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-   Practical Travel Safety and Security Issues (https://www.flyertalk.com/forum/practical-travel-safety-security-issues-686/)
-   -   Contact lens solution "medically necessary"? (https://www.flyertalk.com/forum/practical-travel-safety-security-issues/1081276-contact-lens-solution-medically-necessary.html)

Ari May 8, 2010 12:30 pm


Originally Posted by PhlyingRPh (Post 13894659)
1) Get your physician to write the following prescription: Ophthalmic Saline Solution 0.9% (Opti-Free**), 8 Fl. Oz***
Use as directed for contact lens care.
Refill PRN

2) Visit your phriendly pharmacist and ask that the dispensed product be labeled using the pharmacy's computerized dispensing system.

3) Keep a copy of the prescription

4) Leave the dispensed prescription product in your carry on as you go through the checkpoint

5) If a TSO discovers it (approx. 80% chance, based on my metrics), tell him or her it is a medically necessary item dispensed pursuant to a prescription

6) About half the time, the TSO will let it go. However, the remainder of the time, you will be asked what your medical condition is, to which you should reply "It's part of my private medical history, and as a government agent you should be aware of HIPAA privacy laws allowing me to keep that information private.

Step (0): Find a pharmacy willing to indulge you!


Originally Posted by PhlyingRPh (Post 13894659)
7) If the TSO insists that he or she needs to know, tell them you need their name so that you can report them to the TSA, the State Board of Medical Examiners and Dr. Sanjay Gupta.

:D


Originally Posted by PhlyingRPh (Post 13896162)
Yes, I understood what you meant, and my point was that even legend drugs prepackaged in say, a thirty day supply are required to have a pharmacy label on them in the US, Canada and EU countries. Certainly, the prescriptions I've had filled in the UK and other european countries have often been dispensed in manufacturer blisterpaks but have had a pharmacy label bearing the actual prescription number, physician name, etc.

As a different experience, I've had scripts filled in China, Hong Kong and Israel and they just dispensed the stuff without any labels at all. So a lot of the world is left in the dark, so to speak.


Originally Posted by PhlyingRPh (Post 13913187)
Whoa there Tex. How do you perform this "test?"

That's what voodoo paper strips are for! (Unless they have another test, which is quite possible based on the number of vendors that always have something newer and better than the last guy to swindle to the tax payer out of more $$).

RichardKenner May 8, 2010 12:48 pm


Originally Posted by TSORon (Post 13912568)
If it is claimed as a medical necessity then it is required to be tested. If it fails the test then it does not enter the sterile area. If it passes the test, then it passes into the sterile area. Pretty simple, right?

I'm missing something here. If a liquid is a medical necessity, that means that the passenger will be harmed by not having the liquid available. The fact that it "fails" a so-called "test" (the details of which we are not permitted to know) doesn't change the fact that it's a medical necessity. Once an item is declared to be a necessity, it's no longer sufficient for the TSA to say it might be a threat to aviation, it can only be prevented from traveling if the TSO determines it is a threat to aviation. This is especially true if "the test" involved the kind of ETD that generates a false-positive in numerous ways. I have no problem with using a "screening" test to see if the item needs further testing, but denying an item based just on such solely a screening test is a violation of the Americans with Disability Act and could subject the TSO to civil and criminal charges if the passenger was harmed due to the denial (and possible even if they weren't). Note that the TSA letter to persons with disabilities didn't say that it will be allowed only if it doesn't "fail a test", but that it will allowed "after it's been screened". That's consistent with the law: the shorter version that you posted isn't.

ND Sol May 8, 2010 2:08 pm


Originally Posted by TSORon (Post 13922315)
Sure it happens. I cant quote SOP for you (SSI stuff), but what I told you is what is supposed to happen. That it does not sometimes is not a shock. If a supervisor tells me that we don’t have the time for the testing then I do as I am told. I know that it’s a pain for the passenger, but the priorities have been changed by the person allowed to change them, for reasons that are allowed. More of that “flexibility” I was talking about earlier. Its not always a good thing for some folks, and that’s just the way life is.

