painful experience in-flight
Join Date: Mar 2002
Location: London
Posts: 49
Likes: 0
Received 0 Likes
on
0 Posts
this thread has really opened my eyes.
i am a doctor and am shocked that the Doctor "was asked to sign a form indemnifying Airtours against any claim ....".
what kind of deal is that.
as an anesthetist , used to caring people with life threatening problems , my actions would be judged quite severely by the courts. also, most patients are grateful for the care they receive ...but once they are well and talk to their friends etc ...the idea of profit creeps in and they then could decide to sue. even if i do my job well ...i still have to pay my lawyers to prove that i did my job well ..and that cost much more than a bottle of champagne.
i think this issue is an very important one that needs to be addressed by the medical community and the aviation professionals.
if things are not solved ...doctors might try to hide their identity or might just give non commital or legal responses. just imagine if a doctor on board tells the captain to land asap for an condition that is clearly not life threatening .... this then places the captain in a very difficult situation. a medically qualified person is saying to land ..but it is obvious that the condition is not too bad ..say indigestion. the captain would rather land ...since he /she would not want the weight of liability.
this is legal medicine ..... as is seen often in the united states ...where the law is treated better than the pateint.
airlines get free medical cover by the doctor, but the least a doctor would like is for their legal fees to be covered.
when i was in med school ....i saw this training video on resuscitation and it started by telling me that it was legal to drive on ignoring the road traffic accident .what a way to start training!
in the above case, what if the patient sued for mental trauma due to the pain?
the airline will turn around and say the captain is not a medic ....if he was told , he would have landed asap. now the doctor is on his own feet.
even if medical advise is sought over the radio , who is responsible?
i think doctors should be given a clear statement from the airlines . please help and you will be fully legally covered. otherwise , it should be sop to land asap for anything , even if the doc is working on the case. otherwise the doctor is the one who helps and also the one to get caught in any cross fire.
recently ,a friend of mine had to help out and he was apalled at the quality of medical kit. ... so not all airlines are equal.
i am a doctor and am shocked that the Doctor "was asked to sign a form indemnifying Airtours against any claim ....".
what kind of deal is that.
as an anesthetist , used to caring people with life threatening problems , my actions would be judged quite severely by the courts. also, most patients are grateful for the care they receive ...but once they are well and talk to their friends etc ...the idea of profit creeps in and they then could decide to sue. even if i do my job well ...i still have to pay my lawyers to prove that i did my job well ..and that cost much more than a bottle of champagne.
i think this issue is an very important one that needs to be addressed by the medical community and the aviation professionals.
if things are not solved ...doctors might try to hide their identity or might just give non commital or legal responses. just imagine if a doctor on board tells the captain to land asap for an condition that is clearly not life threatening .... this then places the captain in a very difficult situation. a medically qualified person is saying to land ..but it is obvious that the condition is not too bad ..say indigestion. the captain would rather land ...since he /she would not want the weight of liability.
this is legal medicine ..... as is seen often in the united states ...where the law is treated better than the pateint.
airlines get free medical cover by the doctor, but the least a doctor would like is for their legal fees to be covered.
when i was in med school ....i saw this training video on resuscitation and it started by telling me that it was legal to drive on ignoring the road traffic accident .what a way to start training!
in the above case, what if the patient sued for mental trauma due to the pain?
the airline will turn around and say the captain is not a medic ....if he was told , he would have landed asap. now the doctor is on his own feet.
even if medical advise is sought over the radio , who is responsible?
i think doctors should be given a clear statement from the airlines . please help and you will be fully legally covered. otherwise , it should be sop to land asap for anything , even if the doc is working on the case. otherwise the doctor is the one who helps and also the one to get caught in any cross fire.
recently ,a friend of mine had to help out and he was apalled at the quality of medical kit. ... so not all airlines are equal.
