Narrative:

At approximately PM40 on V-47 midpoint from rosewood to cvg, at 16000 ft altitude, the flight attendant came to the flight deck and told me that he was not feeling well and that he'd spilled a couple of drinks on a passenger. I was the PNF and the first officer was the PF. I asked the flight attendant what was wrong (symptoms, dizziness, etc). He said he felt weak and hot. He appeared pale, glassy-eyed, and confused. Then he held out his hand and it was trembling. Shortly thereafter, he momentarily lost his balance. I told him to situation down on the step to the flight deck, which he did. I notified ZID of the situation and requested clearance to cvg and an ambulance. We were given an immediate descent and started on vectors for cvg. As I reached around to my right for the PA phone to address the passenger, the flight attendant's body straightened out, with his head between my seat and the center control pedestal. He began shaking violently, his eyes were fixed in a glassy gaze, and foam was coming out of his mouth. He was pale and his lips were blue. I immediately declared an emergency, so that no delays on approach to cvg would be encountered. I believe I also advised ATC that the flight attendant was now in convulsions. The flight attendant then stopped shaking for a short period of time. We continued the descent at vmo/min torque. Shortly thereafter, the flight attendant began flailing his arms and upper torso, while remaining unconscious. He was reaching over and behind his head for whatever happened to be in the way. He was grabbing at the center pedestal (power levers hpc, flap controls area) my right side, and the first officer's left side. I asked the first officer to concentrate on flying the airplane, which he did a superb job of doing. We restrained his arms from grabbing or striking the controls, power levers, hpc's, etc, and I held his upper torso down with my right arm. His body went limp again, he regained a state of 'semi- consciousness,' sat up, and fell aft onto the floor of the cargo area, below the step to the flight deck. This gave me my first opportunity to brief the passenger. I told them that the flight attendant had become seriously ill, that we were landing in cvg for medical assistance, and that we'd be on the ground in a few mins, and that they'd be accommodated on to lex when we reached the gate. Cvg approach (it may have been tower) asked if we would be taxiing to the gate on arrival. I replied negative, and asked that an ambulance meet us as soon as we were stopped clear of the runway. Cvg approach control aligned us with the final approach course to runway 18R. When the runway was in sight, we were handed off to tower and cleared to land. We were instructed to turn left on 9/27 and stop when east of 'D' taxiway. On short final, the flight attendant regained consciousness and proceeded back into the cabin. This distressed me greatly as I could not monitor his actions, and was too busy to do anything but get the aircraft on the ground and stopped. I prayed though. Once on runway 9, stopped, brake set, I shut down both engines, asked the first officer to accomplish the after landing and shutdown checks, and immediately proceeded to the cabin. The flight attendant was seated at his position, in a daze, wet with sweat, repeating 'I want to go home.' I helped him remain upright on his seat and opened the passenger entrance door. The paramedics were there and lowered him to the stretcher. I explained what happened, and they asked the flight attendant whether he was on any medication for seizures, to which he replied yes. Some of the passenger heard this and were distressed, even angered. Once the flight attendant was in the care of the medics, I spoke with the passenger, some of whom were visibly upset, one of which was perturbed because the flight attendant had spilled a drink on him earlier in the flight. I apologized for the inconvenience and any anxiety they may have suffered and assured them that they'd be re-accommodated to lex as soon as we arrived at the gate. As a ground power unit was not available, I obtained permission from dispatch/maintenance for a battery start and taxied the aircraft to the gate. I asked the first officer to remain with the passenger in the cabin. An agent occupied the right seat for the taxi to the gate. I discussed this with dispatch prior to starting up. Once at the gate the passenger were deplaned and the aircraft was returned to dtw under part 91, once the first officer and myself took a break and felt mentally prepared to fly again. In conclusion, I have reviewed the events in my mind many times. The sequence of the events and unpredictability of what would happen next with the flight attendant made leaving the flight deck an unviable alternative. My main concern was getting the aircraft on the ground once the flight attendant was unconscious on the cargo deck. If I or the first officer attempted to go aft to summon passenger assistance, it would have left 1 pilot on the flight deck, on final approach, with an unpredictable situation immediately behind him. I am open to suggestions, correction, reprimand. In retrospect, I would have done 2 things differently: (a) placed the ignitions to on, should the flight attendant have managed to inadvertently manipulate an engine control. (B) I would have kept the first officer in his position during the taxi to the gate, and the agent in the cabin. At that juncture, I was terribly concerned for the experience the passenger had gone through, and the first officer seemed to have a calming effect. I feel the first officer and I worked as a team throughout, but I alone assume full responsibility for any decisions actions that may have been contrary to the safest course of action. I was informed by company dispatch, following this occurrence, that in-flight services personnel were apparently aware of this man's having previous seizures. This dangerous situation could have been avoided altogether by removing him from flight duties. At the very least, as the PIC, I should have been made aware of this crucial medical history information.

