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route climb, I had to remind the Captain to reset his altimeter, as
well as insist that he participate in altitude awareness
procedures. Small portions of the Captain’s speech became
unrecognizable. I took control of the aircraft, and advised the
Captain that I would fly the remainder of the flight. The Captain
agreed, however, his actions indicated that he wanted to
participate. Not wanting to create a confrontational atmosphere,
I asked the Captain to get the ATIS and the approach plates.
These tasks became too difficult for the Captain to accomplish.
An uneventful landing was accomplished.
The incapacitation was very subtle, with the Captain going into
and out of a completely normal state periodically. He wanted to
“help” with the flying when he was not lucid. I wish that it had
been a sudden and complete incapacitation, as this would have
been easier to recognize and deal with.
Kudos to this First Officer for keeping a calm and cooperative
atmosphere on the flight deck during this episode. The Captain
was later diagnosed with a serious systemic infection.
In a report describing profound incapacitation, a First Officer
found its sudden onset no easier to cope with than the previous
reporter’s encounter with subtle incapacitation.
■ We had started the final descent to the ILS. The Captain was
flying the autopilot. ATC gave us a heading change. I acknowledged,
but noticed that the Captain was not turning the heading
knob. I repeated the heading change to him, and he reached for
the airspeed knob. I asked him if he was OK. He suddenly
started shaking all over and...pushing on the rudder and leaning
on the yoke. I quickly started to counter his inputs as the
autopilot disconnected.
When the flight attendant came in, I was still wrestling with the
controls. The Captain suddenly went limp, but with his leg still
pushing on the rudder. A doctor sitting in First Class came up to
help move the Captain out of his seat. In the meantime, I had
declared an emergency and requested a turn to final. By then, the
Captain had wakened and was fighting the doctor and the Flight
Attendant to get back up. [Eventually], they secured the Captain.
required further medical treatment. This type
of incident is fortunately rare, and the flight crew and cabin
responded well, using all crew and medical resources on board.
The crew might have found it easier to help the Captain if
seatbelt extensions had been available, which can be used to
secure persons and large objects.
The First Officer added that all his previous training had
discussed only subtle incapacitation, in which the crew member
would “fade away,” but not become violent. As a result of the
First Officer’s experience, his air carrier will be addressing
violent incapacitation in future training sessions.
An Unnerving Experience
A commuter First Officer reporting to ASRS described an
incapacitation hazard involving prescribed medication. Our
reporter had received a physical exam from a doctor who
was not an Aviation Medical Examiner. During the exam,
the doctor prescribed a tranquilizer. The reporter continues:
■ ...I inquired if this medication would affect my flying
performance or my job. [The doctor’s] opinion was that it
would not affect either. Based on what I thought was his
“expert” opinion, I agreed to take the medication. I flew for
approximately 1- 1/2 months while taking the medication. I
did not notice any side effects of the medication either on or
off the job...
[Several months later], I went to the local Aviation Medical
Examiner in order to obtain a First Class Flight Medical
Certificate. When filling out the paperwork, I indicated that I
had been taking the [tranquilizer]... Upon reading this, the
A.M.E. notified me that he could not issue a medical
certificate and that I should contact the FAA Aeromedical
Branch. Upon contacting the FAA, I was notified that the
tranquilizer was a disqualifying medication [and] that I
would need to be off the medication for 90 days in order to
receive a medical certificate. I immediately...notified my
employer of the situation. I was taken off flight status
pending the reissuance of my medical certificate...
Our reporter concludes, “A pilot should always seek the
advice and expertise of an A.M.E. before taking any
medication of any kind.” One excellent reason is that
Aviation Medical Examiners have a list of medications that
are prohibited by the FAA. The reporter attributes naiveté
about the tranquilizer to inexperience with all types of
　
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