Photo from AOPA, understanding medical certification
In order to act as a pilot in command or a required crew member for any aircraft, the Federal Aviation Administration requires a medical certificate commonly referred to as just a “medical.”
Medical certificates determine how and if a pilot may fly, but some underlying health concerns may remain unnoticed. There are three different classes of medicals that a pilot may seek depending on the type of flying that a pilot is conducting. An airline pilot will have the strictest medical requirements and will require a First Class Medical. A pilot that flies for recreational reasons will have less rigid medical requirements and requires a Third Class Medical. Each class of medical certificate has different privileges and timelines.
A flight instructor who held a First-Class Medical certificate died after suffering a cardiac arrest mid-flight. The qualified pilot thought he was “joking around” and only realized after safely landing the aircraft that the man was unconscious.
According to the published safety report on the incident, the pilot wanted to fly from Blackpool Airport to another airfield. After deciding that the wind conditions were too challenging for him to fly on his own he asked a familiar 57-year-old flight instructor to accompany him. The flight instructor had close to 9,000 hours of flying experience and had a medical a few months before the incident. He was said to be in good spirits before the flight.
“People who had spoken to him on the morning of the incident said he was his normal cheerful self and there were no indications that he was feeling unwell,” the AAIB report said.
The pilot recalled that shortly after takeoff from the runway, the instructor’s head rolled back. Since the pilot knew the instructor well, he thought that he was just pretending to take a nap whilst the pilot flew, so he did not think anything of it and proceeded to fly the aircraft. As he turned onto the base leg of the approach, the instructor slumped over the pilot’s shoulder. The pilot still had the impression that the instructor was joking with him and continued to fly the approach.
He landed normally and started to taxi back to the apron. However, when the instructor was still resting on his shoulder and was not responding, the pilot realized something was wrong. He signaled to the airport emergency services who happened to be working on the apron, and they came to assist. Unfortunately, the flight instructor remained unresponsive and they were unable to save him.
AAIB Bulletin excerpt on the CAA medical review
The medical department of the UK Civil Aviation Authority reviewed the incident and the instructor’s medical history and concluded that he was known to suffer from high blood pressure, but it was within regulatory limits. The Civil Aviation Authority said they will review their cardiac guidance in light of the latest research.
Cardiac arrest risks are mitigated when a second pilot is present but there is a high risk for single-pilot planes, the authority said. Only three commercial pilots have suffered heart attacks in-flight since 2005, according to the authority’s review of their data. During each instance, the aircraft was safely landed.
While medicals can help to determine how fit pilots are to fly, the risk of a health scare can never be zero. Medicals still remain an important part of becoming a pilot and determining what type of flight a pilot may conduct.
In hindsight, no test or assessment can give a 100% accurate detection of underlying cardiac issues. A balance needs to be struck between minimizing the risk to flight safety and providing a fair and reasonable medical assessment for individuals. The rarity of accidents caused by cardiac events in flight suggests this balance is currently about right and this is continuously being reviewed by the CAA medical department. While rare, cardiac incidents can and have happened in the air, despite a clean medical.
The FAA medical exam process itself generally takes about 30 minutes. The medical examiner will do a physical examination, checking areas such as eyesight, hearing and lung function. They will also check for any heart conditions as well as conduct a urinalysis to check for sugar or protein, which are indicators of possible diabetes or kidney disease. Each pilot is required to meet specific medical standards depending on the class of medical certificate for which the pilot applies. This ensures that only pilots who are physically and mentally fit will be authorized to operate aircraft.
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