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The Head of CASA AVMED Resigned Too Soon...

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The Head of CASA AVMED Resigned Too Soon...

Old 11th May 2015, 02:41
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My turn will come and when it comes I'll hang up my flying boots as I'm not a medical expert and I don't know if my future heart condition will cause me to pass out and take out innocents on the ground. Trouble is that we all feel great until something happens to us
That is not the “turn” to which I was referring, S7700.

The “turn” to which I was referring is the one when you and your DAME and every specialist you’ve consulted agree that you’re as fit to fly as anyone else, but AVMED decides it ‘knows better’. That’s when you’ll realise that it’s best to do whatever’s practicable to keep zealots on a medical crusade under strict control.
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Old 11th May 2015, 03:40
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I'm afraid we are all in that lottery together!
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Old 11th May 2015, 03:41
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The vast bulk of DAMEs I've seen over the yrs have had little to say on CASA, except; "Nah, they don't need to know that!", "Don't tell me that!" etc, etc.

That gives you an idea of its (CASA's) thinking in general. There was one exception (DR.RL).
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Old 11th May 2015, 03:51
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RL would not mind being identified as the best and fairest Director of Aviation Medicine this country has had.



Aviation Safety Regulation Review Submission
Dr Robert Liddell

This submission is a personal submission in relation to the medical certification of aircrew.
I am a current holder of Australian, British and FAA Airline Transport Pilot Licences. I have 7000
hours of flight experience with over 3000 hours in jet operations, mainly in Boeing 727 aircraft in
Europe and Australia. Between the years of 1988 and 1997 I was employed by CASA (then CAA)
as the Director of Aviation Medicine. This position has now been renamed Principal Medical Officer.

Following my resignation at Director of Aviation Medicine the position has been filled by Dr Peter
Wilkins, Dr Ian Hosegood and Dr Pooshan Navathe.
The international nature of aviation and the relationship of each country’s aviation authority
with the standards and recommended practices that they are signatory to in the International Civil
Aviation Organisation has resulted in a safe system that most major aviation countries have seen fit
to deviate from in various ways. The country with arguably the most differences from ICAO is the
country with the largest aviation industry in the world, namely the USA.

In Australia we have had minor differences with the SARPs since their very inception. In some areas
we are more restrictive than the SARPs and in others we are more relaxed. For example during my
tenure as Director of Aviation Medicine I had occasion to be called as an expert witness in the
Federal Court where a Qantas pilot was claiming discrimination on the basis of age as Qantas were
requiring him to retire having reached the age of 60 years. This was done ostensibly on the grounds
of medical risk. My contention has always been that age is not a good predictor of risk and many
pilots are high risk at a relatively young age and many are low risk even in their 70s.

The judge upheld the appeal and Qantas since then and Australia therefore became one of the few countries
to allow pilots to fly heavy jets regardless of age. To achieve this it was requested by the judge that
CASA Aviation Medicine develop a risk mitigation strategy. Consequently we became the first
country in the world to put a risk matrix over pilots at every medical examination, and those that are
at increased risk of heart disease are required to undergo an exercise ECG to prove cardiovascular
health.

This is an example where Australian regulations were far more stringent than the ICAO
SARPS. In other areas such as colour vision, due to a lack of any accident data related to colour
defective vision in pilots Australia chose to allow pilots to fly commercially even if they failed the
colour vision testing. This was a difference from the ICAO SARPS.

This change was brought in around 1990 and remained in place until recently. There are
now hundreds of colour defective pilots flying commercially in all types of operations and who over 20 years will have built up thousands of hours of accident free aviation.
These contracting state differences are advised to ICAO as a difference and the information is
available to other contracting states through ICAO.

Recently there has been a move for reasons that remain unclear to change the Australian
regulations to be totally compliant with the ICAO medical standards. This move is
without any evidence that adopting more restrictive practices will have any effect on safety but rather will
discriminate against some pilots.

I now have several pilots, one of whom has over 16,000 hours of operation, most of it flying night
freight in command on Boeing 727 aircraft and who in mid-career are being advised that they do not
meet the standard because of their colour vision and so cannot hold the required class of licence to
retain their occupation.