Join Date: Mar 2002
Location: London
Posts: 49
Likes: 0
Received 0 Likes
on
0 Posts
i was relived to read the posting from oblaasop above which i had not seen .
according to him :
Also the indemnity form that was signed, was to indemnify the doctor, not the company!!!!!!! Airtours also use Medilink in Arizona via a phone patch and having used it recently, I would say it is absolutly brilliant, they make the medical descisions whether or not a Doc is on board, and they provide the indemnity even if they talk a crew member through giving an injection!
so next time there is a problem on board , i will be glad to help. i don't want a free bottle of champagne ...rather, i would prefer a small lights and switches talk in the flight deck.
prasanna
according to him :
Also the indemnity form that was signed, was to indemnify the doctor, not the company!!!!!!! Airtours also use Medilink in Arizona via a phone patch and having used it recently, I would say it is absolutly brilliant, they make the medical descisions whether or not a Doc is on board, and they provide the indemnity even if they talk a crew member through giving an injection!
so next time there is a problem on board , i will be glad to help. i don't want a free bottle of champagne ...rather, i would prefer a small lights and switches talk in the flight deck.
prasanna
Controversial, moi?
Northern Sky
<<Satphone perhaps, but isn't your employer one of the ones to cease ACARS use as a cost-cutting measure after 110901? A great leap forwards..... >>
Just to clarify we did not stop using ACARS after September 11th. We were asked to think twice before using it i.e. get enroute met via volmet if practical etc. Funny enough it is left to our good judgement.
<<Returning to the main thrust of the argument, as the aircraft commander, I must say that in the majority of cases, the presence of a doctor on board who presumes to treat a sick passenger only increases the exposure to risk. Better, perhaps, to divert straight away that the cabin crew say the passenger needs serious attention, rather than involving individuals who may or may not be who and what they say they are and may or may not expose the commander, crew, and airline, to risk of claims.>>
It is just this sort of 'cover my back' thinking, driven by the opportunist greed of those that believe somebody should be to blame for every misfortune that occurs in life, that serves to make life more and more unpleasant for us all.
If I am taken ill on your aircraft I hope I do not die while you spend several hours diverting to some godforsaken hole in Siberia, or elsewhere, where I would probably die anyway, rather than allow me to be treated by somebody able to help.
I speak from experience. The most notable incident was when a senior registrar on board on the way to Malaysia avoided us diverting by making a difficult but accurate diagnosis of the REAL cause of a crewmembers pain and subsequent collapse. We were over Iran at the time. I also recall the BA HKG - LHR flight where a splendid doctor carried out a remarkable improvised procedure on a young lady with a punctured lung, unknowingly received in an accident on her way to the airport. The aircraft carried on to LHR and the lady survived with little further trauma.
Unfortunately I also have experience of doctors (usually American it must be said) point blank refusing to help.
Their prerogative of course but a sad sign of the times in which we live.
<<Satphone perhaps, but isn't your employer one of the ones to cease ACARS use as a cost-cutting measure after 110901? A great leap forwards..... >>
Just to clarify we did not stop using ACARS after September 11th. We were asked to think twice before using it i.e. get enroute met via volmet if practical etc. Funny enough it is left to our good judgement.
<<Returning to the main thrust of the argument, as the aircraft commander, I must say that in the majority of cases, the presence of a doctor on board who presumes to treat a sick passenger only increases the exposure to risk. Better, perhaps, to divert straight away that the cabin crew say the passenger needs serious attention, rather than involving individuals who may or may not be who and what they say they are and may or may not expose the commander, crew, and airline, to risk of claims.>>
It is just this sort of 'cover my back' thinking, driven by the opportunist greed of those that believe somebody should be to blame for every misfortune that occurs in life, that serves to make life more and more unpleasant for us all.
If I am taken ill on your aircraft I hope I do not die while you spend several hours diverting to some godforsaken hole in Siberia, or elsewhere, where I would probably die anyway, rather than allow me to be treated by somebody able to help.
I speak from experience. The most notable incident was when a senior registrar on board on the way to Malaysia avoided us diverting by making a difficult but accurate diagnosis of the REAL cause of a crewmembers pain and subsequent collapse. We were over Iran at the time. I also recall the BA HKG - LHR flight where a splendid doctor carried out a remarkable improvised procedure on a young lady with a punctured lung, unknowingly received in an accident on her way to the airport. The aircraft carried on to LHR and the lady survived with little further trauma.
Unfortunately I also have experience of doctors (usually American it must be said) point blank refusing to help.
Their prerogative of course but a sad sign of the times in which we live.
