What happened
On January 10, 2007, a Transmile Air Services McDonnell Douglas MD-11F, registration 9M-TGS, was conducting a scheduled cargo flight from Anchorage International Airport to Hong Kong International Airport. While cruising at 38,000 feet over the sea approximately 30km southwest of Cape Ashizuri, the Second in Command (SIC) suddenly lost consciousness.
During the event, the pilot in the right seat experienced physical tremors and involuntary leg movements that pressed against the rudder pedals, causing the aircraft to yaw. The Cruise Captain, acting as the pilot flying, immediately declared a medical emergency with Fukuoka Air Traffic Control. To maintain control, the crew moved the incapacitated pilot's seat backward to clear the pedals and transitioned flight control to the Pilot in Command (PIC).
The crew diverted the flight to Kansai International Airport. Upon arrival at 12:19 JST, the crew requested medical assistance. While the flight crew successfully managed the aircraft and provided first aid—including administering oxygen—the investigation noted delays in ground-based medical response and ambulance dispatch at the airport.
The investigation
The investigation examined flight data recorder and cockpit voice recorder analysis, as well as interviews with the crew and company staff. The investigators also reviewed the medical history of the incapacitated pilot and the coordination between air traffic controllers and ground support organizations at Kansai International Airport.
Findings
- The sudden loss of consciousness in the SIC was preceded by a sudden headache, which was a symptom of intracranial hypertension.
- The pilot had no prior subjective symptoms of a brain tumor, and the investigation noted that standard aviation medical examinations often lack the neuroimaging (such as CT or MRI scans) necessary to detect such conditions.
- While the flight crew's emergency response and aircraft handling were appropriate and compliant with company manuals, there were gaps in communication regarding the specific medical condition of the patient to ground controllers.
- Ground support at the destination airport experienced delays in assigning a handling company and coordinating an ambulance, partly due to procedural confusion between airport operations and fire station authorities.