Panic Attack Causes Delay
 

So was on BA185 over the weekend and almost immediately as we pushed off the gate at Heathrow a passenger and companion come back down the aisle toward the rear galley, something seems clearly wrong. Turns out the one passenger was having a panic attack and was afraid to fly. Crew lets the passengers sit in the last row crew rest seats and starts talking to the passengers. Panic attack passenger seems to start doing better but keeps repeating that she just wants to go home. The FA says "ok that's no problem, I'll just ring the Captain and we'll return to the gate." (It seemed, at least to me, that the crew made no real effort to convince her that it was safe to fly, rather saying "oh yeah the turbulence can be really bad TATL", etc.)

So we're fully pushed off the gate, engines starting up ready to go and the FA calls up front for us to return to stand. Takes 20 minutes to get back on the stand, and another 60 minutes to pull bags, add more fuel, push again, etc. Total 80 minute delay on departure for this. I think the crew just didn't want to be bothered with the prospect of a panicked passenger on an 8 hour flight.

Anyone have anything like this happen before? Reasonable that BA returned to the gate for this inconveniencing 200+ people (many of whom had connections)? Does BA just eat the cost of the delay (additional fuel, etc?) Would be curious to hear thoughts. Never had anything like this happen before and was very surprised how willing the crew was to return to the gate without even trying to calm the passenger down first. Would we have diverted if this happened over Ireland say? Where is the line drawn? Would be curious to hear thoughts on this. Not sure how I felt about it. Part of me felt really badly for the passenger and the other part of me was really annoyed about the delay (especially since I was crammed into the last row of Y for an extra 80 minutes!)

Your being too harsh on the crew. After talking to the passenger and seeing them in person, they would have judged what the best course of action was. Better a 80 minute delay than a divert, not to mention an unpleasant atmosphere with a distressed passenger on board.

Yes, have witnessed several panic attacks (and other medical emergencies) during taxiing which lead to severe delays over the years.

One time actually they had to cancel the flight and rebook all pax to the next day since it took so long to get the issues sorted that the flight couldn't depart without violating the night curfew in FRA. All lot of unhappy passengers... Me included.

Worst panic attack I saw on a domestic Swedish flight on a really old and run down Fokker 50. Even I wasn't to happy about flying that pile of scrab metal ;)

Unpleasant situation, no doubt.

I wonder what the protocol for the crew is. I imagine there is one. If a passenger has a medical issue (even if it is a mental health problem, such as a panic attack) and states that he wishes to leave the aircraft, I suppose the crew have to comply if it is doable?

I experienced these kinds of delays several times while taxiing. Each time the delay was about 1,5 hrs. Once, with AF on a CDG-EVN flight, a passenger who was about to be deported from France started to act up and the plane returned to gate immediately to offload him. Once he was offloaded, the captain came on the intercom to apologise and explain that it was company policy to offload anyone who was acting up on the ground, no matter what. He also explained that the lawyers for the deportees know this and instruct them to cause a disturbance, so that their deportation is stopped.

Another time, in ZRH, a girl started to undress while taxiing for takeoff and then proceeded to kiss the female FA who came to investigate. She was offloaded on the tarmac and taken away by police (also kissed the cop).

Witnessed that too a couple of times ex-Germany. Those lawyers should loose their license and the deportee just strapped down to the seat.

That's sounds hilarious... But most probably wasn't funny for anybody involved.

Duct tape and handcuffs would be a welcome addition to the a/c for this nonsense. :td:

I am going to venture to guess that you've never had s panic attack. I'm confounded as to what the proper way to address this type of incident should be, but duct tape and handcuffs are not on my top 100 list.

+1. It was the right decision to return to the gate and off-load the passenger and suggestions of physical restraint are ridiculous. Sure, it's an irritation to be delayed but how is that compared to having a passenger flipping out for the entire flight?

If a passenger is panicking during pushback then I would not want to takeoff, nevermind cross an ocean, with them onboard. Doing so might lead to a situation where the passenger will have to be restrained in flight.

For the deportation nonsense, perhaps, as the passenger is presumably
still under some kind of custody, but doing any such thing on account
of a health issue would risk serious legal and liability repercussions
(not to mention being humanitarianly reprehensible).

The most unpleasant flight I've ever endured would have been fine if the captain hadn't made the misguided decision to keep a psychotic person on board. I found an obese elderly woman in my bulkhead seat at LAX. I told her she was in the wrong seat, but knew from her response that she was not in her right mind so sat in her assigned seat a couple of rows back. She was in a blind panic, explaining that she couldn't go to Cleveland because they were going to cut her up into little pieces and put them in a garbage bag.

I alerted an FA, who talked with the lady for a few minutes before informing the captain. He came and talked with her for ten or fifteen minutes. I think his reassuring air of authority helped her reorganize her addled mind sufficiently to convince him she was fit to fly.