Last edited by M.Mouse; 7th Apr 2002 at 22:00.
Moderator
Join Date: Apr 1998
Location: err, *******, we have a problem
Age: 58
Posts: 1,335
Likes: 0
Received 0 Likes
on
0 Posts
To clarify... the BA indemnity provided, which is the model used by other airlines is in favour of the Doctor, not the company. This is specifically to encourage medical doctors to answer a plea from the Captain.
I've used both satphone and ACARS to help resolve medical problems when there was no-one coming forward, and they are both fast (ACARS much faster than I thought it would be), accurate, and give that extra piece of information you require when balancing up the go/no-go diversion scenario. We may not use ACARS to check the weather in De Gaulle on an average summers day any more, but no-one would hesitate for a second to use it under any other circumstances.
If Airtours indeed use the BA medical kit, then there was sufficient equipment on board, including a gel (possibly lignocaine-derived anaesthetic gel, but can't recall) to allow a successful cathetirisation; there is even a wide variety of catheter widths to choose from. It was in the B-side of the case, the contents of which are only intended to be used by registered practioners, not crew or First-aiders.
I've used both satphone and ACARS to help resolve medical problems when there was no-one coming forward, and they are both fast (ACARS much faster than I thought it would be), accurate, and give that extra piece of information you require when balancing up the go/no-go diversion scenario. We may not use ACARS to check the weather in De Gaulle on an average summers day any more, but no-one would hesitate for a second to use it under any other circumstances.
If Airtours indeed use the BA medical kit, then there was sufficient equipment on board, including a gel (possibly lignocaine-derived anaesthetic gel, but can't recall) to allow a successful cathetirisation; there is even a wide variety of catheter widths to choose from. It was in the B-side of the case, the contents of which are only intended to be used by registered practioners, not crew or First-aiders.
Last edited by Sick Squid; 8th Apr 2002 at 08:35.
Join Date: Sep 2000
Location: The Valley Where the Thames Runs Softly
Age: 77
Posts: 556
Likes: 0
Received 0 Likes
on
0 Posts
I heard of a Captain who called for an anaesthetist on the cabin address. No response was forthcoming, so he repeated the call.
A passenger in Club said to a steward :- " I am not an anaesthetist, just a GP, but I might be able to help"
"Sorry, no use" said the FA. "We've got a consultant in First Class and he wants his lamp adjusted"
A passenger in Club said to a steward :- " I am not an anaesthetist, just a GP, but I might be able to help"
"Sorry, no use" said the FA. "We've got a consultant in First Class and he wants his lamp adjusted"
Join Date: Apr 2001
Location: a fence in the sun
Posts: 182
Likes: 0
Received 0 Likes
on
0 Posts
M Mouse,
Your ACARS traffic is down substantially. Were you habitually using it to waste the company's money, or have you cut back intelligent use to save money? (I know what I've heard from your trainers).
As for the 'hero' of your piece, it's my belief that he was under the influence at the time he carried out his 'procedure'. My recollection of his own account of it is that he had had a substantial amount to drink, and I wouldn't want anyone who had been quaffing the freebies for hours on end trying to save my life.
I posted about 'exposure to risk', nothing more or less. If you die, my exposure to risk is nil. If you live and sue my airline for allowing a doctor to treat you erroneously, my exposure to risk could be substantial. I have to be responsible for my actions, and if we are all concerned about exposure to risk (and we should be), then it's the people who believe that 'no win, no fee' arrangements, and these pathetic 'claims' companies whose advertisements block up the television schedules, are right, who will ultimately be responsible for the shift in emphasis from doing what seem basically right to doing what seem basically to carry low or no risk.
The ball's in your court!
(I'd rather do what's right - but that's not what I'm paid for any more).
Your ACARS traffic is down substantially. Were you habitually using it to waste the company's money, or have you cut back intelligent use to save money? (I know what I've heard from your trainers).
As for the 'hero' of your piece, it's my belief that he was under the influence at the time he carried out his 'procedure'. My recollection of his own account of it is that he had had a substantial amount to drink, and I wouldn't want anyone who had been quaffing the freebies for hours on end trying to save my life.
