What warrants a medical diversion?

[mike2000]

Hello,

Long time visitor, first time poster.

I was on VS016 from Orlando to Gatwick last night and we had to make a stop at Boston due to a medical emergency. Unfortunately the delay increased as there was a technical issue with a couple of valves after a fuel dump.

Before the descent into London the pilot announced that the lady with the medical issue had already been released from hospital. My question is: what warrants a medical diversion? Obviously it was serious enough to land the plane but to be out of the hospital a few hours later seems a little extreme?

Mike

[Capetonian]

I would have though it was fairly obvious that she received appropriate treatment in hospital, and was stabilised and recovered. Good news?

Perhaps you would have felt better if you'd been told she'd died, or maybe that would have meant the diversion wasn't worthwhile either, they may as well have let her die on the 'plane if she was that bad.

The person in charge made a decision, and such decisions are not made lightly, and only after receiving medical advice, that a divert to offload was necessary.

Your posting comes across as very insensitive, to say the least - maybe you didn't mean it that way.

[Corsairoz]

Just a question from someone who has no idea, but who pays the diversion costs in these cases of medical emergency? Of course if its a violent or drunk passenger they pay.

Clearly it is the Captain's sole decision (under advice) to make the medical diversion. But the extra fuel, the lost time, the landing fees. Does the airline claim that back from the passenger's travel policy? Do the airlines have insurance cover for this stuff? Or is it just accepted as an occasional overhead?

Would the Captain ever have his decision criticised to influency close decisions next time?

Only interest, no other reason for asking. Thanks.

Trevor

[Spooky 2]

Diversions such as this one are typically absorbed by the airline regardless of the out come. Flight crews are only able to offer so much medical assistance based upon fairly basic medical training. If there is a medical doctor, EMT or nurse on board to offfer assistance it can be a great help in diagnosing the probalem and determining the best course of action.

Most of the major airlines operating on the North Atlantic or NoPac have contracts with medical centers set up just to handle these types of situations. The medical facility can, based up certain known parameters determine the best course of action and thus mitigate both the medical hazard for the passenger while at the same time reducing liability to the airline. They can also coordinate medical services in such awy that when the aircraft lands there are personnel standing by both at the airport and the hospital to receieve and treat their condition.

The ones that really upset you are the passengers who say that their pills are in their luggage in the cargo compartment and they are having heart problems without them. Tempting to say, that's your problem not mine, but I guess that would lead to bigger leagal issues down the road. :mad:

[PJ2]

My question is: what warrants a medical diversion?
There used to be a something called "Med-Link" which F/A's could call from on-board the flight when they were having medical difficulties. The system was good in the sense that expert advice was available in-air, from anywhere in the world. I've used it, (rather the FA's did) to diagnose heart issues and so on. Based upon Medlink's diagnosis, the flight would either carry on or divert.

I can't find them on the 'net so perhaps they're out of business. Our company stopped using them a long time ago to save money.

Apropos the cost-saving, neither the Captain nor the F/A's have the medical expertise to make such a decision so it is usually either based upon obvious medical issues or liability issues.

[wiggy]

FWIW Medlink were still in business when we had cause to ring them a month or two back....

[mike2000]

Capetonian - thanks for insinuating I'd like someone dead to warrant a slight delay to my flight but that wasn't what I was getting at.

I was only asking what severity of someone’s illness would warrant a diversion. Thanks for the other useful and sensible replies - guess it's just down to what medical advice you have on offer at the time.

I thought the guys up front and CC handled it extremely well.

[PJ2]

wiggy, thank you. In my view as a (now retired) captain, they were worth their weight in gold when the decision to divert or carry on was made. When over the Atlantic or Pacific, their expertise (contacted by satcom) permitted more decisions to proceed than divert but gave us the confidence that we needed to divert when unsure. The airline usually covers the costs, which can be substantial if hotels, missed connections, etc are included in the operation.