We taxied and took off. She yelled, swung her cane wildly till she was relieved of it, soiled herself, and cried throughout most of the flight. A flight attendant and a heroic fellow passenger sat with her for the entire flight. When we arrived at CLE, the purser asked pax to remain seated because of the "special situation." Now the lady, who had repeatedly asked to get off en route, refused to leave. I had urged the FA to arrange for paramedics to meet us, but that didn't happen. There was a tense standoff for a while, when the lady suddenly bolted off the plane faster than anyone could have imagined.

I would not want to be responsible for judging whether any given passenger was fit to fly.

That is exactly the job of the flight deck and cabin crew but they turned in a poor show here, from the sound of it. But it is just like FAs tolerating intoxicated people, or worse, proactively getting people drunk inflight. The people "who are here primarily for your safety" don't always act the part. Sometimes they just want to get off the gate on time or avoid confrontation.

In this case, it was the captain who decided to make the lady fly. The FAs made the right call to deboard her but were overruled. The FAs had to deal with the very unpleasant result.

Hope I never have to fly with you.

It infuriates me that someone's irrational inability to hold themselves together will cause problems for hundreds of strangers...maybe thousands down the line due to cascading delays and rebooks..And I have seen it myself more than once.

However, I understand that it can be a lesser evil than having an person out of control aboard, once airborne. Frightening stories abound regarding people who have tried to open emergency exits in flight, or tried to bust down the cockpit doors.

If you are prone to such attacks, either medicate yourself appropriately, or don't fly. It's not all about you. Aviation is a vastly complex system and your causing a delay can ruin logistics for the airline and cause all manner of problems for other passengers.

Sad for her, as she was clearly not in her right mind, but terrible for the passengers and FAs who had to deal with this nonsense for a long flight. Glad you survived the experience as it seemed rather nightmarish.

There really was no threat of anything other than discomfort for the rest of the passengers. I did leap over the seatbacks and seize her cane when she started beating the window with it in an attempt to escape -- at 35,000 feet -- but not for fear she'd cause any significant damage. I just thought that other passengers might be alarmed.

Service during the flight suffered as the cabin crew was short the one FA who was dedicated to calming the lady.

According to another passenger, the failures began while this lady was in line at the gate. She was accompanied by two younger men, apparently relatives, who seemed very eager to get her onto the plane. She was ranting while in the line, too. Dealing with psychotic people is something most folks never have to deal with, so I wasn't surprised that the gate agent went ahead and boarded her.

I've seen a bunch of "I need to get off this plane RIGHT NOW!" scenarios over the the many years I've flown commercial. They ranged from genuine medical emergencies to self-induced medical issues, from panic attacks to full-blown psychotic episodes.

In every single instance, I'd rather the person get off the plane before we leave the gate, or before we leave the ground, no matter how much of an inconvenience it might seem to be at the time. Dealing with a sick/frightened/loony person at altitude is much less fun than getting delayed or stuck somewhere, and being diverted is often much worse than never taking off.

If you have never had a panic attack you wouldn't understand. And no one saying it will be fine helps.
It just happens
I have flown many many miles in the past. My first panick attack happened as we pushed off the gate. They allowed me to get off the plane and were quite understanding. I was very embarrassed as I see these gate agents almost every other week. They said it happens more often than you would think.

I now take medication to fly - but if this is their first episode there is nothing you can do.

I have severe anxiety and totally agree with this! My first panic attack turned me into a person that I wouldn't recognise. And while I do always take my medication, it is important to be aware that travelling can make this difficult, because I normally take my medicine in the morning after I wake up and with dinner in the evening, but when getting to different time zones, the timing has to be done appropriately so that I don't miss a dose, but also can still take the medication at convenient times. While I absolutely understand the frustration of such a situation, it isn't appropriate to direct that frustration towards the individual.

So if someone has a heart attack you wouldn't want to go back to the gate as it would inconvenience people?

Mental health is nonsense?

Do you want to take the chance at 30,000 feet of this person really getting agitated and doing something that might harm someone?

Now I'm curious if panic attacks remain the most common in-flight medical (psychiatric?) event that FAs deal with.

It's always unpleasant (infuriating also works) when I'm inconvenienced by someone else's issue, but better an annoyance at ground level than danger at flight level!

I'm not a Doctor but would think there is a difference between a heart attack where there is the imminent risk of great bodily harm and a panic attack. That said, I didn't state an opinion, was curious to gather folks thoughts on whether the return to gate was reasonable. Given the stories here about when flights carried on, it certainly seems like it was the right call to return to gate here.

Fortunately, I've never had to deal with such a situation. Worst I've had to deal with were an irate woman who refused to take her seat and argued with the FA and GA for a good ten minutes that her carry-on, which had been gate checked, should be brought back up from the hold before take-off so she could put it in the space she had created in the overhead. And then there was some sort of non-rev passenger situation with a crying girl who had to be escorted off the plane for some reason; never got the details on that one, but the FAs handled Miss Croc Tears like a champ and got her off the plane before she turned nasty. Neither incident caused more than a 10-15 minute delay in pushback.

