Wjcandee From United States of America, joined Jun 2000, 6263 posts, RR: 24
Reply 2, posted (8 years 11 months 1 week 6 days 18 hours ago) and read 18520 times:
Quoting Saleya22R (Reply 1): Sounds like a pulmonary embolism(blood clot in the lung) caused by a DVT. Very sad indeed.
Sounds more like congestive heart failure, when you hear of the shortness of breath, not being able to walk, and the leg swelling, apparently without leg *pain*. But, as with all things medical, it could be all sorts of stuff. From one article: "People with congestive heart failure often have trouble with swollen legs as the heart pump fails and blood stagnates in the veins. Those afflicted with malnutrition; disorders of the liver, kidney, or intestines; or conditions like allergies, burns, blood clots, insect bites, or bacterial infections may suffer from swollen extremities for a variety of reasons. Blockage of the lymphatic system -- such as from cancer or lymph gland inflammation -- as well as pregnancy can also cause leg edema."
So, DVT is the politically-popular diagnosis when it comes to someone that has flown on a discount airline, but not necessarily the medically-correct one.
Yes, you are right in a sense that many possibilities need to be excluded. In any case she was ill when boarding the flight. What happened had probably nothing to do with flight per se. Given that she was previously healthy I still believe that a pulmonary embolism is a strong option.
LTBEWR From United States of America, joined Jan 2004, 13856 posts, RR: 17
Reply 4, posted (8 years 11 months 1 week 6 days 17 hours ago) and read 18277 times:
Although her death occurred on a LCC, I must say that EasyJet did the best they could and made the truly professional decision to divert.
She probably shouldn't have been flying, but I assume her appearance and symptoms were difficult to diagnose without highly technical tests to a Doctor. In some other places, the doctor probably would have recommended that the patient be checked into a good local hospital ASAP which I assume Majorca has, but the doctor's decision may have been compromised by the family's desire to get home, see there regular doctor and her med records there.
BuyantUkhaa From Mongolia, joined May 2004, 3040 posts, RR: 3
Reply 5, posted (8 years 11 months 1 week 6 days 17 hours ago) and read 18149 times:
Quoting Saleya22R (Reply 1): Sounds like a pulmonary embolism(blood clot in the lung) caused by a DVT. Very sad indeed
Yes... Happened to a friend of mine (30), furtunately she made it but only just. Scary.
One thing I find strange:
Mr Birds said his wife's condition deteriorated about an hour into the flight as she sat next to her 12-year-old daughter Hayley. [..] The flight was immediately diverted to Barcelona while two nurses on the plane battled to save Mrs Birds.
About an hour into the flight from PMI to LTN would have you much closer to Paris, why turn back to BCN?
Britannia191a From United Kingdom, joined Nov 2004, 262 posts, RR: 0
Reply 6, posted (8 years 11 months 1 week 6 days 14 hours ago) and read 17512 times:
Quoting BuyantUkhaa (Reply 5): About an hour into the flight from PMI to LTN would have you much closer to Paris, why turn back to BCN?
PMI - BCN is 150miles which is approx 30min flight, another 150miles north is approx south of Toulouse. So why wouldnt they turn back to Barclelona which is an Easyjet location with the facilities to deal with both the person and the airline.
TeamAmerica From United States of America, joined Sep 2006, 1761 posts, RR: 23
Reply 7, posted (8 years 11 months 1 week 6 days 13 hours ago) and read 17334 times:
Quoting Wjcandee (Reply 2): So, DVT is the politically-popular diagnosis when it comes to someone that has flown on a discount airline, but not necessarily the medically-correct one.
DVT is a "politically popular diagnosis"? I don't understand that comment at all.
As for congestive heart failure, that is a chronic condition not likely to have caused a sudden death like this. Pulmonary embolism is far more likely. You may argue that heart failure could put one at risk of forming such blood clots, but it would be the clot that kills, not the heart failure per se.
Spacecadet From United States of America, joined Sep 2001, 3993 posts, RR: 11
Reply 9, posted (8 years 11 months 1 week 6 days 12 hours ago) and read 17150 times:
Quoting Wjcandee (Reply 2): Sounds more like congestive heart failure, when you hear of the shortness of breath, not being able to walk, and the leg swelling, apparently without leg *pain*.
Congestive heart failure takes years for symptoms to progress to that point. It's rare for anyone to die of congestive heart failure without knowing they have it; rarer still for someone to suddenly have symptoms bad enough to seek medical attention, rarer still for a doctor to completely miss it.
And again, rarer still for somebody that young to have it, and to die from it immediately after seeing a doctor.
The chances of congestive heart failure are remote. There's a reason why people scream "DVT" whenever a story like this pops up - it is the most likely cause.
She would not have had pain in her legs at that stage because the clot had already moved to her lungs.
Most of my experience on both subjects comes from recent family and personal history.
