Narrative:

In 2/91, while preparing to fuel our aircraft, I fell, hitting the back of my head on the concrete ramp. I do not believe I was knocked unconscious, as the chief pilot called out to me immediately and reported that I responded immediately. The blow as sufficient to cause an involuntary exhalation and momentary loss of vision. I saw stars. I rested quietly on the ground for a few mins and then resumed my fueling task. I did not have tenderness at the point of ground contact, or a headache. The next morning I felt considerably worse. While I had no specific pain, I was physically and mentally slow and unsure. I did not feel competent to fly. As my usual aviation medical examiner is in detroit, I sought an aviation medical examiner who was more conveniently located. When I called for an appointment at the offices of dr. A, I was informed that he was an aviation medical examiner and that I could see him that day. I presented myself to dr. A, explaining that I was a professional pilot and had come to him because he was an aviation medical examiner. Dr. A monitored my progress and in 3/91 cleared me to return to flying duties. I went to dr. B for renewal of my medical certificate. He completed the examination and said that while I was physically fit, he could not issue my certificate until the problem of my head injury had been satisfactorily resolved with the FAA. He said that he needed a copy of my records from dr. A, including a letter giving a brief overview of his treatment. I called dr. A's office with the request and was told that they could have the materials ready the next morning. Dr. B told me that 'technically' I was grounded, but he would be able to certify me as soon as he received the information from dr. A. When I called dr. A's office the next morning, I was told that my records were ready, but dr. A would not write a letter until dr. B had reviewed my records and determined that he still needed it. My situation progressed in the wrong direction throughout the day, as the doctors conferred with each other and the FAA. Later that afternoon I was told that the whole matter would have to be reviewed by the FAA, a process which might take 6-8 weeks, and until that time I was grounded. The reprieve came 1 hour later when mr. C at the FAA regional office in chicago told me that dr. B could certify me if I passed an examination given by a neurologist. The examination was scheduled, taken, passed, presented to dr. B and I received a fresh medical certificate. This episode raises several questions. During my recovery, I scoured the pertinent parts of the far's to determine what might be the specific procedures and requirements for returning to flight status. I found no comfort there and relied on the expertise of dr. A when he returned me to work 'full-duty.' see enclosures. When I asked dr. A what would have happened if I had come to him for a flight physical instead of dr. B, he said that the same procedure would have had to have been followed. When I expressed amazement, he said that when I had seen him in feb and march, I was just a patient, he was just a doctor and he had not seen me in his capacity of aviation medical examiner. Where does one go, and who does one see to return to flying duties after a debilitating injury? When is an aviation medical examiner not an aviation medical examiner? Did I fly west/O benefit of proper medical certification for almost 2 months?

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Original NASA ASRS Text

Title: QUESTIONABLE MEDICAL CERTIFICATION PROCS BROUGHT TO LIGHT DURING ROUTINE MEDICAL CERTIFICATION EXAMINATION.

