Narrative:

Approximately 200 NM from lax on the civet arrival at FL390, with ATIS received via ACARS, captain was the PF at this time. We were monitoring service interphone and heard the flight attendants say that a woman had passed out. We began the procedures to get in contact with the commercial medical advisory. The 'a' flight attendant contacted the cockpit and informed us that a woman had passed out and needed medical assistance. The captain attempted a phone patch with the commercial medical advisory with no success, and then with dispatch. He asked me to fly the aircraft. I informed ZLA that we had a medical situation, but didn't want to declare an emergency. (The captain didn't want to declare an emergency.) center said they would pass it on and asked what runway we would prefer. I said runway 24L/right. We were given a descent to FL240 and direct to civet for the remainder of the civet arrival. I began the descent while the captain was handling the medical situation. He seemed to be having a lot of trouble maintaining contact with the commercial medical advisory. We were then given descend to FL200, direct arnes, slow to 250 KTS. I requested to keep our speed up and he said he would pass that on. We were then passed to socal approach and he gave us a descent to FL180, slow to 220 KTS. This controller seemed very busy and rushed. The captain is still in and out of contact with the commercial medical advisory. We were then given descend to 12000 ft, direct to snorkel. I responded 12000 ft, repeat the fix. (I didn't understand the fix.) he didn't repeat so I continued to arnes. A min or so later, he said direct to snorkel and he apologized for not responding sooner. I said direct snorkel, but I was unable to find snorkel. I then told him snorkel was not on the arrival. He said direct to snorkel on the mittz arrival for runway 24R, slow to 200 KTS. (We were never cleared for the mittz arrival.) now, I am preoccupied with finding snorkel on the civet and then loading mittz in the FMS. By this time we are 16000 ft descending, 44 NM from lax slowing to 200 KTS. The controller was getting frustrated that we were not direct snorkel and not descending via the arrival. The captain was returning to frequency. I had just put in the new arrival and was giving him our speed, altitude, and new arrival. When we went to go to direct snorkel, we were already past the fix so the aircraft started to turn back to snorkel. The controller then gave us a heading to intercept runway 24R localizer, slow to 190 KTS, descend to 8000 ft and a new approach frequency. The captain, in attempting to get down to altitude, went in excess of 280 KTS. The new controller then said to fly the localizer and track it inbound and he will give us a turnout closer in and descend to 7000 ft. Approximately 9 NM from lax he gave us a turn to the north then to the east and back to re-intercept the localizer at approximately 17 NM and descend to 3000 ft, slow to 170 KTS. As we re-intercepted the localizer, we were given 2500 ft and to follow a brasilia. Then on short approach, the brasilia was still on the runway, so tower asked if we would accept runway 24L. We did and made a normal landing and taxied to the gate where the emergency crews were standing by. The woman was in and out of consciousness. There were a lot of miscoms, not only between us and the controllers, but also between myself and the captain. There were no TCASII alerts or terrain warnings or any other warnings. The speed and altdevs were there. I think the medical issue was the beginning, but the controller not clearing us for the new arrival was also a major issue compounded by myself, just not asking for a heading or a vector. Declaring an emergency could have made the situation better also. The problems with communicating with commercial radio/dispatch/medical advisory also was not good. Lessons learned.

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Original NASA ASRS Text

Title: B737-700 CREW HAD AN ILL PAX THAT REQUIRED IMMEDIATE MEDICAL ATTN. THE CREW DID NOT DECLARE A PAX MEDICAL EMER, AND HAD A SERIES OF ATC PROBS.

