Narrative:

The air conditioning was very poor in the last 4 rows and worse in the aft galley of the aircraft. We initially pushed off the gate and were unable to start the left engine because the left engine fuel valve did not open. We started the right and taxied back to the gate for maintenance. Maintenance came out and worked on the aircraft. I deplaned the aircraft due to heat concerns for the aft part of the aircraft. I queried the flight attendant's if they wanted to get off the flight. They responded they were staying on the flight. After several hours and working several problems including left bleed duct overheat maintenance finally put an MEL on the aircraft for the left pack inoperative. It is not unusual to have a warm aircraft on the ground when the heat out side is 94 degrees and experience shows that once airborne the aircraft cools down quickly. I conferred with the flight attendant's if they were safe to work the flight with one pack and get airborne and cool off the aircraft. I again offered to replace them if they felt uncomfortable. They said they were good to go. We pushed off the gate again and taxied out. About 5 minutes prior to takeoff the lead flight attendant informed me that another flight attendant had told her we had a passenger with asthma in the rear of the aircraft but related no symptoms or complaints. My understanding was the passenger had no symptoms but asthma was a condition the person had; just as many have asthma. There were no conditions of an asthma attack related. Later this flight attendant would confirm after landing that was the case before takeoff. There must have been some misunderstanding as she later denied she said that. We took off and climbed out passing 15;000 feet we got a call from a flight attendant who said we had an incapacitated passenger from the heat and that it was 104 degrees in the rear of aircraft. I told her we would go back and land and then declared an emergency with ATC and turned back to land. I sent a diversion message and first officer called company; requested gate; jetway drivers; parkers and medics to meet us. I made an announcement to the passengers we were returning to land. We performed the descent and approach checklists and briefed a visual approach. I gave four bells with the no smoking bell descending through 10;000 feet because we were close to the field. We had 4 calls from flight attendant's below 10;000 feet requesting an ambulance for the child who was overcome by heat; lethargic and non-responsive and other issues. Each subsequent call increased the perceived urgency of landing. There were difficulties with communicating with the flight attendant's on interphone and I actually gave an additional 4 bells on the aft flight attendant call bell trying to contact them. We performed the landing checklist after flaps 30. Some flight attendant's were working with the ill passenger in the aisle and may not have heard the signal and did not notice the landing gear go down or other signals due to concern with the child as he was unresponsive and they were very concerned for the child. On landing when engines were reversed and brakes applied; a cart in the rear galley came loose and flight attendant #3 stopped it with her arm as best she could and was injured arm; shoulder; neck; and ankle. She saved probable injuries to passengers by doing so. The lead flight attendant was also was hit by cart; needed assistance from passenger to push the cart back; but said she was not injured. We landed [and] flight attendant requested an additional ambulance and medics for injured flight attendant #3. We called operations again; on ground for a gate and the reply was standby. They then gave us a gate; which was not equipped for a B767 but no one was there to meet us and took a delay to get to jetway; due to repositioning the aircraft. It took a long time to get the jetway hooked to the door. The child was doing better by the time we got to the gate as he had ice packs and medical personnel from on board assisting. Medics came on and child was taken off. Medics went to the rear of the aircraft to assist flight attendant #3 and she was assisted off on stretcher with injuries to her neck; arm; and ankle. Aircraft was written up for poor cooling in the aft section.cause:1. Left pack was on MEL. Rear aircraft vents were putting out hot air raising the temperature to unacceptable levels. Temperatures rose in the rear of aircraft and caused illness for passenger. 2. Additional injury to flight attendant occurred because one of the galley carts was not secured for landing and it rolled out and flight attendant stopped it with her arm. There was some confusion caused by interphone communications which were difficult to understand. Subsequently; the flight attendant's called 4 times below 10;000 feet to request an ambulance and give other advisories. Some of these were garbled and when I answered; went unacknowledged because I could not hear a reply.3. The rear shades where the flight attendant's were working had been closed to help cool the aircraft with a loss of outside visual cues for the flight attendant's in reference to landing. Because of concentration on passenger assistance and all the call bells they were unsure of landing time.4. Because of the urgency expressed by flight attendant's we did not have the luxury of using a time barrier to delay the landing and were concerned with further passenger incapacitation. We were concerned next call would be about a heart attack or stroke.5. On initial communication of problem from lead flight attendant; I told her we were going back to land immediately. Test info may not have been complete enough.suggestions:1. Aircraft need more ground time for maintenance. 2. Operations personnel need better training in responding to emergencies to provide gates and parkers in an expedited manner. They were called and were not available for 14 minutes. 3. Better training with flight attendant's communicating with cockpit and situation awareness.

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Original NASA ASRS Text

Title: B767 Flight Crew reports being dispatched with an inoperative pack and high ambient temperatures. Once airborne the cabin will not cool down and a young child becomes unresponsive; necessitating a return. The quick return catches several Flight Attendant's off guard and an unsecured galley cart causes injuries upon landing.

