D-AIPX - Airbus A320.
24 March 2015
Bureau d’Enquêtes et d’Analyses
pour la sécurité de l’aviation civile.
The BEA report is certainly exhaustive on the subject of the confidentiality between pilot and medico and the circumstances in which entrenched codes of confidentiality may justifiably be breached without fear of retribution from in some countries harsh punitive legal sanctions. Incidentally, let's not fool ourselves, there are countless doctors who in the case of doctor/patient confidentiality, and given the wide variation in doctor competency, are ill equipped to decide the best course of action where a perceived threat to the safety of others lives and property occurs. (Incidentally, in Australia the bureaucrats have infiltrated the aviation medicine department of the regulator to the extent that for many working in the industry any of their dealings with Avmed are fraught with alarm and suspicion, with daily instances of cock-ups and frequent cases of sheer medical ignorance and incompetency. If you tell them on renewal that you sometimes feel sad or nod off in front of the TV you may be scored low on their wacky richter scale. Be very careful how many drinks you admit to imbibing per day or week. )
Back on topic . . .. The BEA report should be required reading for all concerned about the wider implications of medical matters impinging on air accident investigation and reporting.
Some extracts from this fascinating document -
The BEA recommends that:
EASA require that when a class 1 medical certificate is issued to
an applicant with a history of psychological/psychiatric trouble
of any sort, conditions for the follow-up of his/her fitness to fly
be defined. This may include restrictions on the duration of the
certificate or other operational limitations and the need for a specific
psychiatric evaluation for subsequent revalidations or renewals.
Routine analysis of in-flight incapacitation
Currently available data does not provide accurate awareness of in-flight
incapacitation risks, especially in relation to mental health issues. This lack of data,confirmed by the difficulties experienced during the investigation in collecting data on previous similar incidents or accidents, can be explained by the reluctance to report this type of event, by the lack of investigations being carried out, by ongoing judicial proceedings, and/or restrictions linked to medical confidentiality
Promotion of pilot support programmes
The investigation has shown that in spite of the onset of symptoms that could be consistent with a psychotic depressive episode and the fact that he was taking medication that made him unfit to fly, the co-pilot did not seek any aeromedical advice before exercising the privilege of his licence. This is likely the result of difficulties in overcoming the stigma that is attached to mental illness, and the prospects of losing his medical certification and therefore his job as a pilot. Self-declaration in cases where pilots experience a decrease in medical fitness or starting a regular course of medication can be fostered if psychological support programs are available to crews who experience
emotional or mental health issues. Existing programs, overseen by peers, provide a “safe zone” for pilots by minimising career jeopardy as well as the stigma of seeking mental health assistance. These programs are sometimes underutilised for reasons such as: employees questioning the confidentiality of the service; the perception that a stigma is attached to asking for professional help with personal matters; or lack of unawareness of the program and its capabilities. Management of a decrease
in medical fitness can be optimized by including the intervention of peers and/orfamily members. AsMA recommends extending awareness of mental health issues beyond the physician to facilitate greater recognition, reporting and discussion.
Peer support systems are well implemented in major airlines, particularly in North America,where just culture principles are well known. However, these types of systems may pose significant implementation challenges when they are applied to smaller sized organisations that are less mature and have a different cultural background. For these peer support groups to be efficient, crews and/or their families need to be reassured that mental health issues will not be stigmatised, concerns raised will be handled
confidentially and that pilots will be well supported, with the aim of allowing them to return to flying duties.
Some known incidents of disruptive behaviour -
This list does not include events due to terrorist attacks.
Date
Aircraft Operator
State of Occurrence
Deaths
Circumstances
18/01/2015
A320
Condor
Portugal
0
The aircraft was in cruise at FL370 approximately 60 NM from Lisbon
when the co-pilot became incapacitated, and could no longer perform his
duties. The captain diverted to Faro, where the plane landed uneventfully.
