SEPTEMBER 30, 2007
VOLUME 4 NO. 16

PATIENTS & PRACTICE

"Is there a doctor on board?"

Despite doctors' help, airlines are often unappreciative


True airplane emergency horror stories

A Canadian doctor was treating a man who suffered a heart attack on an Air Canada flight to London, and the patient vomited all over him. Stepping off the plane, covered in vomit, not having slept or eaten, he asked the airline for help. The answer was no — until he went to the press, at which point two free tickets materialized.

Two BC nurses got free tickets from WestJet after treating patients when their Calgary to Halifax flight suddenly dropped 300 metres, throwing passengers against the roof of the jet.

Last September an Italian woman died on Ryanair of a blood clot in her lung. A doctor on board was unable to do anything because the plane carried no medical equipment.

In 1995, a British physician flying out of Hong Kong operated on a woman with a collapsed lung, improvising using only a coat hanger, some tape and a water bottle.

Providing emergency care when you're miles above the earth is any physician's nightmare. Last year, Montreal FP Henry Coopersmith was called on to help three patients during flights. Now he's suing Air Canada. Dr Coopersmith doesn't just want Air Canada to pay for his help — he wants to establish precedent to make all the airlines compensate doctors for airplane emergency services.

"IT WAS CHAOS"
Here's Dr Coopersmith's story. A squawk over the PA asking for a doctor. Dr Coopersmith stands up dutifully. It's October 11, 2006 and Dr Coopersmith and his wife are on an Air Canada flight to Paris to begin a five-day vacation.

"I was taken to the back cabin of the airplane," Dr Coopersmith recalls. "The lights were on. Everyone was running around. Three passengers were ill, and the workers thought something might be wrong the food or the air."

Dr Coopersmith took it all in stride and began working. The first case was a simple case of abdominal pain. He calmed the patient and resolved the problem quickly. But the next patient didn't appear to be doing well at first glance.

"She was about about to faint," he says. "She was sweaty, diaphoretic. And she was white, clammy — she didn't look good."

While he tried to elicit some answers from her, Dr Coopersmith administered oxygen and had her lie down. "After dealing with her for a while, I found she'd taken sleeping medication and then drunk some alcohol. No major problem."

The third case was the worst. A woman sitting in the back was outwardly upset. "She was very agitated," says Dr Coopersmith, who had trouble getting any coherent answers out of her. "I asked a man there if he knew anything about her history. He refused to answer." He asked nearby passengers if they knew her. They said no, but told him the tight-lipped Frenchman was a doctor. Odd, thought Dr Coopersmith, considering the man wasn't doing anything to help. "I asked if he needed help, and he refused to answer again," Dr Coopersmith says. "I went back to sleep, but the chief stewardess came and woke me up and told me the French doctor was going to inject her with something." So Dr Coopersmith got up again and tramped back to the rear of the plane.

"When he saw me coming back, he flipped out and start yelling, questioning my credentials," says Dr Coopersmith. "He threw the syringe back in the cart and left." Dr Coopersmith checked the syringe: valium. He talked to the woman and managed to calm her down without any valium, and then went back to his sleep to try to rest a while longer.

But again, he was woken by the stewardess. This time it was to fill out incident report forms. "I was up all night," he says.

"NOT ENOUGH"
After his arrival, Dr Coopersmith called Air Canada to ask them to replace his 160,000-point executive class tickets as compensation for the time he spent helping their customers. "They said, 'No, you're ethically bound to do it,' and they offered me 10,000 miles," he recalls. "I said, 'That's not enough.'"

Little did Air Canada know they weren't dealing with just any doctor. Henry Coopersmith is also a lawyer, and in mid-September he filed a lawsuit in Montreal small claims court. Because a physician's help saves airlines from having to hire their own medical staff, and can prevent planes from making unnecessary emergency landings, Dr Coopersmith says they should replace doctors' tickets, give them extra miles or even pay them for their time.

"It's a natural obligation on behalf of doctors, to help people when we can," Dr Coopersmith says, "but that shouldn't be taken for granted — even abused — by the airlines."

AIR DISASTER
Doctors have long complained that airlines don't help them enough when they help the airlines. In August, Vancouver physician Muni Nazerali had to treat two critically ill patients while an Air Transat plane made an emergency landing in Iqaluit. Speaking to the Vancouver Sun afterwards, she bemoaned the poor supply of adrenaline and nitroglycerine on board, the basically useless little hijack-proof scalpel, a broken oxygen tank, and needles that didn't fit the syringe tube.

"They are not carrying enough [equipment]," Dr Nazerali told the Sun. "Some of the things are inadequate... It is terrible to be put in a position like this."

Concerns about insufficient equipment raise liability questions for physicians. Do you need to keep medical records? What if a patient sues?

But Canadian Medical Protective Association (CMPA) risk management director Dr William Beilby says not to worry — you'll most likely be covered by Canadian law if you're on a Canadian flight, and the CMPA will cover you except in truly exceptional circumstances. "Most provinces have some sort of Good Samaritan protection built into the legislation, and it's usually worded that actions have to be grossly negligent or pretty egregious to incur liability," he says. Nevertheless, he says, keep a record of the incident — just in case.

 

 

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