Pilot Incapacitation

Pilot Incapacitation

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Definition

Pilot Incapacitation is the term used to describe the inability of a pilot, who is part of the operating crew, to carry out their normal duties because of the onset, during flight, of the effects of physiological factors.

Description

Death is the most extreme example of incapacitation, usually as a result of a heart attack, but is not necessarily the most hazardous. Although most recorded deaths of operating pilots in flight have been found to be due to cardiovascular disease, by far the most common cause of flight crew incapacitation is gastroenteritis.

Incapacitation may occur as a result of:

  • The effects of Hypoxia (insufficient oxygen) associated with an absence of normal pressurisation system function at altitudes above 10,000 ft.
  • Smoke or Fumes associated with an Fire in the Air or with contamination of the air conditioning system.
  • Gastro-intestinal problems such as severe Gastroenteritis potentially attributable to Food Poisoning, or to Food Allergy.
  • Being asleep.
  • A medical condition such as a heart attack, stroke or seizure, or transient mental abnormality.
  • A Bird Strike or other event causing incapacitating physical injury.
  • A malicious or hostile act such as assault by an unruly passenger, terrorist action or small arms fire, or possibly malicious targeting of aircraft with high powered lasers by persons on the ground.

Unless the incapacitation occurs on a single pilot operation, incapacitation of one pilot may not be immediately obvious, become only progressively evident, or escape notice altogether until an unexpected absence of response or action occurs.

Effects

Clearly, if the single pilot of a small aircraft becomes incapacitated then the safety of the flight is liable to be severely compromised and Loss of Control may result. However, for the two pilot case typical of larger transport aircraft, incapacitation of only one of the pilots is unlikely to present a significant risk given the attention which pilot training, especially for low minima precision approaches, is usually required to give to the implications of single pilot incapacitation.

Loss of Separation may be a secondary effect of total crew incapacitation or side effect of the additional workload imposed upon the remaining crew member(s).

Solutions

The key to avoiding serious problems from the incapacitation of one pilot in a multi crew aircraft is the availability of appropriate SOPs and recurrent training which includes practice in their use.

Correct control of both the aircraft pressurisation system and, if necessary, use of the emergency oxygen supply will both prevent Hypoxia and protect the crew from the effects of Smoke and Fumes. Therapeutic Oxygen supplies can also alleviate the condition of a crew member or passenger suffering a medical condition. Staggering crew meal times and ensuring that each pilot eats different meals both prior to and during flight, will usually prevent both pilots becoming incapacitated due to Food Poisoning and is currently common practice. Intentional sleep whilst on the flight deck may be relevant on long haul flights but should only take place if an appropriate SOPs exists and is followed.

The first indication that a controller might get of total flight crew incapacitation is Loss of Communication. Having tried all means, without success, to contact the aircraft, it is extremely difficult for a controller to ascertain what is happening on an aircraft. If the aircraft autopilot is engaged then it will be likely to follow the flight plan route towards the destination. Conforming with standard loss of communication procedures, military aircraft can be tasked to intercept the aircraft and inspect it visually but there is little that a controller can do other then ensure the safety of surrounding traffic by maintaining separation.

Accidents & Incidents

Events on the SKYbrary Database which list Incapacitation as a causal factor:

B712, vicinity Hobart Tasmania Australia, 2023

On 6 June 2023, a Boeing 717-200 was on base leg about 10 nm from Hobart when chlorine fumes became evident on the flight deck. As the aircraft became fully established on final approach, the Captain recognised signs of cognitive impairment and handed control to the initially unaffected First Officer. Just before touchdown, he was similarly affected but was able to safely complete the landing and taxi in. The same aircraft had experienced a similar event two days earlier with no fault found. The Investigation determined that the operator’s procedures for responding to crew incapacitation in flight had been inadequate.

A339, en-route, east of Antigua & Barbuda, 2022

On 17 January 2022, about 30 minutes after takeoff from Fort-de-France, Martinique, on an ETOPS flight, an Airbus A330-900 was approaching its initial cruise altitude when the apparently unconscious Captain appeared initially unresponsive. On being more aggressively roused, he seemed normal and a doctor on board initially assessed him as fit to continue. However, about two hours into the flight his condition subsequently deteriorated and the First Officer called the Chief Purser to take his seat to assist. A PAN, later upgraded to a MAYDAY, was declared and a diversion was made to Lajes where the Captain was hospitalised.

A359, en-route, west southwest of Manila Philippines, 2019

On 21 February 2019, the Captain of an Airbus A350-900 in the cruise en-route to Hong Kong became and remained incapacitated. The First Officer took over control and completed the flight as planned without further event. The Cabin Crew Manager was called to the flight deck and advised and a doctor on board provided medical assistance to the Captain who remained conscious but with slurred speech and was hospitalised on arrival. It was concluded that the response to the situation had been effectively handled and the remainder of the flight was completed in accordance with all applicable procedures and training.

A321, en-route, north of Kaohsiung Taiwan, 2019

On 29 October 2019, an Airbus A321 was descending towards its destination, Kaohsiung, when the First Officer suddenly lost consciousness without warning. The Captain declared a MAYDAY and with cabin crew assistance, he was secured clear of the flight controls and given oxygen which appeared beneficial. He was then removed to the passenger cabin where a doctor recommended continuing oxygen treatment. On arrival, he had fully regained consciousness. Medical examination and tests both on arrival and subsequently were unable to identify a cause although a context of cumulative fatigue was considered likely after three consecutive nights of inadequate sleep.

B772, en-route, north of Bahrain, 2017

On 27 September 2017, a Boeing 777-200LRF Captain left the flight deck to retrieve their crew meal about 40 minutes after departing Abu Dhabi but whilst doing so he collapsed unconscious in the galley and despite assistance subsequently died. A MAYDAY was declared and a diversion to Kuwait successfully completed by the remaining pilot. The Investigation determined that the cause of death was cardiopulmonary system collapse due to a stenosis in the coronary artery. It was noted that the Captain’s medical condition had been partially concealed from detection because of his unapproved use of potentially significant self-medication.

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Categories
Human Behaviour, HF-AO, Aircraft Emergency & Unusual Situations

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