The copilot was then transported to the hospital, where he exhibited
behaviour during the following days that raised psychiatric concerns.
29/11/2013
ERJ190
LAM
Namibia
33
The aeroplane was in cruise at flight level FL380 when the co-pilot left the
cockpit to go to the toilet, leaving the captain alone. On three occasions,
different altitudes were selected to order a descent to the ground with
autopilot. The CVR showed variable levels of aural warnings, as well as
noises of repeated knocking and calls, corresponding to attempts to get
into the cockpit.
27/03/2012
A320
JetBlue USA
0
As the plane was leaving New York-JFK and climbing in altitude in its
scheduled five-hour flight to Las Vegas, the captain said something to the
first officer (FO) about being evaluated by someone, but the FO did not
know what he meant. The captain then talked about his church and the
need to “focus” and asked the FO to take the controls and work the radios.
The captain began talking about religion, but, according to the FO, his
statements were not coherent. The FO became concerned when the
captain said “things just don’t matter.” According to the FO, the captain
yelled over the radio to air traffic control and instructed them to be quiet.
The captain turned off the radios in the aircraft, dimmed his monitors, and
sternly admonished the FO for trying to talk on the radio. When the captain
said “we need to take a leap of faith,” the FO stated that he became very
worried. The captain told the FO that “we’re not going to Vegas” and
began giving what the FO described as a sermon. The FO suggested to
the captain that they invite the off-duty JetBlue captain who was on board
the flight into the cockpit. However, the captain abruptly left the cockpit to
go to the forward lavatory, alarming the rest of the flight crew when he
didn’t follow the company’s protocol for leaving the cockpit. When flight
attendants met the captain and asked him what was wrong, he became
aggressive and banged on the door of the occupied lavatory, saying he
needed to get inside. While the captain was in the lavatory, at the request
of the FO, a flight attendant brought the off-duty captain to the cockpit,
where he assisted the FO with the remainder of the flight. When the
captain exited the lavatory, he began talking to flight attendants,
mentioning “150 souls on board.” The captain walked to the rear of the
aircraft but along the way stopped and asked a male passenger if he had a
problem. The captain then sprinted back to the forward galley and tried to
enter his code to re-enter the cockpit. When the FO announced over the
public address system an order to restrain the captain, several
passengers assisted and brought him down in the forward galley, where
he continued to yell comments about Jesus, September 11, Iraq, Iran, and
terrorists. The FO declared an emergency and diverted the aircraft to
Amarillo (Texas), landing with passengers still restraining the captain in
the galley. He was removed from the aircraft and taken to a facility in
Amarillo for medical evaluation. This incident is being investigated by the
FBI.
30/07/2009
Saab 340B
Mesaba USA
0
The flight was in cruise with 33 passengers on board when the cockpit
crew was alerted by a passenger that the single flight attendant had
become "no longer coherent" and was performing "numerous unusual
activities." The captain instructed the passenger to get the flight attendant
seated and the beverage cart stowed, and then diverted to a nearby
airport. The flight attendant was transported to a local emergency room
and diagnosed with "acute anxiety." There were no indications that the
flight attendant had any pre-existing medical or psychiatric conditions.
28/01/2008
B767
Air Canada
North Atlantic Ocean
0
The aircraft was
operating a scheduled passenger service from Toronto
(Pearson) to London (Heathrow). On first contact with Shannon ATC the
commander made a PAN call and requested a diversion to Shannon
Airport due to a medical emergency. The First Officer’s behaviour became
belligerent and uncooperative which convinced the commander he was
now dealing with a crew-member who was effectively incapacitated The
aircraft landed safety at Shannon where medical assistance was waiting to
meet the aircraft.
