What Happens If You Have a Medical Emergency on a Plane?

In-flight medical emergencies on commercial airlines are relatively common occurrences.  It is estimated that anywhere between 200 to 1400 in-flight medical emergencies occur daily worldwide. Due to cabin pressurization at cruising altitude, typically 30,000 to 40,000 feet, passengers are more susceptible to health problems during flight including hypoxia, decreased venous flow, systemic inflammation, and exposure to allergens and communicable infectious diseases.

As a result, passengers suffering from in-flight medical emergencies have a heightened risk of serious injury or death if their medical emergencies are not addressed properly by the aircrew.

If you have experienced a medical emergency that was not properly addressed, a personal injury lawyer can help.

Understanding Medical Emergencies During Flights

While the flight crew undoubtedly faces serious and often difficult choices on how to deal with in-flight medical emergencies, ultimately, they have a duty to make reasonable decisions and exercise “due care” to ensure that passengers arrive at their destinations safely.  At a minimum, all US airlines must comply with the Federal Aviation Administration’s (FAA) regulation, 14 C.F.R. § 121.803, which mandates that airplanes carrying loads of more than 7,500 pounds be equipped with emergency medical kits, including an approved automated external defibrillator, a general first aid kit, blood pathogen spill equipment, and oxygen for first aid.

In some cases, airlines who have failed to maintain equipment that meets the FAA’s specifications, have found themselves the subject of lawsuits. This is due to the fact that airlines have a duty to safely maintain their aircraft.

For example, in 2019, the family of a newlywed who died after suffering a pulmonary embolism during a flight sued American Airlines for failing to have properly functioning medical equipment on board, including FAA-mandated blood pressure monitors and a defibrillator. See Starks, et al. v. American Airlines, Inc.,4:19-cv-00253 (N.D.Tex 2019)(MP).

Most Common Medical Emergencies on a Plane

Of all the types of medical emergencies that happen on airplanes, a handful are repeated much more often than others. In no special order, these include:

• Lightheadedness and losing consciousness
• Cardiac-related symptoms, such as tachycardia, chest discomfort, and arrhythmia
• Nausea
• Vomiting
• Seizures
• Respiratory problems, including shortness of breath, wheezing, and pain
• Head trauma and brain injury
• Wrongful death

In these emergencies, it is likely that the person suffering needs hasty and thorough medical attention. In other words, the plane should land, and the victim should seek immediate medical attention from a qualified healthcare provider.

Is There Always a Doctor on Board?

Although many believe that the answer is yes, it is no. Airlines do not place doctors or other similar medical professionals on every flight in case of an in-flight medical emergency. With that being said, the odds are often good that there is a doctor on your flight. There are over 1,000,000 trained physicians in the U.S., and many of them fly regularly.

However, doctors may not have a legal duty to assist in a medical emergency, even if they have a moral duty to help. Under the Aviation Medical Assistance Act, doctors have immunity from liability for providing medical care as long as they aren't under the influence of substances, acting with gross negligence, or performing care beyond the scope of their training.

However, passengers should never assume that there will be a doctor on board, especially if they are prone to medical emergencies. Instead, individuals who may potentially experience a medical emergency should seriously ask themselves if the risk is worth it and whether other forms of transportation are available.

What Happens During a Medical Emergency on a Flight?

During in-flight medical events, a doctor or other qualified healthcare professional should attend to the ailing passenger. However, if there are no healthcare professionals onboard, the flight attendants will step in.

Flight attendants are not medical professionals, and most do not possess the training or the equipment to treat people suffering from the most serious incidents. What flight attendants do know is basic first aid. They also have some resources at their disposal for an in-flight medical event, such as an emergency medical kit and OTC inflammatory medicines and painkillers.

Essentially, flight attendants are trained to manage in-flight medical emergencies rather than treat the patients suffering from them. This involves stabilizing the person as much as possible while the plane is in the air. If the emergency continues, the plane will be diverted to the nearest airport to drop off the suffering patient.

By the time the patient reaches the ground, the flight crew will have communicated the patient's symptoms to the waiting healthcare professionals. This helps immensely in prepping emergency medical service providers to treat the suffering passenger.

Who Can You Sue in In-Flight Medical Incidents?

Depending on the circumstances, you may be able to sue a number of different parties for what transpires during an in-flight medical emergency.

The Flight Attendants

If a flight attendant or pilot fails to discharge their duties in a reasonable fashion during a medical emergency, they can face liability for the injuries that occur as a result.

