The bit the mainstream press seized upon was:
As he turned onto base leg the instructor slumped over with his head resting on the pilot’s shoulder. The pilot still thought the instructor was just joking with him and continued to fly the approach.
Other than the sensationalist nature, I do think there are a few useful points.
A class I medical, the most comprehensive and frequent, didn’t catch it. A review by the CAA medical department concluded they couldn’t have caught it, and in view of the bigger picture didn’t recommend any changes. Maybe an implicit admission of the fallability of the system? Either way, a reminder to manage one’s weight and blood pressure.
I do agree that this kind of eventuality is very low probability and near-impossible to prevent. Luckily on this flight there was another pilot on board.
As a pilot, don’t expect anything from any passenger, including instructors. A minor example: I had a school checkout in the US where we both thought the other had checked notams and weather. Passenger issues are a bigger consideration with discovery or cost-sharing flights etc.
As an aside, the examiner for my BB would occasionally pretend to fall asleep when instructing to help some pilots feel more relaxed or confident.
As a doctor I would strongly advise anyone from thinking that passing a medical (or any recent medical examination, no matter how comprehensive) protects one from sudden death.
In the past five years, working at one of the preeminent university hospitals of the country, I have both witnessed and treated many freak medical incidents at almost any age. Whereas a healthy lifestyle and “good” genetics provide a reasonable protection from suddenly dropping dead, there is no absolute safety and occurrences like spontaneous intracranial haemorrhage from a ruptured aneurysm can happen even in twenty-somethings, and heart attacks are far from impossible in 30 year olds.
But cowering in fear is pointless as well, because luckily these incidents are nevertheless very rare and worrying about them is much less effective than worrying about the “common killers” like obesity, diabetes, smoking etc. – or in the case of us GA pilots, weather, wind, fuel etc.
I very much agree with @Capitaine that for those of us who fly with an instructor or examiner, the only lesson to be learned is that one must always be prepared to fly and land the aircraft wholly on your own. Of course if an instructor or even passenger collapses against the controls, your control authority might be severely compromised.
The previous flight was a “trial flight” ;-(
I remember around 60 years ago a winch launched glider, on pupil’s first flight, dived into the ground after cable release. The full-time professional instructor was not required to have a medical at that time. He had a number of known but not disclosed conditions, including epilepsy.
MedEwok wrote:
As a doctor I would strongly advise anyone from thinking that passing a medical (or any recent medical examination, no matter how comprehensive) protects one from sudden death.In the past five years, working at one of the preeminent university hospitals of the country, I have both witnessed and treated many freak medical incidents at almost any age.
Yes, indeed. A few years ago we had a train accident in Sweden where a train ran into a concrete buffer block at the end of the track at a station after the driver passed out. (It was just before the end of track so the emergency brake didn’t have time to activate.) The train was going very slow, so fortunately only minor injuries but of course the train was badly damaged. It turned out the driver had an unknown preexisting medical condition which could not have been detected at the normal medical examinations. (Which are similar to those of pilots, but not identical – I have a valid “railway medical”, too.)
Of course the issue is single pilot operation. The AAIB is careful to avoid this topic and rightly so, as quite a few TSBs would be very happy to start badgering about it.
This case had a “fortunate” ending, as the pilot on board was able to land. Had this happened on the previous demo flights, the outcome would have been very different
This makes a case for both BRS system and autoland systems.
But for us regular flyers and also in connection with the family issues we quoted, there is another thing: Pinch Hitter courses.
PH courses have several advantages: First of all, it familiarized passengers with what is going on on the flight deck, puts them into the loop and gives them an idea what to do in cases of cases. Which of course will also increase their confidence.
Capitaine wrote:
As a pilot, don’t expect anything from any passenger
Well, when flying my Savannah with my wife on board, I definitely expect her to pull the chute in case I should have an heart attack. I have no doubts she will 
We have talked about this, and it is a big relief to her that she will survive if I should have an heart attack. Rather funny actually. The one thing she is afraid of when I am flying (mostly without her) is that I will have an heart attack, not that I will do some other stupid thing (which has much larger possibility)
I remember when I was on a repetition exercise in the air force. I was transferred to the 330 sqd, which is a rescue sqd with Seakings at the time. Another one, also on repetition, was a rescue man from the air ambulance. At that time they flew these rather small MBB helicopters. There were only space for one pilot, one rescue man and one doctor on board. He told me, in case of pilot incapacitation, he would have to land the aircraft. All these rescue men had PPL theory and a few hours of practical flying so they could put the aircraft down at the nearest available spot and get out alive.
Pilot incapacitation is definitely something to think about. Even though the possibility is slim, it is something that happens from time to time.
Airborne_Again wrote:
Yes, indeed. A few years ago we had a train accident in Sweden where a train ran into a concrete buffer block at the end of the track at a station after the driver passed out. (It was just before the end of track so the emergency brake didn’t have time to activate.) The train was going very slow, so fortunately only minor injuries but of course the train was badly damaged. It turned out the driver had an unknown preexisting medical condition which could not have been detected at the normal medical examinations. (Which are similar to those of pilots, but not identical – I have a valid “railway medical”, too.)
In the UK we had this, which was possibly medical and possibly not, never fully explained. Outcome much more serious.
I recall reading at the time that witnesses saw the driver sitting upright, eyes open and fixated straight ahead. So probably a suicide.
Rest ECGs predict basically nothing of negative value. If the ECG is bad then yeah something is wrong but you can produce a good ECG even with arteries so bunged up that you can’t walk up stairs. Most of an ECG is from the depolarisation (deformation) of the heart muscle so as long as it is beating, the ECG should be good.
One AME told me many years ago that there was a proposal for a treadmill ECG (Bruce Protocol 1 2 3 as usual) annually for ATPs and it got squashed because one estimate was that 3% would get a heart attack on the treadmill. In the end this is not a big issue in airline ops due to the 2nd pilot, good hardware, and good automation. On single pilot public transport ops, here the CAA demands a 6 monthly medical but the ECG is still only a resting one.
It’s a sleeping dog nobody wants to wake up. Airline pilot lifestyles are almost as unhealthy as GA pilot lifestyles, on average, but the former have super powerful unions
Yikes. RIP to the instructor. Fortunate the student was able to land. Graham wrote:
which was possibly medical and possibly not, never fully explained
That is far more common than you might think. The AAIB report linked above says “fatal heart attack” in the title but the report description mentions “acute cardiac failure” as the cause of death. That means nothing – everybody who is not a massive neurotrauma victim dies of cardiac failure. And a post-mortem is not like what you see on CSI.
Agree with @medewok on the limitations of medical screening – it’s there to catch the low hanging fruit. But it’s really the tip of the iceberg. All those athletes you see on the news that have cardiac arrest are also screened, every year, and quite intensively so.
Peter wrote:
I recall reading at the time that witnesses saw the driver sitting upright, eyes open and fixated straight ahead. So probably a suicide.
Yes but the investigation also found that based on the driver’s record, habits, plans and general demeanour, suicide seemed pretty unlikely.