Narrative: IN 2/91, WHILE PREPARING TO FUEL OUR ACFT, I FELL, HITTING THE BACK OF MY HEAD ON THE CONCRETE RAMP. I DO NOT BELIEVE I WAS KNOCKED UNCONSCIOUS, AS THE CHIEF PLT CALLED OUT TO ME IMMEDIATELY AND RPTED THAT I RESPONDED IMMEDIATELY. THE BLOW AS SUFFICIENT TO CAUSE AN INVOLUNTARY EXHALATION AND MOMENTARY LOSS OF VISION. I SAW STARS. I RESTED QUIETLY ON THE GND FOR A FEW MINS AND THEN RESUMED MY FUELING TASK. I DID NOT HAVE TENDERNESS AT THE POINT OF GND CONTACT, OR A HEADACHE. THE NEXT MORNING I FELT CONSIDERABLY WORSE. WHILE I HAD NO SPECIFIC PAIN, I WAS PHYSICALLY AND MENTALLY SLOW AND UNSURE. I DID NOT FEEL COMPETENT TO FLY. AS MY USUAL AVIATION MEDICAL EXAMINER IS IN DETROIT, I SOUGHT AN AVIATION MEDICAL EXAMINER WHO WAS MORE CONVENIENTLY LOCATED. WHEN I CALLED FOR AN APPOINTMENT AT THE OFFICES OF DR. A, I WAS INFORMED THAT HE WAS AN AVIATION MEDICAL EXAMINER AND THAT I COULD SEE HIM THAT DAY. I PRESENTED MYSELF TO DR. A, EXPLAINING THAT I WAS A PROFESSIONAL PLT AND HAD COME TO HIM BECAUSE HE WAS AN AVIATION MEDICAL EXAMINER. DR. A MONITORED MY PROGRESS AND IN 3/91 CLRED ME TO RETURN TO FLYING DUTIES. I WENT TO DR. B FOR RENEWAL OF MY MEDICAL CERTIFICATE. HE COMPLETED THE EXAMINATION AND SAID THAT WHILE I WAS PHYSICALLY FIT, HE COULD NOT ISSUE MY CERTIFICATE UNTIL THE PROB OF MY HEAD INJURY HAD BEEN SATISFACTORILY RESOLVED WITH THE FAA. HE SAID THAT HE NEEDED A COPY OF MY RECORDS FROM DR. A, INCLUDING A LETTER GIVING A BRIEF OVERVIEW OF HIS TREATMENT. I CALLED DR. A'S OFFICE WITH THE REQUEST AND WAS TOLD THAT THEY COULD HAVE THE MATERIALS READY THE NEXT MORNING. DR. B TOLD ME THAT 'TECHNICALLY' I WAS GNDED, BUT HE WOULD BE ABLE TO CERTIFY ME AS SOON AS HE RECEIVED THE INFO FROM DR. A. WHEN I CALLED DR. A'S OFFICE THE NEXT MORNING, I WAS TOLD THAT MY RECORDS WERE READY, BUT DR. A WOULD NOT WRITE A LETTER UNTIL DR. B HAD REVIEWED MY RECORDS AND DETERMINED THAT HE STILL NEEDED IT. MY SITUATION PROGRESSED IN THE WRONG DIRECTION THROUGHOUT THE DAY, AS THE DOCTORS CONFERRED WITH EACH OTHER AND THE FAA. LATER THAT AFTERNOON I WAS TOLD THAT THE WHOLE MATTER WOULD HAVE TO BE REVIEWED BY THE FAA, A PROCESS WHICH MIGHT TAKE 6-8 WKS, AND UNTIL THAT TIME I WAS GNDED. THE REPRIEVE CAME 1 HR LATER WHEN MR. C AT THE FAA REGIONAL OFFICE IN CHICAGO TOLD ME THAT DR. B COULD CERTIFY ME IF I PASSED AN EXAM GIVEN BY A NEUROLOGIST. THE EXAM WAS SCHEDULED, TAKEN, PASSED, PRESENTED TO DR. B AND I RECEIVED A FRESH MEDICAL CERTIFICATE. THIS EPISODE RAISES SEVERAL QUESTIONS. DURING MY RECOVERY, I SCOURED THE PERTINENT PARTS OF THE FAR'S TO DETERMINE WHAT MIGHT BE THE SPECIFIC PROCS AND REQUIREMENTS FOR RETURNING TO FLT STATUS. I FOUND NO COMFORT THERE AND RELIED ON THE EXPERTISE OF DR. A WHEN HE RETURNED ME TO WORK 'FULL-DUTY.' SEE ENCLOSURES. WHEN I ASKED DR. A WHAT WOULD HAVE HAPPENED IF I HAD COME TO HIM FOR A FLT PHYSICAL INSTEAD OF DR. B, HE SAID THAT THE SAME PROC WOULD HAVE HAD TO HAVE BEEN FOLLOWED. WHEN I EXPRESSED AMAZEMENT, HE SAID THAT WHEN I HAD SEEN HIM IN FEB AND MARCH, I WAS JUST A PATIENT, HE WAS JUST A DOCTOR AND HE HAD NOT SEEN ME IN HIS CAPACITY OF AVIATION MEDICAL EXAMINER. WHERE DOES ONE GO, AND WHO DOES ONE SEE TO RETURN TO FLYING DUTIES AFTER A DEBILITATING INJURY? WHEN IS AN AVIATION MEDICAL EXAMINER NOT AN AVIATION MEDICAL EXAMINER? DID I FLY W/O BENEFIT OF PROPER MEDICAL CERTIFICATION FOR ALMOST 2 MONTHS?

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.