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Original NASA ASRS Text

Title: MEDICAL INFLT EMER DECLARED AS CABIN ATTENDANT BEHAVIOR ILLNESS TURNS INTO INCAPACITATION.

Narrative: AT APPROX PM40 ON V-47 MIDPOINT FROM ROSEWOOD TO CVG, AT 16000 FT ALT, THE FLT ATTENDANT CAME TO THE FLT DECK AND TOLD ME THAT HE WAS NOT FEELING WELL AND THAT HE'D SPILLED A COUPLE OF DRINKS ON A PAX. I WAS THE PNF AND THE FO WAS THE PF. I ASKED THE FLT ATTENDANT WHAT WAS WRONG (SYMPTOMS, DIZZINESS, ETC). HE SAID HE FELT WEAK AND HOT. HE APPEARED PALE, GLASSY-EYED, AND CONFUSED. THEN HE HELD OUT HIS HAND AND IT WAS TREMBLING. SHORTLY THEREAFTER, HE MOMENTARILY LOST HIS BAL. I TOLD HIM TO SIT DOWN ON THE STEP TO THE FLT DECK, WHICH HE DID. I NOTIFIED ZID OF THE SITUATION AND REQUESTED CLRNC TO CVG AND AN AMBULANCE. WE WERE GIVEN AN IMMEDIATE DSCNT AND STARTED ON VECTORS FOR CVG. AS I REACHED AROUND TO MY R FOR THE PA PHONE TO ADDRESS THE PAX, THE FLT ATTENDANT'S BODY STRAIGHTENED OUT, WITH HIS HEAD BTWN MY SEAT AND THE CTR CTL PEDESTAL. HE BEGAN SHAKING VIOLENTLY, HIS EYES WERE FIXED IN A GLASSY GAZE, AND FOAM WAS COMING OUT OF HIS MOUTH. HE WAS PALE AND HIS LIPS WERE BLUE. I IMMEDIATELY DECLARED AN EMER, SO THAT NO DELAYS ON APCH TO CVG WOULD BE ENCOUNTERED. I BELIEVE I ALSO ADVISED ATC THAT THE FLT ATTENDANT WAS NOW IN CONVULSIONS. THE FLT ATTENDANT THEN STOPPED SHAKING FOR A SHORT PERIOD OF TIME. WE CONTINUED THE DSCNT AT VMO/MIN TORQUE. SHORTLY THEREAFTER, THE FLT ATTENDANT BEGAN FLAILING HIS ARMS AND UPPER TORSO, WHILE REMAINING UNCONSCIOUS. HE WAS REACHING OVER AND BEHIND HIS HEAD FOR WHATEVER HAPPENED TO BE IN THE WAY. HE WAS GRABBING AT THE CTR PEDESTAL (PWR LEVERS HPC, FLAP CTLS AREA) MY R SIDE, AND THE FO'S L SIDE. I ASKED THE FO TO CONCENTRATE ON FLYING THE AIRPLANE, WHICH HE DID A SUPERB JOB OF DOING. WE RESTRAINED HIS ARMS FROM GRABBING OR STRIKING THE CTLS, PWR LEVERS, HPC'S, ETC, AND I HELD HIS UPPER TORSO DOWN WITH MY R ARM. HIS BODY WENT LIMP AGAIN, HE REGAINED A STATE OF 'SEMI- CONSCIOUSNESS,' SAT UP, AND FELL AFT ONTO THE FLOOR OF THE CARGO AREA, BELOW THE STEP TO THE FLT DECK. THIS GAVE ME MY FIRST OPPORTUNITY TO BRIEF THE PAX. I TOLD THEM THAT THE FLT ATTENDANT HAD BECOME SERIOUSLY ILL, THAT WE WERE LNDG IN CVG FOR MEDICAL ASSISTANCE, AND THAT WE'D BE ON THE GND IN A FEW MINS, AND THAT THEY'D BE ACCOMMODATED ON TO LEX WHEN WE REACHED THE GATE. CVG APCH (IT MAY HAVE BEEN TWR) ASKED IF WE WOULD BE TAXIING TO THE GATE ON ARR. I REPLIED NEGATIVE, AND ASKED THAT AN AMBULANCE MEET US AS SOON AS WE WERE STOPPED CLR OF THE RWY. CVG APCH CTL ALIGNED US WITH THE FINAL APCH COURSE TO RWY 18R. WHEN THE RWY WAS IN SIGHT, WE WERE HANDED OFF TO TWR AND CLRED TO LAND. WE WERE INSTRUCTED TO TURN L ON 9/27 AND STOP WHEN E OF 'D' TAXIWAY. ON SHORT FINAL, THE FLT ATTENDANT REGAINED CONSCIOUSNESS AND PROCEEDED BACK INTO THE CABIN. THIS DISTRESSED ME GREATLY AS I COULD NOT MONITOR HIS ACTIONS, AND WAS TOO BUSY TO DO ANYTHING BUT GET THE ACFT ON THE GND AND