Ryanair B738 near Pisa on Jul 6th 2011, first officer incapacitated

Last Update: November 6, 2012 / 15:09:52 GMT/Zulu time

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Incident Facts

Date of incident
Jul 6, 2011

Classification
Incident

Airline
Ryanair

Aircraft Type
Boeing 737-800

ICAO Type Designator
B738

Spain's CIAIAC released their final report in Spanish on pages 57-71 (English version pages 167-180) of their quarterly bulletin concluding the probable cause of the incident was:

the sudden incapacitation of the copilot. Medically the event was classified as a syncope, likely caused by prolonged heat exposure. There were no indications in either the copilotÂ’s medical history or in follow-up tests to suggest that the syncope could have been anticipated.

CIAIAC reported that the aircraft was about 30 minutes into the flight when the first officer (33, CPL, 4,000 hours total, 2,050 hours on type) informed the captain (39, ATPL, 9,000 hours total, 7,000 hours on type) that he was feeling sick and suffered from head ache handing controls to the captain. Moments later the first officer felt dizziness and tremors, no longer responded to questions by the captain and eventually became unconscious. The captain requested a flight attendant to the cockpit to take care of the first officer, the first officer was treated with oxygen. In the meantime the captain declared medical emergency with Marseille Center (France) and requested to divert to Girona. The first officer was stabilised, regained consciousness about 4-5 minutes after becoming unconscious, but remained incapacitated. The aircraft landed safely on Girona's runway 20 about 45 minutes after the first officer handed the controls to the captain. Following an initial assessment by medical services the first officer was taken to a hospital, where medical tests confirmed there was no serious health problem. The first officer was discharged from the hospital soon after.

CIAIAC reported the cause of fainting was given by the hospital as "vasovagal syncope", the most common form of fainting as result of a stimulus to the vagus nerve resulting in reduction of heart rate and dilation of blood vessels via the parasympathetic system. This causes less blood being delivered to the brain and fainting. Typically, unconsciousness is short and recovery is quick after changing body position.

CIAIAC reported that the captain reported a medical emergency with Marseille without indicating the medical emergency concerned the first officer. Only after contact Girona Approach, upon being queried about the nature of the medical emergency, the captain reported the first officer was incapacitated and the aircraft was in "single pilot operation". This information was forwarded to Girona Tower, who asked whether they should deploy the trucks (fire services), approach suggested that wasn't necessary as it was a medical emergency only.

The CIAIAC analysed that Ryanair did provide simulator training for commander incapacitation, however, had not provided training for first officer incapacitation. The commander immediately reacted to the first officer's first indications of health deterioration and took control of the aircraft without any disruption of the aircraft handling. He requested the purser to the flight deck to provide first aid to the first officer, however, he did not relay the fact to ATC, that the first officer had been incapacitated causing the impression with ATC that a passenger had a medical emergency. When French ATC queried to state the nature of emergency, the captain still maintained it was just a medical emergency. Only on approach to Girona the captain revealed the aircraft was down to single pilot operation. The CIAIAC states that there was lack of clarity in the procedures permitting the captain to focus on the medical side of the events but did not perceive the situation affecting the safety of the flight.

On the ground there was confusion about how to respond to the emergency following the captain's revelation of a pilot incapacitation. The plans for passenger medical emergency were carried out rather than the aircraft in emergency response plans. The confusion arose out of the captain's continued wording "medical emergency" which is generally understood as not affecting safety of the flight, although following the revelation of a single pilot operation it should have been clear this was an emergency affecting safety of the flight.

CIAIAC released three safety recommendations as result of the investigation:
- Ryanair should introduce a scenario of first officer incapacitation into their simulator training
- Ryanair should review their operating manual in order to provide for emergency declaration in case of flight crew member incapacitation and purser involvement in reading checklists prior to landing
- AENA (Spanish Airport Operator) should verify all ATC personnel and personnel in focal points of airports being aware that flight crew incapacitation must be treated as declared emergency in flight and thus activate the emergency response plans.
Incident Facts

Date of incident
Jul 6, 2011

Classification
Incident

Airline
Ryanair

Aircraft Type
Boeing 737-800

ICAO Type Designator
B738

This article is published under license from Avherald.com. © of text by Avherald.com.
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