The part I bolded is inexcusable. Because the TSA decides it doesn't want to follow SOP due not having the time to do so is not a valid excuse. If that would occur to me, I would ensure that the time spent by TSA in discussing with me their failure to follow SOP would greatly exceed the time it would have taken to test the liquid. :mad:

TSORon May 8, 2010 5:26 pm


Originally Posted by RichardKenner (Post 13922491)
I'm missing something here. If a liquid is a medical necessity, that means that the passenger will be harmed by not having the liquid available. The fact that it "fails" a so-called "test" (the details of which we are not permitted to know) doesn't change the fact that it's a medical necessity. Once an item is declared to be a necessity, it's no longer sufficient for the TSA to say it might be a threat to aviation, it can only be prevented from traveling if the TSO determines it is a threat to aviation. This is especially true if "the test" involved the kind of ETD that generates a false-positive in numerous ways. I have no problem with using a "screening" test to see if the item needs further testing, but denying an item based just on such solely a screening test is a violation of the Americans with Disability Act and could subject the TSO to civil and criminal charges if the passenger was harmed due to the denial (and possible even if they weren't). Note that the TSA letter to persons with disabilities didn't say that it will be allowed only if it doesn't "fail a test", but that it will allowed "after it's been screened". That's consistent with the law: the shorter version that you posted isn't.

“Claiming” something is a medical necessity and it actually being one are two different things.

We as TSO’s have no way of determining if it is such. What we can determine is if it contains a prohibited substance, by testing it. We don’t have a full lab available to us, and even if we did the time it takes to make such a determination will quite honestly make the passenger miss their flight. Prohibited substances are not allowed onboard commercial aircraft in passenger carryon luggage. There are ways to get them on by different methods, but I am not an expert in this area.

Contact solution bottles specifically have been used in the past as part of a terrorist plot to destroy an aircraft. Claiming that what is in one as a medical necessity sounds like the perfect way to get a prohibited substance past security, which is why we test.

As for the Americans with Disabilities Act, the law requires that we make reasonable accommodations for those with disabilities, not that we kow-tow to their every demand. TSA makes such accommodations, but we must also balance the safety of the other passengers with the needs of the disabled. That’s why we have procedures for this type of thing.


Originally Posted by ND Sol (Post 13922744)
The part I bolded is inexcusable. Because the TSA decides it doesn't want to follow SOP due not having the time to do so is not a valid excuse. If that would occur to me, I would ensure that the time spent by TSA in discussing with me their failure to follow SOP would greatly exceed the time it would have taken to test the liquid. :mad:

Are you under the impression that the SOP is an absolute black and white directive that demands total compliance?

I'm surprised that you find your ignorance such a comfort that you refuse to discard it. The SOP is an evolving document, it gives us leaway in many areas because the job demands it. TSA and its employee's must be flexible to the situation, and a black and white document such as you envision would be counter to that need.

jkhuggins May 8, 2010 6:40 pm


Originally Posted by TSORon (Post 13918773)
Maybe the screener had an itch between his ears. Part of the “Engage” training we received was to encourage the use of our intuition. The subconscious is a remarkable thing, it sees things that the conscious mind ignores, and has a nasty habit of telling us about it. Hunch, itch, feeling, sweating, butterflies in the stomach, whatever. “Engage” taught us to look not so much for the weapon but for the person who is likely to use it. They taught us to trust our intuition, and that if we do so then the TSA will back our decisions. They also gave us a bit of wiggle room in several areas, wiggle room that allows us to make choices or decisions based on our experience or our intuition.

Serious question here ... which is going to sound snippy, which is why I'm starting with the disclaimer ...

What happens when a TSO's "intuition" tells him/her that "everyone who looks like an [insert ethnicity here] is suspicious"? Doesn't that start to create problems that, for all intents and purposes, end up becoming racial profiling?

LuvAirFrance May 8, 2010 7:47 pm

People give their eyes a rest with regular frame glasses. Couldnt you just do that during the flight?

Ari May 8, 2010 8:03 pm


Originally Posted by TSORon (Post 13923403)
“Claiming” something is a medical necessity and it actually being one are two different things. We as TSO’s have no way of determining if it is such.

So then what do you do if I claim something is medically necessary? I can claim a bottle of water is a medical necessity; I can claim contact solution is a medical necessity; I can also a 120 mL bottle of Rx medicine is a medical necessity.

