What happened
On March 7, 2004, an All Nippon Airways Boeing 777-200, registration JA705A, was operating a scheduled passenger flight from New Tokyo International Airport to Changi International Airport, Singapore. During the cruise phase over the South China Sea, approximately 700 km east-northeast of Singapore, the first officer began experiencing sudden illness.
Following a meal, the first officer experienced nausea and vomiting. Shortly thereafter, he developed intense abdominal pains. The captain requested medical assistance from the cabin crew, and while a passenger with medical expertise was identified on board, the flight crew elected not to consult them to avoid distractions during the upcoming descent. As the pain intensified, the first officer became unable to perform his duties as the Pilot Not Flying (PNF). To prevent accidental interference with flight controls, the first officer reclined his seat and secured himself with his shoulder harness.
With the first officer unable to assist, the captain managed the descent and approach alone. To ensure a high margin of safety, the captain utilized an automated landing. The aircraft landed at Changi International Airport at 23:54 JST without injuries to the 186 persons on board.
The investigation
The investigation focused on the medical cause of the crew member's decline in health and the crew's response to the situation. Investigators examined flight data, cockpit voice recordings, and statements from the captain, the first officer, and cabin crew. The investigation also reviewed the airline's operations manual and cabin attendant handbook regarding procedures for crew incapacitation.
Findings
- The first officer was suffering from acute pancreatitis, which caused severe, periodic abdominal pain and physical distress.
- The crew did not formally recognize the situation as a state of incapacitation. The captain believed the symptoms might be temporary food poisoning, and the cabin crew believed the first officer was still capable of performing duties because he was still interacting with cockpit switches.
- Because the crew did not categorize the event as incapacitation, they did not notify Air Traffic Control (ATC) of the medical emergency, nor did they request the assistance of the doctor on board.
- The first officer's decision to restrain himself with his harness was a functional response to prevent physical movement from affecting the aircraft's controls during periods of intense pain.