Narrative:

Made diversion into position (ttpp), trinidad, while flying flight to sbgr due to medical emergency. I was awoken from my break at approximately XA30 and advised 'you need to land now, immediately' by a flight attendant. When I asked her who was the source of this information, she then told me that she had been in contact with 3 onboard medical personnel (2 of which were doctors) that we needed to land, 'now' because of medical complications and symptoms given by passenger. Returned to cockpit to find that both of my coplts were already in contact with dispatch, via ACARS, as well as that piarco ATC was advised of our intention to turn north, back to either san juan or ttpp for a medical diversion. It was my desire to get more information from dispatch, but already having 2 doctors on aircraft stating passenger health was in imminent danger, basically short cut my decision to land at 'nearest suitable alternate.' after having been briefed by dispatch ACARS messages on available alternates and WX, I elected ttpp. Attempts to contact dispatch directly were complicated by poor and intermittent satcom signal. Did manage to get direct voice contact for a few mins at which time dispatch seemed to be leaning towards san juan (450 mi away) versus our choice of position (ttpp), which dispatcher stated was closed by his information. We contacted ttpp airport, then about 150 mi away, by VHF and were told by tower that they were indeed open. ATC confirmed this, and that conditions there were good (some broken clouds but basically, VFR). Advised dispatch of this and he then agreed that ttpp was best choice. Briefed for ILS runway 10. Made smooth, uneventful overweight landing (330000 pounds) at ttpp. Passenger was met by ambulance and deplaned. A mechanic on field accomplished overweight landing inspection. Other air carrier operation agent and GA services, manager accomplished handling of aircraft. Also had great deal of problems getting direct contact with dispatch even on ground. Attempted 'HF ldoc' link, with limited success (too garbled). Tried first class phone, but later decided this was a bad idea due to how limited communication were on my side with passenger all listening in. Did make it very clear early on, that oxygen was going to be a problem, as well as fuel and landing inspections. After about 1 hour or so more on ground, other company mechanic shows up and offers their office phone. This was the first time I felt I had a true link up to maintenance control and dispatch. After about 5 hours on the ground of trying to get everything done, with people and flight attendants all confined on aircraft by customs, and after accomplished all necessary paperwork and inspections, refueling, flight plans, flight was killed by maintenance control due to lack of mrd. The reason for this was other air carrier maintenance coordination would not ok loan of 2 oxygen bottles necessary to bring us up to 5 bottle minimum for dispatch. Local mechanic and people had no problem with it. Imho bottles were exactly the same, even had same DOT numbers, pressure and volume, mask design. Crew and passenger were released to go to customs. While in customs, I was called back to airplane by local civil air authority/authorized for inspection of airplane. It was another 30 mins before I was back with crew and we were allowed to go to customs. End of report. My opinion/conclusions: I was told next day that passenger that caused all of this was fine, and had suffered nothing more than an acute case of altitude sickness. Further, he had to wait more than 4 hours in hospital before he was seen by a doctor and cleared. These facts, along with the lack of credibility for prognosis from 2 brazilian doctors, as well as the lack of workable parts/maintenance agreements with other carriers for getting oxygen bottles and parts, lead me to conclude that diversion is not necessarily the best way to get passenger to competent medical help as soon as possible. Further, the inevitable long ground delay times that result after landing off schedule in a place like south america, put many other physically marginal passenger under high stress. Being confined to a coach seat in 88 degree air, in an emotionally charged atmosphere of uncertainty and frustration, takes its toll over a 5+ hour period. These unforeseen problems will be considered before any future decision is made to divert in the middle of the night. Our company just does not have the experienced dispatch/maintenance personnel and support agreements with other carriers necessary to support such a diversion without creating more risk than they alleviate.