I posted about 'exposure to risk', nothing more or less. If you die, my exposure to risk is nil. If you live and sue my airline for allowing a doctor to treat you erroneously, my exposure to risk could be substantial. I have to be responsible for my actions, and if we are all concerned about exposure to risk (and we should be), then it's the people who believe that 'no win, no fee' arrangements, and these pathetic 'claims' companies whose advertisements block up the television schedules, are right, who will ultimately be responsible for the shift in emphasis from doing what seem basically right to doing what seem basically to carry low or no risk.
The ball's in your court!
(I'd rather do what's right - but that's not what I'm paid for any more).
Last edited by NorthernSky; 10th Apr 2002 at 00:40.
Join Date: Feb 2002
Location: EGHH
Posts: 60
Likes: 0
Received 0 Likes
on
0 Posts
Why should a doctor end up in court at all for trying to help a pax out!!! At best it is inconvenient to have to apprear in court in the first place and worse could be damaging to his proffesional standing, all when said doctor was off on his hols.
If you travel on an airline..Caveat Emptor
If you travel on an airline..Caveat Emptor
Join Date: May 2000
Location: New York
Posts: 510
Likes: 0
Received 0 Likes
on
0 Posts
With the aging population, these incidents are likely to increase. Unfortunately, the attitude of many people is that the airlines owe them transportation regardless of their physical condition. Next it will become a "right" to airtravel and that airlines are responsible for your medical condition even if you don't tell them.
It's amazing that some idiots take all kinds of medications, yet slam down alcohol, then have a reaction.
My favorite is the son that put his elderly father on a flight unconcious (he was "sleeping"). Of course he was probably actually dead, but I suppose he though it was cheaper to put him in a seat than have him examined at departure station and take the chance on having to ship his remains.
It's amazing that some idiots take all kinds of medications, yet slam down alcohol, then have a reaction.
My favorite is the son that put his elderly father on a flight unconcious (he was "sleeping"). Of course he was probably actually dead, but I suppose he though it was cheaper to put him in a seat than have him examined at departure station and take the chance on having to ship his remains.
Join Date: Jan 2001
Location: The Burrow, N53:48:02 W1:48:57, The Tin Tent - EGBS, EGBO
Posts: 2,297
Likes: 0
Received 0 Likes
on
0 Posts
I spent ages composing a reply only to have it eaten by the computer! Second attempt:As a nurse I was struck by the apparently immature attitude of the doctor and what appeared to be an unwillingness, or maybe even an inability, to think around the problem. Perhaps he was so newly qualified that he could only use equipment he had used during training, or so old that he wasn't too sure about newer forms of equipment. Whatever it was, there was apparently, a marked lack of forethought. We all know that catheterisation is an uncomfortable procedure at the best of times so a couple of minutes careful thought and preparation would have been time well spent. The report poses many questions: why did the Doctor apparently not check the availability of an alternative to lubricating gel before commencing the procedure? Cool, previously boiled water could have been used even if it is not quite as effective as gel. If the poor patient really was screaming in pain why was an oral or, if available, intramuscular analgesic not administered first? Why did he not do a simple suprapubic bladder aspiration with a syringe and needle - I know this is not often used with adults but we frequently use it on tiny babies and it would have reduced the risk of trauma to the urethra by continuing to pass a catheter and relieved some of the pressure so that an attempt at catheterisation would be more likely to succeed, etc, etc. Doctors and nurses need to remember that, with the possible exception of the RFDS, aircraft are not flying hospitals and it is necessary to be able to think on your feet and be prepared to adapt. Don't knock the available equipment, be glad there is some available, after all, you won't find most other forms of public transport nearly as well equipped as aircraft. Talk to the cabin crew, they are usually only too willing to help. We look to their expertise in an emergency and they will, in my experience, give all the help they can when we need it. Mind you, start acting like a prima donna and throwing your weight around and I, for one, wouldn't blame them for vanishing to attend to others needs and leaving you to manage on your own. This is one time when different professions can work together to make a real difference, they know their aircraft and its equipment and we, hopefully, have our our medical / nursing knowledge. I will always be willing to help as I hope others would be if I or my friends and family were in need. It does pose a problem however in that I wonder how far the airlines would be willing to cover us as nurses. Hopefully it would be the same as for doctors. Anyone able to enlighten me?