[Edited 2007-06-20 22:35:47]
I'm tired of being a wanna-be league bowler. I wanna be a league bowler!
Why wouldn't they? In the best interest of the passenger, airlines are required to take the safest course of action for the said passenger. If someone is suffering a heart attack, using the AED and other medical equipment on the aircraft is only a temporary measure. A medical facility is what's required, and to refuse an option to save someone's life can be considered manslaughter. Legacy or LCC, that means trouble...$9 fares notwithstanding.
Zeke From Hong Kong, joined Dec 2006, 10820 posts, RR: 76
Reply 11, posted (8 years 11 months 1 week 6 days 11 hours ago) and read 16903 times:
Quoting NASBWI (Reply 10):
Why wouldn't they? In the best interest of the passenger, airlines are required to take the safest course of action for the said passenger.
It is not as simple as that, we only divert if medlink instructs us to do so. No airline or pilot is going to put the life of one passenger above the rest of the passengers, crew, or aircraft. The safest option for the majority is what will underline the decision making process.
I am not a doctor, I just drive aeroplanes, I defer medical assessments to others, they defer operational decisions to me.
We are addicted to our thoughts. We cannot change anything if we cannot change our thinking – Santosh Kalwar
EXAAUADL From , joined Dec 1969, posts, RR:
Reply 12, posted (8 years 11 months 1 week 6 days 11 hours ago) and read 16877 times:
Quoting NASBWI (Reply 10): Why wouldn't they? In the best interest of the passenger, airlines are required to take the safest course of action for the said passenger. If someone is suffering a heart attack, using the AED and other medical equipment on the aircraft is only a temporary measure.
I mean if she is already dead, Ryan Air Mgmt might think it better to continue on with the flight. It would be a waste of money to divert, plus they would be doing the dead woman and her family a great service by delivering her to her final resting place. That way the family doesnt have to go pick her up in some far away airport.
Aviateur From United States of America, joined Apr 2004, 1370 posts, RR: 11
Reply 15, posted (8 years 11 months 1 week 6 days 8 hours ago) and read 16158 times:
Why the hell is it news just because somebody dies aboard a commercial flight? Something like four million people fly commercially each day around the world. One of them dies, and this is news? Why? Is it news when somebody has a heart attack on the NYC subway? Is it news when somebody dies on board a Greyhound bus?
Obviously it is sad what happened to the woman, but in the context of air travel, should this really be a media story?
[Edited 2007-06-21 03:05:51]
Patrick Smith is an airline pilot, air travel columnist and author
Iflyac From Canada, joined Jun 2007, 50 posts, RR: 0
Reply 17, posted (8 years 11 months 1 week 6 days 8 hours ago) and read 15892 times:
Very sad story indeed.
Personally, I suffer from congenital CHF and have to wear compression socks to prevent leg swelling and DVT in flight. It sounds like this woman had something similar, but it doesn't happen all of a sudden like that. Perhaps she was suffering from acute renal failure and the doctor missed it.
What was it we had for dinner tonight? Well, we had a choice of steak or fish. Yes, yes, I remember, I had lasagna.
Mudboy From United States of America, joined Jan 2006, 1167 posts, RR: 5
Reply 20, posted (8 years 11 months 1 week 6 days 7 hours ago) and read 15528 times:
If the woman had CHF(Congestive Heart Failure), when the MD listened to her lungs, He would have been able to hear Rales(Fluid backing up in the Lungs, known as Pulmonary Edema). This usually takes time to develop. I would hope the MD did not miss this in his assessment. If she had a PE(Pulmonary Embolism) her lung sounds could have been clear, when the MD listened to them, as this can have an acute onset and could have happened in flight. It normally depends on the size of the clot. Another thing could be that she had a spontaneous pneumothorax(collapsed lung) and as they rose in altitude the pneumo worsened due to Boyles Law, but it would not explain the swollen legs. Or, she just had an old fashioned MI. You be the judge. I would guess, but how accurate is the press report?
I'm sure there's some equivalent. I recall a Virgin Atlantic incident a few years ago where a full 747-400 diverted to YFB (Iqaluit, formerly Frobisher Bay) in far northern Canada due to a medical emergency. The aircraft struck a piece of ground equipment on the ramp and damaged an engine. They had to cancel the flight and fly in an empty 747 to rescue the stranded passengers and ferry the original aircraft empty back to LHR.
It was in the middle of the peak season so the two 747s out of service meant quite a few other cancelled flights for several days. If memory correct, VS said later that the entire incident cost them something like $3 million in lost revenue, repair costs and passenger expenses. And it turned out that the passenger with the medical emergency only had a relatively minor problem which hadn't warranted the diversion.
I recall VS stating that they were significantly upgrading their access to the MedLink type of service as a result of that incident.
Cha747 From United States of America, joined Dec 2003, 821 posts, RR: 5
Reply 22, posted (8 years 11 months 1 week 6 days 6 hours ago) and read 14552 times:
From a board certified Emergency Medicine Physician...