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Original NASA ASRS Text

Title: DURING A FLT TO SBGR, A B767-300 FLT CREW PERFORMS A DIVERSION WHEN A PAX IS MISDIAGNOSED BY ONBOARD DOCTORS AS BEING VERY ILL, REQUIRING AN IMMEDIATE LNDG AT THE CLOSEST ARPT WHICH IS TTPP. FLT SUFFERS AN 'RON' WHEN 2 OXYGEN BOTTLES CANNOT BE FURNISHED FOR THE FLT ON TO DEST ARPT.

Narrative: MADE DIVERSION INTO POS (TTPP), TRINIDAD, WHILE FLYING FLT TO SBGR DUE TO MEDICAL EMER. I WAS AWOKEN FROM MY BREAK AT APPROX XA30 AND ADVISED 'YOU NEED TO LAND NOW, IMMEDIATELY' BY A FLT ATTENDANT. WHEN I ASKED HER WHO WAS THE SOURCE OF THIS INFO, SHE THEN TOLD ME THAT SHE HAD BEEN IN CONTACT WITH 3 ONBOARD MEDICAL PERSONNEL (2 OF WHICH WERE DOCTORS) THAT WE NEEDED TO LAND, 'NOW' BECAUSE OF MEDICAL COMPLICATIONS AND SYMPTOMS GIVEN BY PAX. RETURNED TO COCKPIT TO FIND THAT BOTH OF MY COPLTS WERE ALREADY IN CONTACT WITH DISPATCH, VIA ACARS, AS WELL AS THAT PIARCO ATC WAS ADVISED OF OUR INTENTION TO TURN N, BACK TO EITHER SAN JUAN OR TTPP FOR A MEDICAL DIVERSION. IT WAS MY DESIRE TO GET MORE INFO FROM DISPATCH, BUT ALREADY HAVING 2 DOCTORS ON ACFT STATING PAX HEALTH WAS IN IMMINENT DANGER, BASICALLY SHORT CUT MY DECISION TO LAND AT 'NEAREST SUITABLE ALTERNATE.' AFTER HAVING BEEN BRIEFED BY DISPATCH ACARS MESSAGES ON AVAILABLE ALTERNATES AND WX, I ELECTED TTPP. ATTEMPTS TO CONTACT DISPATCH DIRECTLY WERE COMPLICATED BY POOR AND INTERMITTENT SATCOM SIGNAL. DID MANAGE TO GET DIRECT VOICE CONTACT FOR A FEW MINS AT WHICH TIME DISPATCH SEEMED TO BE LEANING TOWARDS SAN JUAN (450 MI AWAY) VERSUS OUR CHOICE OF POS (TTPP), WHICH DISPATCHER STATED WAS CLOSED BY HIS INFO. WE CONTACTED TTPP ARPT, THEN ABOUT 150 MI AWAY, BY VHF AND WERE TOLD BY TWR THAT THEY WERE INDEED OPEN. ATC CONFIRMED THIS, AND THAT CONDITIONS THERE WERE GOOD (SOME BROKEN CLOUDS BUT BASICALLY, VFR). ADVISED DISPATCH OF THIS AND HE THEN AGREED THAT TTPP WAS BEST CHOICE. BRIEFED FOR ILS RWY 10. MADE SMOOTH, UNEVENTFUL OVERWT LNDG (330000 LBS) AT TTPP. PAX WAS MET BY AMBULANCE AND DEPLANED. A MECH ON FIELD ACCOMPLISHED OVERWT LNDG INSPECTION. OTHER ACR OP AGENT AND GA SVCS, MGR ACCOMPLISHED HANDLING OF ACFT. ALSO HAD GREAT DEAL OF PROBS GETTING DIRECT CONTACT WITH DISPATCH EVEN ON GND. ATTEMPTED 'HF LDOC' LINK, WITH LIMITED SUCCESS (TOO GARBLED). TRIED FIRST CLASS PHONE, BUT LATER DECIDED THIS WAS A BAD IDEA DUE TO HOW