High Courts blocks DVT claims

[Flying Lawyer]

A High Court ruling has blocked an attempt by DVT victims and their relatives to sue 27 airlines claiming that airlines failed to warn them of the risks of long-haul flights.
The judgment is a victory for the airlines, which faced a multi-million pound bill if the case went against them, and came just hours after the Australian courts decided DVT victims could sue airlines in a virtually identical case.

The airlines said they were protected under the Warsaw Convention from paying compensation for medical problems classed as a "passenger reaction to the normal operation of an aircraft". The Warsaw convention, which governs all international carriage of persons by aircraft for reward, only allows for recovery of compensation in respect of personal injury or death caused by an accident.

Mr Justice Nelson ruled that, under the terms of the Warsaw convention, DVT cannot be deemed an "accident" and therefore airlines cannot be held responsible for the condition.

Counsel for the claimants had asked for the case to be adjourned so that the ruling in an Australian case could be considered, but the Judge said: "I am satisfied that it is appropriate for the line to be drawn. The line should be drawn now." (UK Courts are not bound by decisions of foreign courts.) The Judge gave the claimants leave to appeal.

After the ruling, a BA spokesman said: "We are pleased that the High Court has recognised the fact that such legal action is unfounded under the terms of the Warsaw Convention. British Airways sympathises with all victims of DVT but since the World Health Organisation and the House of Lords agree that there is no evidence of a specific link between flying and DVT any future claims will continue to be resisted."

In the Australian ruling, 59-year-old Brian Povey, took both Qantas and BA to court after suffering an attack of DVT which he blamed on a three day return business trip from Sydney to London. Mr Povey said the illness was an "accident" as defined by the Warsaw convention, and he said airlines failed to do enough to warn passengers about the risks of DVT on long-haul flights. The Court rejected the airlines' argument and the full case, involving some 500 claimants, is expected to go ahead next year.

Tudor Owen

[overstress]

Perhaps this will act in some way towards curbing the rise of the 'compensation culture' in the UK

Although I doubt it.

Dontcha hate the way Sky news calls it economy class syndrome? That's discriminatory against all those who paid good money to sit in Business or First and still got a blood clot.

[Danny]

Surely a study of DVT amongst airline pilots would be the best bet of finding out if there is a higher risk for air travellers. Who else flies as often as we do? We already know that media luvvies only call it 'economy class syndrome' because they are the lowest denominator when it comes to catchy 'themes'. In reality we know that DVT affects passengers from all classes of seating.

I know of some pilots who have suffered from DVT but surely a study of the number of cases amongst the airline pilot population as a whole would be the most sensible course. After all, we come in all shapes, sizes, colours and ages. Why the media luvvies or anyone else haven't mentioned this yet baffles me. :confused:

[Tartan Giant]

A High Court ruling has blocked an attempt by DVT victims and their relatives to sue 27 airlines claiming that airlines failed to warn them of the risks of long-haul flights.

I am very pleased some sense still remains in UK court rooms.

I wonder if drunk drivers will sue for not being told of the risks whilst driving - how many have they killed over the years ?

Life is a risk - manage it.

TG

[Silver Tongued Cavalier]

My friend works for a large international company which (albeit begrudgingly) puts it's employees travelling on company business, up the front for fear of claims against the company in the case of DVT.

He does lots of business travel, and says the only reason he's still travelling up the front in these harder economic times, is the fear his company has over any future DVT case against them!

Maybe a cunning ploy BA etc can take advantage of to keep them all up the front in the posh seats!!??

My thoughts go out to the people who died because of this, all just coming home from holiday. Hopefully research and awareness etc will prevent further cases.

[Scudhunter]

Danny:


I'm no medical expert but I think a study of pilots would be dismissed for a couple of reasons.

Pilots are required to pass strict medicals on a regular basis, and I suspect this general level of good health would distort any results.

Secondly your average pilot isn't sat in your typical airline seat -- be that first-class or economy -- and I reckon doesn't replicate the same typical movements of a passenger.

These might be significant, or they might not. Either way, this whole DVT thing seems to be difficult enough to pin down without introducing the difference in pilot/passenger situations as a possible influence.

Incidentally, there was an interesting news article published a few days ago citing a study which shows that DVT mortality rates from air travel are no higher than those for the general population...

...and it didn't even mention the phrase 'economy class syndrome' ;)

[Alty Meter]

I wonder what the people who criticise the airlines for economy seating would say if the there were less seats at higher prices. The two go together.

[Crosswind Limits]

A good decision under present legislation. The old "flood gates" argument definitely applied in this case [breathes a sigh of relief].