By history, this was a deep vein thrombosis (DVT...or blood clot) that then traveled from the leg vein to the inferior vena cava to the right side of the heart and then to the lungs and became a pulmonary embolism (PE). Further, it sounds like while they were at altitude, the PE became what is known as a "saddle embolus" as the clot(s) totally blocked-off blood flow from the lungs to the heart and therefore to the rest of the body; a recipe for sudden death.
While air travel (rather, long trips without moving your legs) is a risk factor, other things like family history, clotting disorders, whether or not the patient smokes, whether or not the patient has cancer, and whether or not the patient takes birth control pills or hormones all play into this. The doctor at the airport did not take a complete history as this is diagnosed first by history, then by fancy tests (blood test called d-dimer, nuclear medicine v/q scans, and computed tomographic pulmonary angiography...aka...CT PE protocol). I would never have let this woman fly had I seen her. To say that this woman died from her flight in and of itself is a false statement, it was merely a risk factor.
CHF, Pneumothorax, and Myocardial Infarction (MI...heart attack) while possibilities, are less likely on the differential diagnosis given the histories. The betting man should and would bet for DVT with subsequent PE for this case.
You land a million planes safely, then you have one little mid-air and you never hear the end of it - Pushing Tin
N908AW From United States of America, joined Aug 2005, 948 posts, RR: 1
Reply 23, posted (8 years 11 months 1 week 6 days 5 hours ago) and read 14472 times:
Quoting Zeke (Reply 11): No airline or pilot is going to put the life of one passenger above the rest of the passengers, crew, or aircraft.
Not so fast...well at least not in America. I've been on a med emergency diversion (LAS-MSP on Sun Country diverting to FSD at 1am. weeeee) and the crew was extremely nice about it. Wish the pax coulda felt the same. However, your argument still could hold water...I'd chalk their caring about the person up as 1) It's more than likely in the FAR 121 rules, and 2) It's cheaper than dealing with lawyers.
'Cause you're on ATA again, and on ATA, you're on vacation!
Quoting Embajador3 (Reply 15): That's mean!! No matter the airline you are flying with, if the someone's life is at risk, they will divert to the neares airport!
Not necessarily. It depends on a number of factors and on what the airline's operations centre will advise the captain of the aircraft after consulting the appropriate authorities. The ultimate decision will rest with the captain.
MOL on SRB's latest attack at BA: "It's like a little Chihuahua barking at a dying Labrador. Nobody cares."
: Exactly; as a "13-15yr old" in the USA, I doubt he's ever flown them, esp. when he spells it Ryan air. I doubt any family would want a dead member tr
: erm... It is as simple as that. Any life threatening situation on board concerning anyone whether it be an adult or child means an immediate diversio
: Whatever the cause, my thoughts go out to her family, a tragic thing to happen in any circumstances ...a holiday they will never forget. May she rest
: Not nearly enough information to come to that conclusion, besides the victim complained of breathlessness and lower limb oedema for 48 hours prior to
: I developed a little bit of a medical emergency on board an AA flight from ORD-PVG last February, when I realized that I had stupidly left my insulin
: Emmm, not wanting to nitpick but the Easyjet website lists the block time PMI-LTN as 1:25-1:35, so one hour into flight, Paris would have been far cl
: The lady was not already dead; she had lost consciousness.
: Times quoted are local times and PMI is +1 hour ahead of UK, so the flight's duration is 2 hours 10 minutes. An interesting and informative post that
: Congestive Heart Failure =CHF can have a sudden onset given the right circumstances,and what if any pre-existing conditions the patient may have had.
: Any airline would face the same dilemna, and on occasion that is the correct decision. It has been discussed here many times before, following incide
: Ah, what a clumsy mistake... So it would be more than two hours. Anyway I often fly LIS-BRU and one hour of flying (in an A32x) usually puts me just
: As far as i'm aware, if a medlink doctor recommends immediate hospital treatment, then the crew should inform airline ops, who then recommend where t
: I also thought about that possibility and was fully prepared for that circumstance if the plane was forced to divert due to my carelessness in forget
: Again, leg(s) swollen with shortness of breath with sudden change in mental staus (the "unconsciousness" referred to in the article) is DVT and PE un
: The only alternative is having them laid out on the deck, and I don't see that that would be any more (or even as) dignified. Hey, I know! Strap the
: Or, if feasable, land at the nearest airport and have them taken to hospital as soon as possible?
: Is it necessary to be so repetitive ?
: you self obsessed ******** nothing nice to say execpt 'why should this be in the news',how about a condolence or something , of course it should be i
: Yes, that is probably inaccurate. Maybe they where some 30-45min into the flight and had to choose between BCN and TLS and decided to land in BCN.
: Medlink is based in the USA, but we can get them anywhere in the world that we have satellite communications coverage. No FAR 121 rule requires a div