I suspect that due to my previous role in CASA, I seem to attract many pilots who are totally
confused and despondent at their medical certification by CASA aviation medicine. This involves
conditions such as head injury, hearing, cardiovascular disease and prostate cancer, where the
opinions of the pilots own specialist doctors are ignored and stringent and expensive repetitive
imaging and blood testing is required, if the individuals wish to retain their medical certificates. On a
weekly basis I receive requests for assistance by pilots with conditions ranging from renal stones to
early type 2 diabetes , where the pilots own specialist’s advice is ignored by CASA, and further
expensive or repetitive testing in required to obtain a medical certificate.

The dangerous result of CASA’s draconian regulatory measures is that
now many pilots tell CASA as
little as possible about any medical problems in order to protect themselves from expensive and
repetitive investigations or possible loss of certification . Most pilots are responsible people and
they have no desire to be in charge of an aircraft if their risk of incapacity is unacceptable. When
their DAME and their specialist believe they meet the risk target for certification without endless
further testing demanded by CASA and the advice of their own specialist is ignored by the regulator
then the pilot’s lose confidence in the regulator.

In medical certification, CASA appears to have lost sight of the fact that all pilots self-certify
themselves fit to fly, every day they take control of an aircraft. The only day in the year when a
doctor has any control over their fitness to fly, is the day that they have their medical examination.

Dr Robert Liddell

24 January 2014

Last edited by Fantome; 11th May 2015 at 10:26.
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Old 11th May 2015, 11:55
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Great read that letter.

Picking up a point in it tho, just thinking about a friends fight to get his Class 2 medical back (prostrate)...

This involves
conditions such as head injury, hearing, cardiovascular disease and prostate cancer, where the
opinions of the pilots own specialist doctors are ignored
A similar sentence to this appears later in the letter.
However, in my mates case, CASA have also been ignoring the reports of the specialists that CASA has sent the man to...at his own expense.

Sorry it just beggars my understanding that they can send someone to CASA's own nominated specialist, and then reject that person's ok to fly advice
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Old 11th May 2015, 12:38
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Remember, according to the regs, if you have an illness that stops you for flying for 7 days or more for a Class 1 (30 days for a class 2) [CASA 2015], then you are supposed to go to your DAME before you fly again to get the OK to fly. So that flu you had last week that kept took you down for a week, you had better had seen a DAME before you took the stick in your hands again, or you just contravened a CASA regulation. Hold a Class 2 and broke your hand or leg, then better see your DAME before you fly again.

CASA 2015, 'Reporting Medical Conditions to CASA', CASA, viewed 10 May 2015, Civil Aviation Safety Authority - Reporting medical conditions to CASA
WOW! for the first time in Australian Aviation, well, PPrune History, (quite possibly Internet forum history)someone has actually referenced their quote! Harvard style no less..
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Old 11th May 2015, 16:52
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they can send someone to CASA's own nominated specialist, and then reject that person's ok to fly advice
no surprise there. . .they've been practising this obstructionism for a few years now. One of the arch perpetrators of this virtual knee-capping had some explaining to do before the AAT last year. He came out a tad shame-faced.
But of course the poor sod who mounted the appeal got nothing for many months out of work.
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Old 15th May 2015, 04:38
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received from SAAA today

Message to SAAA members from CASA AVMED

Dear SAAA members

The following is an extract from a letter from Dr Michael Drane, Acting Principle Medical Officer, Aviation Medicine at CASA. It is a follow up to the meeting he had with Neil Unger, discussing the many problems our members have reported to SAAA regarding their pilot medicals.

“ …. Our assessors are a kind and hard-working group who will be able to deal with many of the questions – and do every day. Where there are doctor matters, they will be able to refer to a doctor. It is a fact of life and funding that are not always doctors available to talk on the phone and I regret that I am not in a position to change that. However, where we can we will do our best to call applicants when there is a complicated matter that needs sorting out. Often in fact our nurse is the person who co-ordinates such complex cases, and there is not much she does not know!