Narrative: The air conditioning was very poor in the last 4 rows and worse in the aft galley of the aircraft. We initially pushed off the gate and were unable to start the left engine because the left engine fuel valve did not open. We started the right and taxied back to the gate for Maintenance. Maintenance came out and worked on the aircraft. I deplaned the aircraft due to heat concerns for the aft part of the aircraft. I queried the Flight Attendant's if they wanted to get off the flight. They responded they were staying on the flight. After several hours and working several problems including Left Bleed Duct overheat Maintenance finally put an MEL on the aircraft for the Left Pack inoperative. It is not unusual to have a warm aircraft on the ground when the heat out side is 94 degrees and experience shows that once airborne the aircraft cools down quickly. I conferred with the Flight Attendant's if they were safe to work the flight with one pack and get airborne and cool off the aircraft. I again offered to replace them if they felt uncomfortable. They said they were good to go. We pushed off the gate again and taxied out. About 5 minutes prior to takeoff the Lead Flight Attendant informed me that another Flight Attendant had told her we had a passenger with asthma in the rear of the aircraft but related no symptoms or complaints. My understanding was the passenger had no symptoms but asthma was a condition the person had; just as many have asthma. There were no conditions of an asthma attack related. Later this Flight Attendant would confirm after landing that was the case before takeoff. There must have been some misunderstanding as she later denied she said that. We took off and climbed out passing 15;000 feet we got a call from a Flight Attendant who said we had an incapacitated passenger from the heat and that it was 104 degrees in the rear of aircraft. I told her we would go back and land and then declared an Emergency with ATC and turned back to land. I sent a diversion message and First Officer called company; requested gate; jetway drivers; parkers and medics to meet us. I made an announcement to the passengers we were returning to land. We performed the Descent and Approach checklists and briefed a visual approach. I gave four bells with the No Smoking bell descending through 10;000 feet because we were close to the field. We had 4 calls from Flight Attendant's below 10;000 feet requesting an ambulance for the child who was overcome by heat; lethargic and non-responsive and other issues. Each subsequent call increased the perceived urgency of landing. There were difficulties with communicating with the Flight Attendant's on interphone and I actually gave an additional 4 bells on the Aft Flight Attendant call bell trying to contact them. We performed the Landing checklist after flaps 30. Some Flight Attendant's were working with the ill passenger in the aisle and may not have heard the signal and did not notice the landing gear go down or other signals due to concern with the child as he was unresponsive and they were very concerned for the child. On landing when engines were reversed and brakes applied; a cart in the rear galley came loose and FA #3 stopped it with her arm as best she could and was injured arm; shoulder; neck; and ankle. She saved probable injuries to passengers by doing so. The Lead Flight Attendant was also was hit by cart; needed assistance from passenger to push the cart back; but said she was not injured. We landed [and] Flight Attendant requested an additional ambulance and medics for injured Flight Attendant #3. We called Operations again; on ground for a gate and the reply was standby. They then gave us a gate; which was not equipped for a B767 but no one was there to meet us and took a delay to get to jetway; due to repositioning the aircraft. It took a long time to get the jetway hooked to the door. The child was doing better by the time we got to the gate as he had ice packs and medical personnel from on board assisting. Medics came on and child was taken off. Medics went to the rear of the aircraft to assist Flight Attendant #3 and she was assisted off on stretcher with injuries to her neck; arm; and ankle. Aircraft was written up for poor cooling in the aft section.Cause:1. Left pack was on MEL. Rear aircraft vents were putting out hot air raising the temperature to unacceptable levels. Temperatures rose in the rear of aircraft and caused illness for passenger. 2. Additional injury to Flight Attendant occurred because one of the galley carts was not secured for landing and it rolled out and Flight Attendant stopped it with her arm. There was some confusion caused by interphone communications which were difficult to understand. Subsequently; the Flight Attendant's called 4 times below 10;000 feet to request an ambulance and give other advisories. Some of these were garbled and when I answered; went unacknowledged because I could not hear a reply.3. The rear shades where the Flight Attendant's were working had been closed to help cool the aircraft with a loss of outside visual cues for the Flight Attendant's in reference to landing. Because of concentration on passenger assistance and all the call bells they were unsure of landing time.4. Because of the urgency expressed by Flight Attendant's we did not have the luxury of using a time barrier to delay the landing and were concerned with further passenger incapacitation. We were concerned next call would be about a heart attack or stroke.5. On initial communication of problem from Lead Flight Attendant; I told her we were going back to land immediately. TEST info may not have been complete enough.Suggestions:1. Aircraft need more ground time for maintenance. 2. Operations personnel need better training in responding to emergencies to provide gates and parkers in an expedited manner. They were called and were not available for 14 minutes. 3. Better training with Flight Attendant's communicating with cockpit and situation awareness.

Data retrieved from NASA's ASRS site as of April 2012 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.