I posted this on the
Empire Strikes Back thread earlier:
If there aren't enough examples already of Avmed's incompetent decision making, here's another recent example from the AAT files. There's definitely a common trend starting to develop...
Bolton and Civil Aviation Safety Authority [2013] AATA 941 (23 December 2013)
23.CASA called Dr Pooshan Navathe, its principal medical officer and the primary decision-maker. Some of Dr Navathe’s evidence detailed, quite unnecessarily, the legal framework for regulatory aviation medicine, the processes of aviation medicine decision-making within CASA, risk management and suchlike. The relevance of that evidence was never explained to me. Dr Navathe’s statement discussed, and annexed, various articles from medical research before expressing the opinion that[15],
... given Mr Bolton's history of head injury, there is a significant risk of [posttraumatic seizure]. There is a substantial or real and not remote possibility that Mr Bolton will suffer a [posttraumatic seizure] whilst in flight. Were Mr Bolton to suffer a fit whilst at the controls of an aircraft in flight, then this would pose a clear threat to the safety of air navigation, and thus I have reached the conclusion that the extent to which Mr Bolton fails to meet the class 1 and class 2 medical standard is such that I cannot issue him with a medical certificate under r.67.180 of the CASR.
24.Dr Navathe’s witness statement concluded in this way:
90.Having reviewed all three specialist reports, I remain convinced that I have made the safest decision in refusing Mr Bolton a Class 1 and 2 medical certificate at this time. I have formed the view that is supported by all three specialists, that Mr Bolton does not have a severe head injury, and ceteris paribus [all other things being equal] will be able to obtain medical certification after a period of 18 – 24 months has elapsed from the time of the injury.
91. I acknowledge that I have an overriding duty to provide impartial assistance to the Tribunal. No matters of significance have been withheld from the Tribunal
Despite the fact that the statement does contain the declaration of duty required by the Guidelines it could not be plainer that Dr Navathe is an advocate for his own decision. I do not propose to have any regard to his opinions. For the future I would trust that CASA’s Legal Branch would exercise independent judgement in deciding what witnesses ought be relied upon and the content of their statements. They ought, obviously enough, be confined to matters that are relevant and witnesses ought be those who can truly provide an independent opinion.
25.Finally, CASA relied upon evidence (including a report of 4 November 2013) of Dr Ernest Somerville, a consultant neurologist. I have already made mention of the reference in Dr Somerville's report to a document from the Proserpine Hospital which is not in evidence in the proceedings. The failure to comply with the Guidelines is exemplified by this passage from Dr Somerville's report[16]:
The following opinion is provided in response to your letter of 30 October 2013 and telephone conversation with Dr Pooshan Navathe on 1 November 2013. Information about Mr Walker's [sic] medical condition is limited to the documents provided with your letter of 30 October 2013.
It is not known what documentary material was provided to Dr Somerville nor is it known what was conveyed to him by Dr Navathe in the conversation on 1 November 2013. Moreover, it is highly irregular that one expert witness, who is as well the primary decision-maker, was apparently briefing another expert witness in terms not disclosed. The danger of such a practice ought to have been evident. The vice is merely compounded by the failure to make clear what information was conveyed.
31. But even if that evidence was to be regarded as being evidence of a condition or of an effect of a head injury I have a distinct preference for the evidence of Dr Cameron. He alone had the benefit of a clinical examination of Mr Bolton. He concluded that Mr Bolton’s risk of posttraumatic seizures was no greater than that of the general population. The studies relied upon by the other witnesses, he said, considered the full range of head injuries not merely the very mild head injury suffered by Mr Bolton. It was Dr Cameron's opinion that a skull fracture increased the risk of posttraumatic epilepsy only if there had been penetration of the dura or if there had been bleeding in the cavities of the brain. Neither occurred in the present case. That evidence satisfies me that, had I concluded that Mr Bolton did not meet the medical standards, his present medical condition is not likely to endanger the safety of air navigation.
32.I will then set aside the decision to cancel and substitute a decision that Mr Bolton’s medical certificates not be cancelled.