So may I request that you advise your members of the following:

“If you have queries about your application for a Class 1,2 or 3 medical certificate, please call the AvMed hotline: 1300 4 AVMED [1300 428 633]. Alternatively, you may email: [email protected].

Background information about the importance of some medical conditions can be found on the CASA website at:
http://casa.gov.au/scripts/nc.dll?WC...::pc=PC_101484

These guidelines also explain the reasons why some conditions are of particular concern in aviation.”

I will continue to take a close interest in the removal of barriers, perceived or real, hindering pilots and controllers understanding more about the medical aspects of aviation safety – we will be in touch shortly with some material for your consideration.

I appreciate your efforts in moving things forward.

With kind regards,

Dr Michael Drane
A/g Principal Medical Officer
Aviation Medicine

MBBS MAvMed FACAsM DipOccMed
PGCAeroRet MRCGP FRACGP DRCOG
Principal Medical Officer”
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Old 15th May 2015, 10:55
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Not long after Pooshan quit I renewed my class one, did it on a Monday, got the medical by email on the following Wednesday, thread drift I know but perhaps a sign things are on the improve?
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Old 15th May 2015, 11:22
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It's taken one of my students five months to get his medical, due to him having had laser eye surgery a few years ago and being constantly sent back to do more tests, each time the doctor saying it wasn't necessary but of course he had a bill to pay each time.
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Old 17th May 2015, 09:02
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Please try reporting these problems via the 'Hotline'. If you don't get a satisfactory response, let SAAA know: [email protected]

Dr Drane has extended the invitation - let's use it to raise awareness of AVMED's failings.
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Old 17th Nov 2015, 03:52
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Angry CASA Medical Incompetence

A couple of weeks ago i did my Class2 renewal; with all the requested ophthalmology and endocrinology reports together with a positive report from my GP with excellent pathology plus a positive report from my DAME (who then reissued my med cert).

Weeks later, some clerk at CASA writes to me for additional info from the ophthalmologist (a specialist in private practice certified by CASA itself) after he's certified my as having faultless vision and good general ophthalmic health. Not satisfied with that, the idiots now want even more form that specialist who has now reported positively again regarding my vision and ophthalmic health.

Not satisfied with that nonsense, the idiots then write to tell me i must undergo a cardiac stress test (notwithstanding that i had one a few months ago with perfect results). When i rang the idiots today to remind them that a CASA doctor wrote to me a bit over year ago to say that i would have to do another stress test only if the DAME scored me as greater that 15. But when i reminded the clerk that the DAME rated me a few weeks ago as exactly 15, the idiot clerk at the other end said that the CASA doctor shouldn't have written to me stipulating the +15 score!

Clearly, my medcert (assuming i ever see another one!) will not be effective for anything like 2 years. And the cost will have beaten me by then anyway!

Is one to assume that the (mere) clerks at CASA have greater authority than CASA's own in-house doctors? What disgraceful nonsense .. thank heavens we're not at war because the staff work of these cretins is utterly dreadful.
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Old 17th Nov 2015, 22:55
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The joke here is that aviation medicals have NOTHING to do with aviation safety.

Our friends in the US look like getting them severely downgraded for private pilots. I looked into that a couple of years ago and since the early 1970s there have been at least 3 large scale studies of the efficacy of aviation medicals. There is a natural control group of private glider and hot air balloon pilots who self certify in the US (and in Australia for glider pilots - not sure about balloons, it has been a long time since I was peripherally involved with hot air balloons. The results were that there was ZERO evidence that medical causes were a serious cause of accidents(well under 1% of them) and the self certifying group had a slightly lower incidence of them.

Before some idiot goes on about how gliding is less stressful medically - it isn't. Try flying solo for up to 8 to 10 hours or more, no autopilot, in turbulence and pulling around 1.4 g for a significant part of the time, with the sun beating into the cockpit.

So we've run that experiment and the results are clear.