[Wobbler]

Scudhunter,

A study amongst pilots probably would not distort the findings. General good health does not reduce the chances of developing a DVT. Any (in)activity which involves immobility for 4 hours or more puts you at risk. I had a DVT some time ago, yet I hold a Class 1 medical and play a great deal of sport. There were a significant number of athletes travelling to/from the Sydney olympics who ended up with DVT's and they, I would suggest would be in the best of physical shape. Also the type of seat is also largely irrelevant. Broadly speaking the same proportion of 1st class passengers as economy passengers end up with DVT - you just get to hear more about the people down the back because there are more of them. A study (published in ther BMJ I think) about 18 months ago showed that approximately 10% of passengers on long haul flights end up with some form of clot in their lower limbs. The vast majority of these are not dangerous and you would not know anything about them - however for the unlucky few..... A possible symptom of a clot is one stiff leg (as opposed to two!) that may develop days later - I have spoken to many long haul travellers over the last few years who have recognised such symptoms, but done nothing about them - they could well have been clots.

The problem is awareness - people need to know that they should be exercising their calf muscles ideally every hour, drink plenty of water, avoid alcohol and caffeine (to prevent dehydration and consequent 'thickening' of the blood making clots more likely) and possibly take aspirin (after seeking a doctors advice) before flight.

And they can affect anybody - fit and unfit alike!

[bblank]

I understand from Flying Lawyer's post that the court's decision does
not relate to cause of DVT but only to the strictly legal matter
of whether the occurence of DVT is compensable.



BA: "... but since the World Health Organisation and the House of
Lords agree that there is no evidence of a specific link between
flying and DVT ... "



Disingenuous! The House of Lords' Select Committee report is
excellent but to summarize its discussion in such simplistic
terms is misleading, as can be seen from one of the recommendations,
which reads "We recommend that airlines and their associates reappraise
their current practices in relation to not only the provision of
information for passengers but also the design of the cabin and cabin
service procedures."



"Dontcha hate the way Sky news calls it economy class syndrome?"



The name "economy class syndrome" originated in the British medical
literature in the 1970s. The press merely repeated it. DVT was
noticed among those sitting in cramped shelters for hours on end during
the London Blitz, 1940, hence the inferred association with economy
class. Whether or not the rate of DVT in air economy class pax is
greater than among other travellers does not appear to have been
conclusively established. The House of Lords' report suggests the
alternative descriptions "flight-related DVT" and "traveller's thrombosis."



"I think a study of pilots would be dismissed for a couple of reasons ..."



Not neccessarily. There are statistical procedures that deal with
multiple risk factors and you certainly would want subjects without any
risk factors at all. The main difficulty in such a study would be
obtaining the required data. The House of Lords' report rejected the
financing of comprehensive studies. On a cost-benefit basis I think that
they were right to do so.



"there was an interesting news article published a few days ago citing a
study which shows that DVT mortality rates from air travel are no higher
than those for the general population ... "



I think that you are referring to a University of the West of England/
Gloucestershire Royal Hospital study. It's new - no doubt its conclusions
will eventually be challenged. I can think of two obvious grounds. Its
mortality findings are based on the upward revising of PE mortality
rates in the general population. However, epidemiologists know that
incidence of DVT in travellers is also underestimated. When that number
is also revised upward the cited study, which was small anyway, will be
out of date. Secondly, PE mortality is relatively rare among those with
DVT (around 1%) so the study sheds little light on flight-related DVT.

The following data may be of interest. A large French study published
one year ago looked at pulmonary embolism that occurred among passengers
within one hour of landing at CDG. Draw your own conclusions, remembering
that the DVT rate would be about 100 times greater.

Distance (km) PE Rate (per million)
< 5000 0.01
> 5000 1.5
> 10000 4.8


Wobbler, there is one (surprising) study that goes even further than
your statement that "general good health does not reduce the chances
of developing a DVT." Looking at long distance travel (not only by air)
the study found that DVT among such travellers is idiopathic.

[slim_slag]

A study (published in ther BMJ I think) about 18 months ago showed that approximately 10% of passengers on long haul flights end up with some form of clot in their lower limbs.

I haven't read the BMJ in years, but was that the 10% have clots, 10% of those extend above the knee, 10% of those break off and 10% of those cause nasty problems?

A cardiologist friend of mine was in talks with a large airline to do some more definitive studies on this. This would involve nurses at check in selecting & consenting passengers, and taking blood. At the other end of the long haul flight, nurses would question the passenger, take more blood and relevant investigations performed.

The airline was very interested in this, but really wanted it to prove that the problem existed in all classes of service, and also wanted it to prove that the same problem existed in car/rail/bus travel. Last I heard the airline was plucking up the courage to agree to the trial, but petrified that the study would show that those nasty economy seats might be blamed.

I think that hurdle was overcome and more definitive studies are being done.