In the case of the water, I doubt a TSO will buy it. In the case of contact solution, it seems that it will be allowed unless a supervisor tells you that you "don't have the time". In the case of the Rx medicine, I seriously doubt it would not be allowed in any case, even if the checkpoint were busy. So at some point, the TSO does have to make a judgment, right? If I claimed that a bottle of water was a medical necessity, would that just be accepted and would it be tested, or would there be some debate in the matter and a common-sense judgment?


Originally Posted by TSORon (Post 13923403)
“What we can determine is if it contains a prohibited substance, by testing it. We don’t have a full lab available to us, and even if we did the time it takes to make such a determination will quite honestly make the passenger miss their flight. Prohibited substances are not allowed onboard commercial aircraft in passenger carryon luggage.

What is the test (a vague description, eg. ETD, paper strips, etc)?


Originally Posted by TSORon (Post 13923403)
“There are ways to get them on by different methods, but I am not an expert in this area.

Your security expertise doesn't extend to that?


Originally Posted by TSORon (Post 13923403)
“Contact solution bottles specifically have been used in the past as part of a terrorist plot to destroy an aircraft. Claiming that what is in one as a medical necessity sounds like the perfect way to get a prohibited substance past security, which is why we test.

Was that part of the London plan, or another one?


Originally Posted by TSORon (Post 13923403)
“As for the Americans with Disabilities Act, the law requires that we make reasonable accommodations for those with disabilities, not that we kow-tow to their every demand. TSA makes such accommodations, but we must also balance the safety of the other passengers with the needs of the disabled. That’s why we have procedures for this type of thing.

The interplay of the ADA and ACCA are interesting in terms of ground services in an airport vs. those offered by an airline. In any event, I think that safety and assistance devices are interesting; a disabled person can bring a cane through the checkpoint, but if an able person attempted to bring a very similar item (like a pool cue) that would not be allowed.

ND Sol May 8, 2010 8:06 pm


Originally Posted by TSORon (Post 13923422)
Are you under the impression that the SOP is an absolute black and white directive that demands total compliance?

I'm surprised that you find your ignorance such a comfort that you refuse to discard it. The SOP is an evolving document, it gives us leaway in many areas because the job demands it. TSA and its employee's must be flexible to the situation, and a black and white document such as you envision would be counter to that need.

What is inexcusable is what I stated previously. Because the TSA has time constraints, the passenger suffers and loses medically necessary property due to the TSA's incompetence when the documentation states that is permitted. The TSA all too often does what is expedient for the TSA and ignores the needs of the passenger. Let me know where it states that the SOP doesn't have to be followed because of "time constraints." :rolleyes:

Ari May 8, 2010 8:29 pm

In threads that ask about liquid exemption, you always suggest alternatives that don't require the use of the liquid exemption:

---------------------------------------------------------------------------------------------


Question: "[Is c]ontact lens solution 'medically necessary'?"

Originally Posted by LuvAirFrance (Post 13923828)
People give their eyes a rest with regular frame glasses. Couldnt you just do that during the flight?

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Question: "[Can I carry on a liquid p]rescription exceeding 4 ounces, without label"

Originally Posted by LuvAirFrance
I just put 3 oz of any liquid in a generic bottle. A person doesn't need to carry on a whole bottle of anything.

http://www.flyertalk.com/forum/trave...out-label.html

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Question: "OTC [liquid] medication - what is allowed?"

Originally Posted by LuvAirFrance
Why use a liquid med when the same thing is available in pill form? No security has ever blocked any of my pills.
. . .
Pills can be dissolved in water. Liquid cold medicine pretty consistently tastes abominable.

http://www.flyertalk.com/forum/trave...t-allowed.html

---------------------------------------------------------------------------------------------


You constantly suggest unnecessary alternatives in response to simple questions as to whether something will be allowed through the checkpoint or not. Why is that? Do you have something against the liquid exemption?

LuvAirFrance May 8, 2010 9:54 pm

There is no "exemption". Liquids are the one thing that is strictly controlled! Why do I need to explain something like that.

RichardKenner May 8, 2010 10:37 pm


Originally Posted by TSORon (Post 13923403)
“Claiming” something is a medical necessity and it actually being one are two different things. We as TSO’s have no way of determining if it is such.

Right. So you have to assume that is it. But I'm talking about the case where it can be determined after-the-fact (e.g., in court) that it actually is medically-necessary.


We don’t have a full lab available to us, and even if we did the time it takes to make such a determination will quite honestly make the passenger miss their flight.
If you don't have sufficient tools to do your job within the bounds of the law, you need to get them.