Narrative: APPROX 200 NM FROM LAX ON THE CIVET ARR AT FL390, WITH ATIS RECEIVED VIA ACARS, CAPT WAS THE PF AT THIS TIME. WE WERE MONITORING SVC INTERPHONE AND HEARD THE FLT ATTENDANTS SAY THAT A WOMAN HAD PASSED OUT. WE BEGAN THE PROCS TO GET IN CONTACT WITH THE COMMERCIAL MEDICAL ADVISORY. THE 'A' FLT ATTENDANT CONTACTED THE COCKPIT AND INFORMED US THAT A WOMAN HAD PASSED OUT AND NEEDED MEDICAL ASSISTANCE. THE CAPT ATTEMPTED A PHONE PATCH WITH THE COMMERCIAL MEDICAL ADVISORY WITH NO SUCCESS, AND THEN WITH DISPATCH. HE ASKED ME TO FLY THE ACFT. I INFORMED ZLA THAT WE HAD A MEDICAL SIT, BUT DIDN'T WANT TO DECLARE AN EMER. (THE CAPT DIDN'T WANT TO DECLARE AN EMER.) CTR SAID THEY WOULD PASS IT ON AND ASKED WHAT RWY WE WOULD PREFER. I SAID RWY 24L/R. WE WERE GIVEN A DSCNT TO FL240 AND DIRECT TO CIVET FOR THE REMAINDER OF THE CIVET ARR. I BEGAN THE DSCNT WHILE THE CAPT WAS HANDLING THE MEDICAL SIT. HE SEEMED TO BE HAVING A LOT OF TROUBLE MAINTAINING CONTACT WITH THE COMMERCIAL MEDICAL ADVISORY. WE WERE THEN GIVEN DSND TO FL200, DIRECT ARNES, SLOW TO 250 KTS. I REQUESTED TO KEEP OUR SPD UP AND HE SAID HE WOULD PASS THAT ON. WE WERE THEN PASSED TO SOCAL APCH AND HE GAVE US A DSCNT TO FL180, SLOW TO 220 KTS. THIS CTLR SEEMED VERY BUSY AND RUSHED. THE CAPT IS STILL IN AND OUT OF CONTACT WITH THE COMMERCIAL MEDICAL ADVISORY. WE WERE THEN GIVEN DSND TO 12000 FT, DIRECT TO SNORKEL. I RESPONDED 12000 FT, REPEAT THE FIX. (I DIDN'T UNDERSTAND THE FIX.) HE DIDN'T REPEAT SO I CONTINUED TO ARNES. A MIN OR SO LATER, HE SAID DIRECT TO SNORKEL AND HE APOLOGIZED FOR NOT RESPONDING SOONER. I SAID DIRECT SNORKEL, BUT I WAS UNABLE TO FIND SNORKEL. I THEN TOLD HIM SNORKEL WAS NOT ON THE ARR. HE SAID DIRECT TO SNORKEL ON THE MITTZ ARR FOR RWY 24R, SLOW TO 200 KTS. (WE WERE NEVER CLRED FOR THE MITTZ ARR.) NOW, I AM PREOCCUPIED WITH FINDING SNORKEL ON THE CIVET AND THEN LOADING MITTZ IN THE FMS. BY THIS TIME WE ARE 16000 FT DSNDING, 44 NM FROM LAX SLOWING TO 200 KTS. THE CTLR WAS GETTING FRUSTRATED THAT WE WERE NOT DIRECT SNORKEL AND NOT DSNDING VIA THE ARR. THE CAPT WAS RETURNING TO FREQ. I HAD JUST PUT IN THE NEW ARR AND WAS GIVING HIM OUR SPD, ALT, AND NEW ARR. WHEN WE WENT TO GO TO DIRECT SNORKEL, WE WERE ALREADY PAST THE FIX SO THE ACFT STARTED TO TURN BACK TO SNORKEL. THE CTLR THEN GAVE US A HEADING TO INTERCEPT RWY 24R LOC, SLOW TO 190 KTS, DSND TO 8000 FT AND A NEW APCH FREQ. THE CAPT, IN ATTEMPTING TO GET DOWN TO ALT, WENT IN EXCESS OF 280 KTS. THE NEW CTLR THEN SAID TO FLY THE LOC AND TRACK IT INBOUND AND HE WILL GIVE US A TURNOUT CLOSER IN AND DSND TO 7000 FT. APPROX 9 NM FROM LAX HE GAVE US A TURN TO THE N THEN TO THE E AND BACK TO RE-INTERCEPT THE LOC AT APPROX 17 NM AND DSND TO 3000 FT, SLOW TO 170 KTS. AS WE RE-INTERCEPTED THE LOC, WE WERE GIVEN 2500 FT AND TO FOLLOW A BRASILIA. THEN ON SHORT APCH, THE BRASILIA WAS STILL ON THE RWY, SO TWR ASKED IF WE WOULD ACCEPT RWY 24L. WE DID AND MADE A NORMAL LNDG AND TAXIED TO THE GATE WHERE THE EMER CREWS WERE STANDING BY. THE WOMAN WAS IN AND OUT OF CONSCIOUSNESS. THERE WERE A LOT OF MISCOMS, NOT ONLY BTWN US AND THE CTLRS, BUT ALSO BTWN MYSELF AND THE CAPT. THERE WERE NO TCASII ALERTS OR TERRAIN WARNINGS OR ANY OTHER WARNINGS. THE SPD AND ALTDEVS WERE THERE. I THINK THE MEDICAL ISSUE WAS THE BEGINNING, BUT THE CTLR NOT CLRING US FOR THE NEW ARR WAS ALSO A MAJOR ISSUE COMPOUNDED BY MYSELF, JUST NOT ASKING FOR A HEADING OR A VECTOR. DECLARING AN EMER COULD HAVE MADE THE SIT BETTER ALSO. THE PROBS WITH COMMUNICATING WITH COMMERCIAL RADIO/DISPATCH/MEDICAL ADVISORY ALSO WAS NOT GOOD. LESSONS LEARNED.

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.