity and honesty as was the case with Mr McKenzie who brought his health status to the attention of CASA.
A totally arbitrary figure of one year has been imposed as the time for follow-up and follow-up investigation. Mr McKenzie had follow-up investigation much earlier at 3 months after the procedure, and I have no doubt would be happy to undergo further MRA investigations, on a more regular basis, if that were sufficient to convince CASA of his bona fide commitment to ensure both his own health and air traffic safety.
To impose arbitrary, essentially non-scientific qualifications on fitness to fly, appears contradictory to CASA’s commitment to impose rigorous scientific techniques to its assessment of pilots.
The rigour to which CASA has explored the validity of claims must be seen as a great credit to CASA, including the involvement of a Professor of Neurosurgery. Nevertheless the data upon which CASA and Professor Stoodley rely is, of itself, based on arbitrary dates and speculative risk factors which do not appear to apply to Mr McKenzie, who not only was shown to have complete resolution of the fistula at the time of performing the ONYX embolisation but the subsequent imaging 3 months later showed ongoing resolution without any recanalisation, which appears to be the major concern of all those wishing to stop him flying.
The point that needs to be considered is the fact that Mr McKenzie was asymptomatic at the time of his presentation, with regard to the fistula, and the hearing deficit was of a different aetiology. He did see an Ear, Nose and Throat surgeon, who organised the MRI, which produced the coincidental finding. Further, Mr McKenzie did follow through with neurosurgical opinion and spent a great deal of time considering his options and chose that which he felt was the safest and most reliable option.
Mr McKenzie has proven himself to be an absolutely reliable and straightforward witness and I have no doubt would be prepared to have further imaging, as may be required from time to time, and thus far he has had 3 month follow-up imaging that was normal, as was the imaging of the time of the procedure, and I am sure would be prepared to have further imaging if that could be agreed to be sufficient to allow him to reinstate his Class 2 license.
Having respect for all the risks, already identified both by CASA and Professor Stoodley, I tested Mr McKenzie’s higher centre function and he scored well above average. It is thus not a cognitive issues that is causing any concern.
Likewise there were no focal or lateralising neurological signs with no suggestion of raised intracranial pressure on fundoscopy and his hearing, that was the basis of the initial complaint, at least within the confines of an office examination, was completely normal. Corrected vision was likewise perfectly normal at N4 and 5/6, thus demonstrating that there was absolutely no current neurological basis upon which he should be denied access to flying, at this time, other than speculative risks based on poor quality data taken from small number surveys that have no relevance when applied to a single case.
This single case represents a completely normal individual with normal testing, who would be prepared to have further testing, if that was all that was required, to confirm his status, and that should be sufficient to respond to the arbitrary rules, based on pseudoscience from small case series. I would hope that commonsense would prevail to accommodate all who are involved.