Prohibited substances are not allowed onboard commercial aircraft in passenger carryon luggage.
Sure, but see below.


Contact solution bottles specifically have been used in the past as part of a terrorist plot to destroy an aircraft.
Agreed. It was in "Bojinka", right?


As for the Americans with Disabilities Act, the law requires that we make reasonable accommodations for those with disabilities, not that we kow-tow to their every demand.
I would consider allowing the person to fly without risking their life to be a "reasonable accommodation" and not "kow-towing to their every demand", wouldn't you?

The issue here are items that "fail the test" but are not "prohibited substances". I think the law is clear: these must be allowed on board the aircraft.

Let me give you an example. A diabetic is a hunter and goes on a hunting trip with friends. They're all very ardent hunters and load their own ammunition. So gunpowder residue gets into everything. The diabetic hunter now goes to fly home. He hasn't broken any laws, but you test his insulin with an ETD and it comes back positive. Now what? Having measurable amounts of gunpowder residue on insulin neither makes it a prohibited item nor makes it any less of a medical necessity. How could you legally prohibit that from coming on a plane?

Even worse, suppose you give that diabetic a hard time about it and convince him "it's a short flight" and he can put it in his checked baggage and it'll be OK (because he's the type that submits to authority). Unknown to you and him, though, there are thunderstorms in his destination area and the flight takes delay after delay. He goes into diabetic coma on the airplane, but the thunderstorms mean that by the time the pilot is able to find a safe place to divert, the passenger's dead. Since there's no legal basis to prevent the insulin from coming on board (it's not a prohibited substance and detailed testing of the insulin in the checked bag proves that), I believe you would be held civilly (and possible criminally) liable for that person's death.


Originally Posted by TSORon (Post 13923403)
but we must also balance the safety of the other passengers with the needs of the disabled.

You mean the safety of the disabled. The problem in the case of medical necessity is that there is no "safe" option. Either decision, if made incorrectly, can cost somebody their life. If you mistakenly believe that a diabetic's insulin is a prohibited item and force them to check it, they can die. If you allow a terrorist posing as a diabetic to bring onboard a liquid explosive, other passengers may die.

So you can't argue that one choice is the "safer" one. That means that you cannot claim an exception to the ADA on safety grounds.

Now, sure, I agree that contact lens solution isn't insulin, but if you have somebody that's immune-compromised (e.g., an HIV patient), not taking care of contact lenses can cause life-threatening illness. And you can't simply say "then wear eyeglasses" because the person might not be able to afford eyeglasses: in this country, we don't put poor people's lives at risk just because they're poor.

As you said, you have no way of determining what's "medically necessary" or not, but I can think of numerous cases where the absence of a liquid that isn't necessary to you or I could cause a cascade or events that could threaten somebody's life. The bottom line is again that there is no safe choice. Prohibiting an object that's claimed to be a medical necessity from an aircraft can threaten somebody's life. As can allowing it.

LuvAirFrance May 9, 2010 12:31 am

I'm having trouble here. How is a contact lens wearer disabled? Contacts are just a convenience substitute for normal glasses like I wear.

exbayern May 9, 2010 12:33 am


Originally Posted by RichardKenner (Post 13924440)
And you can't simply say "then wear eyeglasses" because the person might not be able to afford eyeglasses: in this country, we don't put poor people's lives at risk just because they're poor.

And for some people, eyeglasses do not correct vision as well as contact lenses.

Suggesting that someone 'just wear eyeglasses' is just like suggesting that someone with liquid medication 'just take pills instead'.

LuvAirFrance May 9, 2010 12:37 am

Your point would be?

YCTTSFM May 9, 2010 1:11 am


Originally Posted by LuvAirFrance (Post 13924662)
I'm having trouble here. How is a contact lens wearer disabled? Contacts are just a convenience substitute for normal glasses like I wear.

For many, contacts are an optional convenience; for some, they are not. Neither you, nor TSA personnel, are qualified to evaluate medical necessity.

Also, many people wear contacts exclusively and do not own eyeglasses. Why should they assume the cost and inconvenience of getting eyeglasses fitted specifically for air travel once or twice a year, when their normal contact lens supplies present absolutely no danger to the aircraft or fellow passengers? :confused:


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