I'll sat this, though - one of your criticisms is that the flight crew made no attempt to reassure the woman that it was safe to fly. Well, that's okay by me, because no amount of reasoning in the world is going to have any measurable effect on a person who is experiencing a genuine phobia. Phobias are, by definition, unreasonable fears, and cannot be combated by simple reasoning; they require lengthy professional counseling and sometimes medication to overcome.

The delay sucks, and it's reasonable to be annoyed by it, but better to endure an 80 minute delay than a TATL with a screaming, crying, panicking passenger ruining everyone's flight.

Yeah, those stories are frightening to Ma and Pa kettle who never fly and don't understand that cockpit doors are reinforced to prevent nutjobs and terrorists (is that a bit redundant?) from getting in, and it's impossible to open ANY exterior doors while a plane is at altitude because of the pressure differential. Neither of those things are dangerous, not one bit. But they would be unbelievably annoying to everyone aboard.

No. As I said, the captain's decision was wrong. He should have unloaded the psychotic passenger at the gate. He hadn't pushed back when he evaluated her, so she could have been turned over to paramedics for treatment.

As the miserable journey unfolded though, she proved to be harmless. I'm sure some pax were concerned when she started beating the window with her cane, so I relieved her of it. She could not have caused significant damage with it though and she never threatened any other people on board.

Huh? I wasn't trying to say that. Just the opposite. Dealing with mental illness is extremely difficult, for both the person suffering with the disease but those around them.

You might want to read your quoted post again.

I watched BA cabin crew handle a pax panic attack incredibly well a few years ago. Calmed the woman down and had her calm and smiling by the time we landed.

In the OP's case, the crew had 3-4 minutes to decide whether the pax would likely calm down. Better to return to the gate than be forced to land mid-flight.

Probably best to remove the person from the flight and not issue any refund at all.

It also seems to me that, if you think you might have a panic attack on a flight like this, you should go to your doctor beforehand and get a prescription for Xanax or Klonopin.

And, wind up with a 5-figure lawsuit to defend?

Presumably in the UK, which has loser pays (so easier to defend and win against nuisance suits), in which case BA would simply argue, successfully, that the passenger said he/she didn't want to fly and wanted to get off the plane, and BA met his/her request.

It Surely Is
 

a judgement call on the part of the crew. Floridly psychotic person on the plane, no way. And I say that as a person who works daily with psychotic people.

Panic attack lady may be different. As a person who is afraid to fly and flies medicated, I've noticed in me and by the comments here that pushback can be the worst time for some people. Teaching the crew how to deal with panic attacks and talking to the person to see if they know how they experience a panic attack could guide the crew into making a decision and maybe avoiding having to return to the gate in the case of anxiety. At least some of the time. Ideally, the FAs would have a drawer full of Klonopin, but that ain't gonna happen.

And yes, if people know that they get anxious when they fly, or might, they do have some responsibility in making sure they do what they can to avoid having the aircraft have to return to the gate.

I was flying DTW-CDG and sat next to an anxious woman who seemed fine until we passed Newfoundland and completely came unglued. Rocked back and forth in her seat, crying, saying "I don't want to drown if we crash, I don't want to drown if we crash." I'm an ER/Trauma nurse and I deal with people who have anxiety attacks all the time and it really sort of annoyed me that I had to deal with one on a transatlantic flight. I asked her if she had any anti-anxiety meds on her. She did but of course they were in her checked bags. Who does that? I just looked at her and said,"Well the good thing is if we crash you'll be dead when we hit the water so you won't need to worry about drowning. Why don't you pull down the shade, listen to some nice calming music and pull yourself together or this is going to be an awfully long flight for both of us." I offered her my Bose noise cancelling headphones so she wouldn't be overdramatic at the various sounds of flight. She followed my advice and in 20 minutes she was snoozing.

Those prone to anxiety really need to pre-plan to have their meds on them (and not in their checked bags) and if they're terrified to fly, then DON'T. Its awfully rude to inconvenience others because of your illness. If I had a stomach virus and was vomiting, I wouldn't think twice about not flying.

Having worked in an MRI suite, I've seen plenty of panic attacks occur. Sometimes it was completely shocking who had trouble with it. I've seen people who worked in mines, wells, and shafts completely lose it in the MRI tube but were fine being in other confined spaces. This was their first time ever having a panic attack.

I would hope that this was the pax's first attack. Otherwise, I'm with everyone else -- know your limitations and plan ahead. Get blitzed at the airport bar like the rest of us do before a long flight.

Don't make me pull this plane over right now!

Anyone with a medical condition should take their meds. I do. If you can't handle a plane ride with meds, don't get on a plane.