Narrative:

Usurpation of captain's authority/authorized. After 4 hours of flight, 300 mi over the pacific ocean from guayaquil, equador, passenger had heart attack. A page resulted in 2 doctors who used the aed and the nitro tablets from the emergency kit to monitor and stabilize the passenger. Investigation of this passenger produced the information that she had a heart attack the previous night at about XA15 in a passenger boarding lounge after deplaning following an aborted takeoff due to aircraft mechanical malfunction. Passenger service reboarded her 12 hours later after a night in the emergency room. The manager was involved in convincing the purser to take this passenger. Reference was made to a signed note from a doctor that she could fly. At no time did the manager consult with the captain to inform him of this passenger and her condition. This is a violation of far 121.533D. The written doctor's permission turned out to be 2 pages of generic emergency room care follow-up advice with a prescription for nitro tablets that the patient hadn't had time to fill before boarding again. At no time was an air carrier physician on call contacted. I was informed by the doctors on board that they thought she might have died without their care, the aed, and the nitro tablets. 300 mi out over the pacific ocean midway between panama, equador, and peru is not the time for the captain to find out that the manager has acted as controling medical and legal authority/authorized to clear a gravely ill passenger for transport.

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Original NASA ASRS Text

Title: MD11 CREW HAD A PAX THAT HAD A HEART ATTACK INFLT ON AN INTL FLT. THE PAX HAD ANOTHER HEART ATTACK 12 HRS PREVIOUSLY.

Narrative: USURPATION OF CAPT'S AUTH. AFTER 4 HRS OF FLT, 300 MI OVER THE PACIFIC OCEAN FROM GUAYAQUIL, EQUADOR, PAX HAD HEART ATTACK. A PAGE RESULTED IN 2 DOCTORS WHO USED THE AED AND THE NITRO TABLETS FROM THE EMER KIT TO MONITOR AND STABILIZE THE PAX. INVESTIGATION OF THIS PAX PRODUCED THE INFO THAT SHE HAD A HEART ATTACK THE PREVIOUS NIGHT AT ABOUT XA15 IN A PAX BOARDING LOUNGE AFTER DEPLANING FOLLOWING AN ABORTED TKOF DUE TO ACFT MECHANICAL MALFUNCTION. PAX SVC REBOARDED HER 12 HRS LATER AFTER A NIGHT IN THE EMER ROOM. THE MGR WAS INVOLVED IN CONVINCING THE PURSER TO TAKE THIS PAX. REF WAS MADE TO A SIGNED NOTE FROM A DOCTOR THAT SHE COULD FLY. AT NO TIME DID THE MGR CONSULT WITH THE CAPT TO INFORM HIM OF THIS PAX AND HER CONDITION. THIS IS A VIOLATION OF FAR 121.533D. THE WRITTEN DOCTOR'S PERMISSION TURNED OUT TO BE 2 PAGES OF GENERIC EMER ROOM CARE FOLLOW-UP ADVICE WITH A PRESCRIPTION FOR NITRO TABLETS THAT THE PATIENT HADN'T HAD TIME TO FILL BEFORE BOARDING AGAIN. AT NO TIME WAS AN ACR PHYSICIAN ON CALL CONTACTED. I WAS INFORMED BY THE DOCTORS ON BOARD THAT THEY THOUGHT SHE MIGHT HAVE DIED WITHOUT THEIR CARE, THE AED, AND THE NITRO TABLETS. 300 MI OUT OVER THE PACIFIC OCEAN MIDWAY BTWN PANAMA, EQUADOR, AND PERU IS NOT THE TIME FOR THE CAPT TO FIND OUT THAT THE MGR HAS ACTED AS CTLING MEDICAL AND LEGAL AUTH TO CLR A GRAVELY ILL PAX FOR TRANSPORT.

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.