As for endangering others on the ground, can anyone here recall when a private pilot or glider pilot injured or killed an innocent third party on the ground in Australia due to any cause?

I know of two accidents, one a fatality (photographer standing on top of a car had his head knocked off - I'm sure you can all draw your own conclusions about flying so that your wingtip is within 2 meters of an obstacle on the ground), involving gliders overseas. Medical certification would not have helped in those.

That pretty much takes care of the "endangering others" bs.

So we are left with protection of other airspace users and a case can certainly be made out that being able to see properly is a good idea although the ATSB seems keen on telling everybody to forget that as it doesn't work. Well it definitely won't work if you don't look.

Now consider the case when you drive a car. The chance of killing or injuring an innocent pedestrian, another road user or someone just minding his own business in his house (cars and trucks seem to impact houses in Australia every week or two it seems) due to a medical problem such as sudden incapacitation for any reason must be much higher. Let alone fools who text or use the cellphone while driving.
Not much medical certification there. In Queensland they don't even do eye tests any more to my optometrist's disgust as he gets people in who he finds to be legally blind, who drove there. A few years ago there was a case where a female diabetic passed out at the wheel on the Sunshine Coast Motorway, crossed the median and went head on into a car coming the other way, killing a small child in the other car. Went free. She was a GP who should have known better and been held to it.

As for this drivel "As a medical student, I can see the benefits of this, if someone turns up in emergency alone, unconscious, you can look up their medical history with may assist with a quicker diagnosis of the problem, and therefore quicker treatment, and potentially save their life."
Unless they have ID in their wallet or purse, how do you know who they are? If they do they should have a little card in the wallet that describes any dangerous or bothersome medical condition. FFS given the propensity to cover your skin in ink that is in vogue they could even get a small discreet tattoo.
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Old 18th Nov 2015, 00:08
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Well said, E.

AVMED's recent decision-making is one of the starkest examples of decision-making that is not based on objective evidence or objective risk. It is based primarily on AVMED's messianic belief that they are carrying the primary burden of aviation safety because, according to the erstwhile PMO, a pilot’s licence goes on forever, but it is the medical certificate which enables the person to use the licence. All of the other so-called specialists and experts can have their opinions, but it is ultimately AVMED who bear the terrible burden of allowing a pilot to fly. And if that burden has been imposed on AVMED, it must surely follow that AVMED knows better that everyone else.

Amazingly, the pilots who have been allowed to fly for decades without NAA medical certificates have not caused carnage as a consequence of their sudden incapacitation. Amazingly, the pilots who do have NAA medical certificates suffer the same rate of sudden incapacity as the general population.

The current regime has little grasp on what causes the substantial risks to aviation safety, or how to mitigate them. If they did have that grasp, they'd realise they're a sideshow. They'd also realise that, as has been pointed out by people like Dr Liddell who do know, that all AVMED is now doing is encouraging pilots to take the risk of telling their DAME and AVMED as little as possible and not seeking medical advice about something that may turn out to be serious if not treated.

Unfortunately, AVMED has been allowed to get out of control and nobody with the power to get them back under control particularly cares.
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Old 20th Nov 2015, 13:22
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Rumour based on hearsay based on scaremongering based on speculative opinion.
If it was the same 182 with a cadet on night circuits that went in on a go-around, it was because of poor instrument flying go around ability. Also the flying school had a different go-around procedure promulgated in the company manual instead of the Cessna 182 manufacturer's POH procedure.

The CASA audit team missed that one?
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Old 23rd Nov 2015, 03:28
  #36 (permalink)  
 
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my GP called me in because one of the markers in my blood had changed.
nothing serious but it had changed.
so he gave me a physical. no problems.
ok it has changed but it is still within normals but the gaps in samples confuse the issue a bit. hmmm, an age related change maybe. you're in bloody good form though, you should have no problems at all with your pilot medical.

do the class 2 with my local DAME.
after a good check over he comments you don't have any problems and signs the form.

the principal medical officer in masturbation manor writes back demanding some information that doesn't exist and requests spirometry to check lung function.