STOPPED. I PRAYED THOUGH. ONCE ON RWY 9, STOPPED, BRAKE SET, I SHUT DOWN BOTH ENGS, ASKED THE FO TO ACCOMPLISH THE AFTER LNDG AND SHUTDOWN CHKS, AND IMMEDIATELY PROCEEDED TO THE CABIN. THE FLT ATTENDANT WAS SEATED AT HIS POS, IN A DAZE, WET WITH SWEAT, REPEATING 'I WANT TO GO HOME.' I HELPED HIM REMAIN UPRIGHT ON HIS SEAT AND OPENED THE PAX ENTRANCE DOOR. THE PARAMEDICS WERE THERE AND LOWERED HIM TO THE STRETCHER. I EXPLAINED WHAT HAPPENED, AND THEY ASKED THE FLT ATTENDANT WHETHER HE WAS ON ANY MEDICATION FOR SEIZURES, TO WHICH HE REPLIED YES. SOME OF THE PAX HEARD THIS AND WERE DISTRESSED, EVEN ANGERED. ONCE THE FLT ATTENDANT WAS IN THE CARE OF THE MEDICS, I SPOKE WITH THE PAX, SOME OF WHOM WERE VISIBLY UPSET, ONE OF WHICH WAS PERTURBED BECAUSE THE FLT ATTENDANT HAD SPILLED A DRINK ON HIM EARLIER IN THE FLT. I APOLOGIZED FOR THE INCONVENIENCE AND ANY ANXIETY THEY MAY HAVE SUFFERED AND ASSURED THEM THAT THEY'D BE RE-ACCOMMODATED TO LEX AS SOON AS WE ARRIVED AT THE GATE. AS A GND PWR UNIT WAS NOT AVAILABLE, I OBTAINED PERMISSION FROM DISPATCH/MAINT FOR A BATTERY START AND TAXIED THE ACFT TO THE GATE. I ASKED THE FO TO REMAIN WITH THE PAX IN THE CABIN. AN AGENT OCCUPIED THE R SEAT FOR THE TAXI TO THE GATE. I DISCUSSED THIS WITH DISPATCH PRIOR TO STARTING UP. ONCE AT THE GATE THE PAX WERE DEPLANED AND THE ACFT WAS RETURNED TO DTW UNDER PART 91, ONCE THE FO AND MYSELF TOOK A BREAK AND FELT MENTALLY PREPARED TO FLY AGAIN. IN CONCLUSION, I HAVE REVIEWED THE EVENTS IN MY MIND MANY TIMES. THE SEQUENCE OF THE EVENTS AND UNPREDICTABILITY OF WHAT WOULD HAPPEN NEXT WITH THE FLT ATTENDANT MADE LEAVING THE FLT DECK AN UNVIABLE ALTERNATIVE. MY MAIN CONCERN WAS GETTING THE ACFT ON THE GND ONCE THE FLT ATTENDANT WAS UNCONSCIOUS ON THE CARGO DECK. IF I OR THE FO ATTEMPTED TO GO AFT TO SUMMON PAX ASSISTANCE, IT WOULD HAVE LEFT 1 PLT ON THE FLT DECK, ON FINAL APCH, WITH AN UNPREDICTABLE SITUATION IMMEDIATELY BEHIND HIM. I AM OPEN TO SUGGESTIONS, CORRECTION, REPRIMAND. IN RETROSPECT, I WOULD HAVE DONE 2 THINGS DIFFERENTLY: (A) PLACED THE IGNITIONS TO ON, SHOULD THE FLT ATTENDANT HAVE MANAGED TO INADVERTENTLY MANIPULATE AN ENG CTL. (B) I WOULD HAVE KEPT THE FO IN HIS POS DURING THE TAXI TO THE GATE, AND THE AGENT IN THE CABIN. AT THAT JUNCTURE, I WAS TERRIBLY CONCERNED FOR THE EXPERIENCE THE PAX HAD GONE THROUGH, AND THE FO SEEMED TO HAVE A CALMING EFFECT. I FEEL THE FO AND I WORKED AS A TEAM THROUGHOUT, BUT I ALONE ASSUME FULL RESPONSIBILITY FOR ANY DECISIONS ACTIONS THAT MAY HAVE BEEN CONTRARY TO THE SAFEST COURSE OF ACTION. I WAS INFORMED BY COMPANY DISPATCH, FOLLOWING THIS OCCURRENCE, THAT INFLT SVCS PERSONNEL WERE APPARENTLY AWARE OF THIS MAN'S HAVING PREVIOUS SEIZURES. THIS DANGEROUS SITUATION COULD HAVE BEEN AVOIDED ALTOGETHER BY REMOVING HIM FROM FLT DUTIES. AT THE VERY LEAST, AS THE PIC, I SHOULD HAVE BEEN MADE AWARE OF THIS CRUCIAL MEDICAL HISTORY INFO.

Data retrieved from NASA's ASRS site as of July 2007 and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.