Medically Trained Passengers

Healthcare professionals do not have to perform emergency medical services, but when they do, they must do so competently. If they don't, they can face significant liability from a lawsuit.

Other Passengers

Other passengers (non-medically trained) on the plane may also potentially face liability for negligent actions committed during an in-flight emergency.

The Airline

The airline may also face liability in a medical emergency.

Grounds for Filing a Lawsuit Against the Airline

The most effective method of suing an airline is to sue under a theory of vicarious liability. Vicarious liability means one party is liable for the actions of another when those actions are negligent and cause harm. In this case, the airline would assume liability for any employee negligence causing harm.

Common grounds for lawsuits include failing to respond appropriately to injuries or medical emergencies that happen while in flight, ignoring industry standards and procedures, or refusing to divert a flight appropriately for a life-threatening condition.

Legal Standards for Airplane Crew During Medical Incidents

All commercial aircraft cabin crew are required to receive first aid and CPR/AED training.  Most US airlines provide some additional training to their crew regarding what emergency procedures to follow when faced with an in-flight medical emergency. In addition, many domestic and international airline carriers contract aeromedical ground support services, such as MedLink (based in Arizona) and Stat-MD (located in Pennsylvania) to provide physician consultations to assist the flight crew with providing in-flight medical care and determining if a flight diversion is necessary.  Miscommunication between in-flight staff and on-the-ground medical support services can lead to the rendering of inappropriate medical assistance by the crew and the failure to divert. These errors are often exacerbated when medically trained passengers, such as on-board doctors and nurses, are asked to assist in the medical care of their fellow passengers and provide conflicting assessments of the passenger’s medical condition to the flight crew and aeromedical ground support.

Ultimately, the decision of whether to divert a flight for a medical emergency like cardiac arrest rests with the pilot-in-command, which can often be a costly one. While many airlines claim to put passenger safety first, the high costs of an unplanned diversion cause carriers to pressure pilots to avoid emergency landings.  Despite the frequency of medical emergencies in the sky, research suggests that diversions occur roughly only 4% of the time.

What to Do?

So what remedies do passengers have if they are harmed by an air carrier’s negligence during an in-flight medical emergency?  For domestic flights that originate and end within US territory, in most cases, passengers can bring a case against the airline in state or federal court.

The most common claims against carriers include:

• Failure to render assistance;
• Failure to divert and/or land as soon as possible;
• Failure to provide or properly maintain mandated medical equipment or supplies;
• Negligence of the crew in providing medical care and/or making decisions.

The Montreal Convention and Airline Responsibility in In-Flight Medical Cases

The Montreal Convention controls in-flight medical cases. Under Article 17 of the Convention, an airline can only be held liable for personal injury or death of a passenger on an international flight between two member nations when the claimant proves that the alleged injury or death resulted from an “accident” on board the aircraft.  In 1985, the United States Supreme Court defined “accident” under the Convention as “an unexpected or unusual event or happening that is external to the passenger.”

In 2004, the Supreme Court broadened the definition of an “accident” in the context of an airline’s failure to provide proper medical attention to an ill passenger in the case of Olympic Airways v. Husain.

The Supreme Court found that the crew’s refusal to move a passenger, whom they knew was allergic to smoke, away from the plane’s smoking section was an “unexpected and unusual event” that caused the claimant’s husband to suffer an on-board medical emergency, an asthma attack, and die.

Since the decision in Husain, claimants who suffered injuries as a result of air carrier negligence during international flights have successfully overcome challenges based on the Montreal Convention by showing that the crew’s conduct was an “unusual” or “unexpected” event which constituted an “accident” that caused injury to the passenger.  

Under the Montreal Convention, when a claimant is successful in showing that an accident occurred, the airline is automatically liable for proven damages up to 113,100.00 Special Drawing Rights (SDR), or approximately $157,000, under current exchange rates.    

Don't Face Airplane Emergency Claims Alone – Jacob Fuchsberg Law Firm Can Guide You

Pursuing personal injury claims involving commercial airlines presents complicated legal questions and obstacles. Our newest associate, Ilana Wolk, has extensive experience prosecuting claims against major airlines. Whether you are suing because of a lack of emergency medical equipment or negligence, the Jacob Fuchsberg Law Firm has the experience and skill to faithfully represent your claim.

If you or a family member were injured during airline travel and wish to discuss the case with us, please contact us at 212-869-3500 for a free consultation.