I write back telling him that his request is nonsense.

sends me a longer letter telling me that spirometry is to check peripheral tissue oxygenation.
it doesn't check for that at all.
having driven a spirometry machine during my training I know what it gives.
his request is still nonsense.
just as a sanity check I have put on my pulse oximeter and checked my peripheral oxygenation. it shows full saturation.

Dr Peter Clem I think you are a clown.
I wonder whether your qualifications are as bogus as your predecessors turned out to be.

I continue to fly and I will continue to ignore the fckuwits in CAsA..
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Old 1st Dec 2016, 13:38
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GregP - I seem to be going through what you went through in Nov last year. I reckon that the CRI matrix is a crock and and easy excuse to purge pilots, especially older ones, clean out of the air. I have been made to undergo numerous extra tests at great expense to myself, only to be told to do some again. And that includes undergoing an angiogram only for my GP to say that it is crystal. Naturally, all of this takes time and money. But you think the avnazis care ? nope...its not them affected, why should they care...
They appear to use this matrix, with great delight, as a deterrent to anyone interested in aviation whether they be young or old. It appears that they go through a lot of 'Drs' up in the castle but doesn't take them long to adopt their old bolshevik ways.
That said, I think I am done...I cant do any more than whats asked of me, I'm spent and broke, and casa avmed wins again.
To those who say " whats the fuss", your turn WILL come as what CreamPuff points out.
Finally, to seal my point on this thread, have a read of this + comments - its gold:
Pilot numbers indicate a major fall in aviation « Assistance to the Aviation Industry
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Old 1st Dec 2016, 14:04
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GregP - I seem to be going through what you went through in Nov last year. I reckon that the CRI matrix is a crock and and easy excuse to purge pilots, especially older ones, clean out of the air. I have been made to undergo numerous extra tests at great expense to myself, only to be told to do some again. And that includes undergoing an angiogram only for my GP to say that it is crystal. Naturally, all of this takes time and money. But you think the avnazis care ? nope...its not them affected, why should they care...
They appear to use this matrix, with great delight, as a deterrent to anyone interested in aviation whether they be young or old. It appears that they go through a lot of 'Drs' up in the castle but doesn't take them long to adopt their old bolshevik ways.
That said, I think I am done...I cant do any more than whats asked of me, I'm spent and broke, and casa avmed wins again.
To those who say " whats the fuss", your turn WILL come as what CreamPuff points out.
Finally, to seal my point on this thread, have a read of this + comments - its gold:
Pilot numbers indicate a major fall in aviation « Assistance to the Aviation Industry
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Old 1st Dec 2016, 21:01
  #39 (permalink)  
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DAME has told me that even the Doctors in CASA are ruled by the lawyers, and they hate it.

What I can say anecdotally is that CASA AVMEDS practices make aviation much less safe because in view of the experiences of people like Inxs and GregP, pilots now go to great lengths to mask possible health conditions because of CASA AVMEDS disproportionate and unreasonable response to a possible abnormality.

Lest you think that this is about a few old fart GA pilots it includes line airline pilots. We used to joke about cabin crew going on the diuretics before a weigh in, but now there are alleged anecdotal reports of airline pilots going on the same before a medical to mask blood pressure issues*.

The DAME handbook now seems to be written to require that even the most remote, unusual and improbable side effects have to be ruled out before someone with a condition is allowed to return to flying - hence potentially life threatening conditions are not reported.

And of course AVMED is not there to in any way protect your health in a positive and timely manner. It is t here to protect CASA and AVMED from you. ...and of course once you have lost your medical they no longer have any interest in your health, do they?

* And that comes from the DAME of the owner of a C172RG who had a heck of a time keeping his medical with diabetes and blood pressure issues, so it is third hand.
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Old 1st Dec 2016, 21:19
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Sunny

If you have some idle time, compare the FAA DAME handbook with the CASA one.

One is easy to read & logical, one is not.

Many of the DAME's that have review positions with CASA have academia listed as their specialisation.

The whole system is Australian is too Canberra based and theortically based and interventionist.
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