[oh-oh]

I'm sure I read an article in the paper (so it must be true :rolleyes: ) that a taxi driver died after a long days work, so guess it's not just the economy seats.:(

[icemaiden]

The whole point of having these conventions is to provide some unification of law. Recent US jurdgements have broadened the term "accident" and I believe rightly the UK has followed the traditional stance. But this effects the concept of the systems, and Montreal (the new convention) has neither cleared up the existing problem with the concept of accident, but has also introduced the fifth jurisdiction - enabling claimants to bring an action under their own laws (not literally their own conept of law but their own national law). Now that being said, Pax A and Pax B both bring a claim, Pax A fails, Pax B succeeds, same grounds, same facts, same law, different result. Hmmm fairness, justice, unification? This isnt just about DVT this is about every incident that could be interpreted as an accident from turbulence to food poisoning, to sexual harassement by other passengers. At least thats my twopeneth worth. Merry Christmas.

[timzsta]

Why do we not hear of cases of DVT from people who undertake long journeys by coach - ie ski trips to the continent, or amongst long distance lorry drivers or sales reps who spend hours behind the wheel?

[virgin]

Three reasons. Money, money and money.

[peeteechase]

Why do we not hear of cases of DVT from people who undertake long journeys by coach - ie ski trips to the continent, or amongst long distance lorry drivers or sales reps who spend hours behind the wheel?

It's a lot easier to sue an international airline?

ATB, PTC

[PaperTiger]

Travelling by ground conveyance does not involve reductions in humidity nor oxygen intake. Either or both of which may be contributing factors.

http://www.veinsurgeon.net/dvt.html#travel

[virgin]

It still hasn't been proved that long flights cause DVT. Even the medical world seems to be divided. So how can anyone prove that their DVT was caused by the flight?
I guess some people are more prone to DVT than others.
How are the airlines to know? Should passengers have to hold a Class 3 medical, or produce a letter from their GP saying they're fit to fly? :rolleyes:

[Charlie32]

The evidence seems to me to be doubtful with regard to establishing whether air travel carries any significant increase in risk for DVT particularly by comparison with other forms of travel.

However even if it does, surely the airlines can only be held liable during the period in which they should reasonably have been expected to know of the risk, (if there was any) and if they failed to make any evidence about that risk available to passengers.

Once the matter is out in the public domain, it is for passengers to choose whether they accept the possible increased risk and if they do, they accept the consequences of exercising their right to choose.

Surely a passenger who suffered from a DVT would, in addition to establishing causation, have to show that had he been aware of the evidence available at the material time, he would not have flown.

Given that the evidence is in dispute, and clearly out in the public domain, how many potential passengers decline air travel on that basis? Very few I suspect.

[bblank]

"was that the 10% have clots, 10% of those extend above the knee,
10% of those break off and 10% of those cause nasty problems?"

slim_slag, from all the 10%s I think you are referring to an
article of Scurr in The Lancet. If so then the situation is not as dire
as you remember. From Scurr's paper, "We conclude that symptomless
DVT might occur in up to 10% of long-haul airline travellers." Note
the adjective "symptomless." The authors write "We accept that
symptomless calf vein thrombosis is probably not a major risk to health."
Citing other research the authors report "Published clinical series
showed that 10-20% of isolated calf vein thromboses extend to more proximal
veins. Pulmonary embolism can arise in about 10% of patients presenting
with isolated calf vein thrombosis." I believe that the work Scurr cites
pertains to symptomatic calf vein thrombosis.

Scurr's 10% figure may be unreliable but so far as I have seen his critics
have not addressed one interesting aspect of the study. Scurr randomized 231
subjects into one group of 116, a second group of 115. Members of both groups
had no DVT risk factors. Of the 116 in the first group, none of whom wore
compression stockings, 12 were diagnosed with symptomless DVT - that's
where the 10% figure comes from. Each member of the second group wore
compression stockings during flight. Not one of them presented any kind
of DVT afterward.

...had he been aware of the evidence available at the material time, he would
not have flown.

I don't know what the legal issues are but there are less drastic measures
listed in the section PRECAUTIONS TO TAKE WHEN TRAVELLING in the link
PaperTiger posted above.

"Money, money and money"

Now that that filthy subject has been brought up, two questions occur.
According to The Scotsman, "the judge decided, in principle, that
the DVT action group should pay the costs of the defendant
airlines - unofficially estimated at £500,000." Isn't that a lot of
money to debate the meaning of "accident"? Also, if the US is the world
leader in litigation, as is so often asserted in PPRuNe, why are the
British and Australian lawyers so far in the lead on this? One would
expect DVT to be a Warsaw-free issue on domestic coast-to-coast
nonstops. Have I missed something going on in the US?

[Hand Solo]

Yes, I think you missed American Airlines settling out of court a month or two ago.

[Bronx]

Seems like England is as far into the compensation culture as the US. The only winners are the darned lawyers.