How would you react if you were given this statement at 38,000 feet above the Atlantic Ocean? Most of us hope we would never be in this position, but unfortunately that is where I found myself two weeks ago flying back from Munich after attending the Osteoarthritis Imaging Conference. My wife, a trained nurse who was traveling with me, was given this information by a passenger we were working on who had taken illicit drugs just before boarding the plane (the passenger was high in more ways than one!). My wife whispered the words to me and I then relayed them to the head stewardess on the flight and we and 2 other physicians worked through the problem.
We tried to ensure very few people knew the issues and so very little was made of this, although it was a tough 7.5 hours. We eventually had the passenger handcuffed and strapped very securely to a seat where one of three of us guarded him for the rest of the flight until we landed in Philadelphia and prevented the plane from being diverted to Shannon or Rechyakic. For those of you who may be questioning the validity of this story on my way back home from the Osteoarthritis Imaging Conference, there was a very limited press release on it that can be found here.
Even in a fully regulated environment such as the airlines, things go wrong and people act in different manners. This plays out with whichever facet of business you are involved, but how we react to challenging situations is a key component. Arguably, the 3 most regulated industries are the Nuclear, Aviation and the Pharmaceutical industries, and yet all three see failures and loss of human life due to errors or where regulations cannot cover every eventuality. As technology improves, we get better at screening out the failures and ensuring higher quality of product safety and efficacy exists. Also, new operational structures get put into position to prevent this sort of event escalating and causing more of an issue and yet, human involvement ensures we can never rule out every eventuality.
The analogy with the pharma industry in the above instance is striking. A safety issue occurred and the a number of described events occurred (many of which I did not realize existed, but now having talked in depth to the US Airways staff realize there is quite the escalation procedure). Arguably, the biggest downfall of the airline industry is how to handle information such as this, and it took the airline 8 days to contact me and solve some of the info, even after I had called them. If this had been a safety issue in a pharmaceutical company, I hope that this would have been dealt with more rapidly and all parties contacted. Improved electronic communications systems ensure this kind of information is handled appropriately and I am pleased to be part of a company that is developing the latest clinical trial management system that will ensure that all relevant information is available in almost real time to clinical trial sponsors.
So what would I do differently next time a passenger tells me we are all going to die because he has a bomb in his bag? Hopefully exactly the same as this – escalate the issue quietly so as not to disturb the rest of the flight, fact find and work as a small team and ensure panic does not set in. I hope the same response occurs for each of us when we are faced with a nasty situation or a serious AE – but hopefully one that is less life threatening on the personal front!!