Off-loading a passenger due purely for non-medically-derived behaviour (drunk, abusive, threatening, etc) has typically been "at their cost" and not the cost of the airline. Also, there is the criminal-record issue for interference with the flight as well, which in my view, is, along with costs, fully deserved.

[Capetonian]

mike2000

I only said : "Your posting comes across as very insensitive, to say the least - maybe you didn't mean it that way."


It's all about perceptions. I may be oversensitive because as a duty officer I had two related experiences, both highly unpleasant. The worst was to inform waiting relatives at the airport of arrival of a death where the decision to divert had not been made and the flight came in with a dead body on board. You might like to think through the implications of that scenario for all concerned, including the other pax.

[Paracab]

Interesting thread, and a subject I have been wondering about lately, please excuse my slight thread hijack.

As a british NHS-EMT who flies often enough for it to happen I wouldn't hesistate to muck in should the need arise on a flight, my questions is how seriously would my opinion on the patients condition be taken?

The divert of a flight is a big responsibility, this is not something I have a problem with, I'm used to lone working and the associated decision making process from plenty of singleton rapid response shifts, but this is clearly an area of medicine requiring a very different and dynamic approach.

[Rainboe]

I believe the decision to divert is down to the airline, so all costs are to the airline. Trying to recover £20,000 from a drunkard is not going to get you far. Their solicitor will say he was 'having a crisis on sedatives and he had a glass of wine too much, that's all!'. It was not the drunks decision to divert, and recovering the money from someone of limited means will not be cost effective.

The decision is easier now with Medical Advice specialists available on the radio- it is basically out of the captain's hands unless there are special extenuating circumstances. Several times I have received this advice and have stuck to it in the face of near revolt from the crew. As long as full details are passed to the advice line, that is it as far as I am concerned- I am not better qualified enough to overrule the specialists! I have been asked to take desperately and terminally ill people back to the UK from far flung places. In circumstances like this, I have told the carers that I am happy to take them, but they must understand there will be no medical diversion under any circumstance. The facilities available in the air exceed what they are likely to get in Kinshasa General Hospital, and is it sensible to dump any near-death person there in the first place? Is it also fair to disrupt 400 people for up to a 24 hours or more for someone who is near death anyway?

Call me hard, but I have had the following incidents. In all cases, I had cabin crew crying at me begging to divert:

Middle aged Arabic woman, dreadful heart attack. All the symptoms- face contorted, colour. Refusal to divert. She then recovered, started claiming someone on board was trying to kill her - you know you have a fruitloop then. During transit at Baghdad, ran down steps of plane and last seen running into the night across the apron pursued by soldiers with machine guns.

Young Malaysian very pregnant woman. Screaming a 747 out. Convinced she was losing baby as 'she had a miscarriage previously'. Distressing for all concerned, cabin crew crying, begging to divert. Refusal. Heard nothing more. At the end of the flight, I asked the crew what became of her. 'Oh, she had a massive release of wind and was alright'. Good job I wasn't near her- I'd have set fire to her! I felt like throwing my briefcase at the cabin crew! Prats.

Attractive volatile blonde slugging passengers nearby. I ordered restraint. Took 8 crew fighting a spitting cat. Turns out it was a cross dresser sex change out of Bangkok still on drugs and anaesthetic. Very unpleasant for the crew. But once in handcuffs, I never understand why flights then divert. Handcuffed to the seat and as far as I am concerned they can crap themselves there, but why disrupt 300 people for them?

[Wannabe Flyer]

Rainboe

You are quite funny I must say and enjoy reading your analysis on everything from Technical to loony tunes on board! :ok: You definitely are someone who sticks by what you believe in and will probably also stand up and take any subsequent ramifications full frontal rather than ducking behind some seat. :D

[propeller]

Med link still on and it's a great help for the crew to decide to continuoe or to divert due to medical reasons, it is an extra cost for the airline but it's also an advantage for the pax Wichita can be any of us.