23/01/2001
DC-3 Galaxy Air Cargo
USA
2
The aircraft departed an island runway in Alaska during dark night VFR
conditions without filing a flight plan. The airplane collided with a volcanic
mountain at 1,500 feet amsl on the runway heading, 4.5 miles from the
airport. The captain's medical certificate had previously been considered
for denial after serving 49 months in federal prison for cocaine distribution,
but after review, the FAA issued the captain a first class medical. FAA
medical records for the captain do not contain any record of monitoring for
substance abuse. The first officer's medical had also been considered for
denial after an episode of a loss of consciousness. After a lengthy review
and an appeal to the NTSB, the FAA issued the first officer a second-class
medical. A toxicological examination of the captain, conducted by the FAA,
found cocaine and metabolites of cocaine. A toxicological examination of
the first officer found two different prescription antidepressant drugs.
31/10/1999
B767
EgyptAir
North Atlantic Ocean
217
The aeroplane was in cruise at flight level FL330 with a flight crew
consisting of a captain, a duty co-pilot and a relief co-pilot. The duty co-
pilot left the cockpit, and the relief co-pilot took his place in the right seat.
Eight minutes later, the captain left the cockpit in turn, leaving the relief
co-pilot alone. The autopilot was then disengaged and nose-down inputs
were recorded on the FDR. The aeroplane descended. The engines were
shut down. The captain returned to the cockpit and tried to take back
control of the aeroplane. The captain repeatedly asked the co-pilot to help
him to pitch up the aeroplane (“pull with me”) but the latter continued to
command the elevator to pitch nose down. The aeroplane regained
altitude before descending again. It collided with the surface of the ocean.
The reasons that led the co-pilot to take these actions could not be
determined.
11/10/1999
ATR-42
Air Botswana
1
The pilot, the only person on board, deliberately flew the aeroplane into
the ground by crashing at Gaborone airport. The validity of his licence had
been revoked for medical reasons.
19/12/1997
B737
Silk Air
Indonesia
104
While the aircraft was in cruise at 35,000 ft, the flight recorders stopped
recording one after the other. The aeroplane suddenly started to descend.
No Mayday message was transmitted before or during the descent. The
aircraft crashed into a river. The Indonesian led safety investigation was
not able to identify any technical problem that would make it possible to
explain the accident though the captain's mental state and sounds on the
CVR led other non-Indonesian agencies to conclude conclusively that the
captain was entirely responsible for the what transpired.
09/05/1996
BAC 111
British Airways
France
0
The aircraft was in cruise between Birmingham (UK) and Milan (Italy)
when the first officer complained of feeling unwell, stating that he was
"frightened of the altitude". The commander summoned the purser onto
the flight deck using a single chime of the cabin staff call system. The first
officer refused the offer of oxygen and a soft drink. He continued to show
symptoms of anxiety and stress, such that the purser felt unable to comply
with the standard incapacitation drill which calls for the crew member to be
slid back in the seat with the harness locked. The captain decided to
divert to Lyon, France where the plane landed without further incident. The
interviews conducted after the incident revealed that it was not the first
time this first officer acted like this, and he admitted having taken
psychotropic medication, without declaring it to the aeromedical
authorities.
21/08/1994
ATR42
Royal Air Maroc
Morocco
44
The captain disengaged the autopilot and deliberately directed the aircraft
towards the ground. The co-pilot was in the cockpit but was not able to
counter the captain’s actions.
09/02/1982
DC-8
Japan Airlines
Japan
24
After having disengaged the autopilot on final approach at a height of 164
ft, the pilot pushed the control column forward and set the thrust levers on
idle. He then moved the thrust levers of engines 2 and 3 to the reverse idle
position. While the aircraft’s attitude decreased, the co-pilot tried to pull on
the control column. The co-pilot was unable to raise the nose of the
aeroplane because the captain was pushing forward on the control
column with both hands. The aircraft crashed into the sea 510 m short of
the runway. The investigation led by a Commission of the Ministry of
Transport of Japan showed that the captain’s actions resulted from a
mental problem. He was suffering from schizophrenia.
Last edited by Fantome; 22nd Mar 2016 at 04:45.