Narrative:

En route; our flight attendants notified us that they had an elderly female passenger on oxygen. When passenger failed to recover her normal breathing; onboard medical professionals came to her aid. We set up phone patch to dispatch and medical. Based on the diagnosis of the doctor who was examining her and medical's concurrence; we declared a medical emergency and diverted. Emt personnel met our flight and transported the passenger to a local hospital. She did not survive. Dealing with this incident brought several safety factors to light. First; we had no approach charts for ZZZ. The company had 'off line' airports for that area removed from our route manual coverage. Also; ZZZ was not stored in our FMS database; presumably as a cost reduction measure. We were forced to rely on ATC vectors to a visual approach in daylight VMC. Another factor was communications. The company had removed the in-flight 'airfone' system from the aircraft. This system would have allowed the doctor to talk directly to medical. Having to relay information via a phone patch was inefficient and took precious time. Lastly; any landing at an 'off-line' airport can present problems which must be dealt with before a flight can continue to its destination. In this incident; we landed the aircraft at a gross weight slightly in excess of the maximum certified landing weight. We discussed the issue with dispatch and our technical center representative. Based on the technical definition of 'overweight landing' and the fact that no 'overweight' alert had been displayed on our FMS; it was determined that an overweight landing had not occurred and; therefore; no inspection was required. After dealing with other items requiring MEL approval; we continued on uneventfully.

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Original NASA ASRS Text

Title: A321 FLT CREW HAS A MEDICAL EMER AND DIVERTS TO ZZZ.

Narrative: ENRTE; OUR FLT ATTENDANTS NOTIFIED US THAT THEY HAD AN ELDERLY FEMALE PAX ON OXYGEN. WHEN PAX FAILED TO RECOVER HER NORMAL BREATHING; ONBOARD MEDICAL PROFESSIONALS CAME TO HER AID. WE SET UP PHONE PATCH TO DISPATCH AND MEDICAL. BASED ON THE DIAGNOSIS OF THE DOCTOR WHO WAS EXAMINING HER AND MEDICAL'S CONCURRENCE; WE DECLARED A MEDICAL EMER AND DIVERTED. EMT PERSONNEL MET OUR FLT AND TRANSPORTED THE PAX TO A LCL HOSPITAL. SHE DID NOT SURVIVE. DEALING WITH THIS INCIDENT BROUGHT SEVERAL SAFETY FACTORS TO LIGHT. FIRST; WE HAD NO APCH CHARTS FOR ZZZ. THE COMPANY HAD 'OFF LINE' ARPTS FOR THAT AREA REMOVED FROM OUR RTE MANUAL COVERAGE. ALSO; ZZZ WAS NOT STORED IN OUR FMS DATABASE; PRESUMABLY AS A COST REDUCTION MEASURE. WE WERE FORCED TO RELY ON ATC VECTORS TO A VISUAL APCH IN DAYLIGHT VMC. ANOTHER FACTOR WAS COMS. THE COMPANY HAD REMOVED THE INFLT 'AIRFONE' SYS FROM THE ACFT. THIS SYS WOULD HAVE ALLOWED THE DOCTOR TO TALK DIRECTLY TO MEDICAL. HAVING TO RELAY INFO VIA A PHONE PATCH WAS INEFFICIENT AND TOOK PRECIOUS TIME. LASTLY; ANY LNDG AT AN 'OFF-LINE' ARPT CAN PRESENT PROBS WHICH MUST BE DEALT WITH BEFORE A FLT CAN CONTINUE TO ITS DEST. IN THIS INCIDENT; WE LANDED THE ACFT AT A GROSS WT SLIGHTLY IN EXCESS OF THE MAX CERTIFIED LNDG WT. WE DISCUSSED THE ISSUE WITH DISPATCH AND OUR TECHNICAL CTR REPRESENTATIVE. BASED ON THE TECHNICAL DEFINITION OF 'OVERWT LNDG' AND THE FACT THAT NO 'OVERWT' ALERT HAD BEEN DISPLAYED ON OUR FMS; IT WAS DETERMINED THAT AN OVERWT LNDG HAD NOT OCCURRED AND; THEREFORE; NO INSPECTION WAS REQUIRED. AFTER DEALING WITH OTHER ITEMS REQUIRING MEL APPROVAL; WE CONTINUED ON UNEVENTFULLY.

Data retrieved from NASA's ASRS site as of January 2009 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.