Following a three week bench trial, during which testimony from 14 fact witnesses and 20 expert witnesses was heard, Hon. Cecilia M. Altonaga of the Southern District of Florida (Miami) entered judgment in favor of Caribbean Airlines Limited (“CAL”) on plaintiffs’ Article 17 claims arising out of CAL’s cabin and cockpit crew’s response to a passenger’s on board medical emergency (stroke). See Singh v. Caribbean Airlines Limited, No. 13-20639-CIV-ALTONAGA, slip. op. (S.D. Fla. Sept. 18, 2014).
On December 15, 2011, plaintiff Rovin Singh was travelling on board CAL Flight BW 484 from Port of Spain, Trinidad to Miami, Florida with his sister (a nurse’s aide) Rita Singh. Approximately ninety minutes into the flight, Ms. Singh noticed that her brother was not feeling well and illuminated the in-flight call button to notify the flight attendants. A flight attendant responded and, upon observing Mr. Singh, believed him to be having a stroke. The flight attendant alerted the Purser, who also assessed Mr. Singh and did not believe him to be having a stroke. Mr. Singh was placed on oxygen and provided a nitroglycerin tablet to prevent cardiac arrest.
The Purser notified the cockpit that there was a passenger who was ill and that the situation was being monitored. Some time later, Mr. Singh slumped over in his seat and the Purser notified the cockpit that the situation had become serious. She also used the aircraft intercom to page for medical personnel on board. After several such pages, a second-year medical student identified himself and was taken to assist Mr. Singh. Upon his arrival at the scene, the medical student believed Mr. Singh was having a stroke.
Meanwhile, the cockpit contacted MedLink, a medical advisory service for medical emergencies that occur in the air and on the ground, which advised that Mr. Singh should be treated at a hospital “within a couple of more hours” and recommended that the flight divert to Nassau, Bahamas because it was “the closest appropriate airport.” The Captain confirmed the recommendation as having been given and, indicating his willingness to divert the aircraft to Nassau in the event that he determined that to be the most suitable course of action after gathering all relevant information; he also directed the First Officer to obtain clearance from Miami air traffic control to divert the flight to Nassau. The Captain contacted the airline Systems Operations Control to assist in determining the nearest suitable airport from a ground operations perspective for Mr. Singh’s condition. Operations advised the Captain that Miami was the more suitable airport because ground staff in Nassau could not be reached to arrange for the diversion; however, emergency medical arrangements were available if the flight continued to Miami. During this call, the Captain was advised that Mr. Singh was now able to move his arm and his condition seemed to be improving. The Captain, taking into consideration all relevant factors, decided that the nearest suitable airport was Miami as the location where Mr. Singh would receive the most expeditious medical care. Mr. Singh’s sister also preferred that the flight continue on to Miami.
Under Article 17 of the Montreal Convention, a carrier is strictly liable “for damage sustained in case of death or bodily injury of a passenger upon condition only that the accident which caused the death or injury took place on board the aircraft or in the course of any of the operations of embarking or disembarking.” The Supreme Court has held that an “accident” under the Montreal Convention must be “an unexpected or unusual event or happening that is external to the passenger.”
Generally, courts have held that a plaintiff must establish that a crew has responded to a passenger’s medical emergency in an “unexpected or unusual” way to satisfy “accident” liability. In Singh, the Court synthesized a line of cases essentially holding that an “imperfect response” to a medical emergency is not, by itself, “unusual or unexpected.”
The Court relied heavily upon the decision in Fulop v. Malev Hungarian Airlines, 244 F. Supp. 2d 217 (S.D.N.Y. 2003). Following trial, the Fulop Court entered judgment for the defendant airline, finding that the airline employees had not “materially deviated from internal procedures or industry standards” in responding to the plaintiff’s medial emergency.
The Court also cited a recent decision in the Eastern District of New York, Safa v. Deutsche Lufthansa Aktiengesellschaft, Inc., No. 12-cv-2950(ADS)(SIL), 2014 WL 4274071 (E.D.N.Y. Aug. 28, 2014), granting the defendant airline summary judgment and holding that there had been no “significant departure” by the flight crew of the airline’s policies and procedures relating to medical emergencies, so as to give rise to “accident” liability.
Ultimately, the Singh Court determined: “While there are certain deficiencies in how the [BW 484] flight and cockpit crew, including the Captain, responded to Mr. Singh’s on-board medical emergency, those deficiencies, whether considered in isolation or collectively, do not support the basis of a claim under Article 17 of the Montreal Convention.” Rather, the crew’s response to Mr. Singh’s condition largely comported with CAL’s policies and procedures, including the Captain’s use of Crew Resource Management whereby he gathered all relevant information, resolved any differences or disagreements, and engaged in “a clear plan of attack after briefing from crew members.” Furthermore, the Court noted that the Captain had exercised Threat Error Management, compelling him to slow down and act thoughtfully so as not to impede the flight’s safe operation. Finally, CAL did not disregard any “explicit health-based request” of Mr. Singh or his sister.
The Singh decision clarifies the standard of liability for airlines responding to medical emergencies on board aircraft: airlines are expected to substantially comply with their internal policies and procedures. The mere fact that a crew’s response is inadequate “in a medical sense” cannot form the basis for a claim under Article 17 of the Montreal Convention.
John Maggio was lead counsel for Caribbean Airlines Limited, with the support of Allison Surcouf at second chair.