This letter from AA summarizes what happened on flight AA #111 from FCO-ORD on Oct 11. We should have been in ORD at 2:35PM instead we arrived around midnight. That's about 20hr (in Y) for FCO-ORD.

Everyone was surprisingly mellow about the whole thing. The medical EM was for a guy having a heart attack. He lived and was left at SNN. AA did give us a voucher to stay at the ORD Westin and $5 each for breakfast, upgraded us to 1st for the ORD-DFW the next day and 9K miles.^
October 16, 2008
Dear Mr. AADJ:
After hearing from one of our managers about the difficulties surrounding your flight with us on October 11, we wanted to take the opportunity to apologize to you. That situation must have been frustrating (to say the least) and we are genuinely sorry that we didn't get you to Chicago as planned.
Besides the medical emergency, there were several operational challenges associated with this flight. Based on the information I received, our captain was required to return the aircraft to the gate upon its initial departure. However, once on your way to Chicago, our captain diverted to Shannon for a medical emergency. As a result of the diversion, our crew would have reached the maximum number of hours they could remain on duty within a 24-hour period prior to arriving in Chicago. At that point, we could have either terminated the flight in Shannon, or continue to Boston for a replacement crew. As you know, the decision was made to travel as far as Boston.
Once in Boston, a couple of maintenance issues arose, prompting an additional delay. After those issues were resolved, you were once again on your way to Chicago.
It's completely reasonable for our valued customers to put on-time flight departures and arrivals at the top of their list of expectations from us. For that reason, the on-time operation of our flights is one of our most important service goals. You can be sure that we will continue our efforts to depart as scheduled.
Sometimes an apology and promise to do better just aren't adequate and so we've added 9,000 Customer Service bonus miles to your AAdvantage® account. This mileage adjustment should appear in your account very soon, and you can view your account via our web site at
Your continued business means a lot to us and we'd consider it a privilege to welcome you on board again soon.
Sincerely,
B. J. Russell
Customer Relations
American Airlines