LIMITED COM WERE ON MY SIDE WITH PAX ALL LISTENING IN. DID MAKE IT VERY CLR EARLY ON, THAT OXYGEN WAS GOING TO BE A PROB, AS WELL AS FUEL AND LNDG INSPECTIONS. AFTER ABOUT 1 HR OR SO MORE ON GND, OTHER COMPANY MECH SHOWS UP AND OFFERS THEIR OFFICE PHONE. THIS WAS THE FIRST TIME I FELT I HAD A TRUE LINK UP TO MAINT CTL AND DISPATCH. AFTER ABOUT 5 HRS ON THE GND OF TRYING TO GET EVERYTHING DONE, WITH PEOPLE AND FLT ATTENDANTS ALL CONFINED ON ACFT BY CUSTOMS, AND AFTER ACCOMPLISHED ALL NECESSARY PAPERWORK AND INSPECTIONS, REFUELING, FLT PLANS, FLT WAS KILLED BY MAINT CTL DUE TO LACK OF MRD. THE REASON FOR THIS WAS OTHER ACR MAINT COORD WOULD NOT OK LOAN OF 2 OXYGEN BOTTLES NECESSARY TO BRING US UP TO 5 BOTTLE MINIMUM FOR DISPATCH. LCL MECH AND PEOPLE HAD NO PROB WITH IT. IMHO BOTTLES WERE EXACTLY THE SAME, EVEN HAD SAME DOT NUMBERS, PRESSURE AND VOLUME, MASK DESIGN. CREW AND PAX WERE RELEASED TO GO TO CUSTOMS. WHILE IN CUSTOMS, I WAS CALLED BACK TO AIRPLANE BY LCL CIVIL AIR AUTH FOR INSPECTION OF AIRPLANE. IT WAS ANOTHER 30 MINS BEFORE I WAS BACK WITH CREW AND WE WERE ALLOWED TO GO TO CUSTOMS. END OF RPT. MY OPINION/CONCLUSIONS: I WAS TOLD NEXT DAY THAT PAX THAT CAUSED ALL OF THIS WAS FINE, AND HAD SUFFERED NOTHING MORE THAN AN ACUTE CASE OF ALT SICKNESS. FURTHER, HE HAD TO WAIT MORE THAN 4 HRS IN HOSPITAL BEFORE HE WAS SEEN BY A DOCTOR AND CLRED. THESE FACTS, ALONG WITH THE LACK OF CREDIBILITY FOR PROGNOSIS FROM 2 BRAZILIAN DOCTORS, AS WELL AS THE LACK OF WORKABLE PARTS/MAINT AGREEMENTS WITH OTHER CARRIERS FOR GETTING OXYGEN BOTTLES AND PARTS, LEAD ME TO CONCLUDE THAT DIVERSION IS NOT NECESSARILY THE BEST WAY TO GET PAX TO COMPETENT MEDICAL HELP AS SOON AS POSSIBLE. FURTHER, THE INEVITABLE LONG GND DELAY TIMES THAT RESULT AFTER LNDG OFF SCHEDULE IN A PLACE LIKE SOUTH AMERICA, PUT MANY OTHER PHYSICALLY MARGINAL PAX UNDER HIGH STRESS. BEING CONFINED TO A COACH SEAT IN 88 DEG AIR, IN AN EMOTIONALLY CHARGED ATMOSPHERE OF UNCERTAINTY AND FRUSTRATION, TAKES ITS TOLL OVER A 5+ HR PERIOD. THESE UNFORESEEN PROBS WILL BE CONSIDERED BEFORE ANY FUTURE DECISION IS MADE TO DIVERT IN THE MIDDLE OF THE NIGHT. OUR COMPANY JUST DOES NOT HAVE THE EXPERIENCED DISPATCH/MAINT PERSONNEL AND SUPPORT AGREEMENTS WITH OTHER CARRIERS NECESSARY TO SUPPORT SUCH A DIVERSION WITHOUT CREATING MORE RISK THAN THEY ALLEVIATE.

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.