Reduced-Crew Operations and Pilot Incapacitation

Proposals to Decrease Number of Flightcrew Members Pose Threat to Safety

By Gavin Francis, Senior Aviation Writer

On May 21, 2020, six-and-a-half hours into the return trip of Delta Air Lines Flight 3343, a cargo flight from Frankfurt Main International Airport to Chicago O’Hare International Airport, F/O Matthew Clark suffered cardiac arrest at 40,000 feet while at the controls of a B-777. Suddenly and without warning, he immediately became incapacitated.

“It was during the first wave of the pandemic,” said Clark. “Delta would ordinarily be flying passenger service. However, passenger demand had plummeted, and as a result we were operating a number of cargo flights. At the moment that I experienced cardiac arrest, I had control of the aircraft, and the captain was the pilot monitoring.”

Clark was flying that day with Capt. Te Lee and F/O Norm Dawkins. At the time of the incident, Dawkins was on his break sleeping in the rest facility, and only Clark and Lee occupied the flight deck.

“I remember looking out the window, and then, in the blink of an eye, I was dead,” Clark remarked. He has no memory of what happened during those moments when his fellow crewmembers worked to resuscitate him, but he later learned some of the details.

It began as Lee noticed that Clark had dropped something when he heard it clatter to the floor. Lee asked Clark if he was going to pick up the item. Getting no response, he asked again. When he queried a third time, Lee reached over and shook Clark by the shoulder. Clark slumped over in his seat. Lee immediately checked Clark for a pulse and breathing. Finding neither, he reclined Clark’s chair, positioned himself over his fellow pilot, and began to administer CPR while continuing to monitor the aircraft.

After several minutes of performing CPR, Lee was eventually able to summon Dawkins to the flight deck to assist. Lee performed CPR for a total of approximately eight to 10 minutes before delivering a shock with an automated external defibrillator (AED). Clark was still unconscious at that point, but the shock had worked as intended and Lee detected shallow breathing and a pulse.

With Dawkins now on the flight deck, Lee contacted ATC, declared an emergency, and requested a diversion to a nearby airport. He was directed to Moncton, N.B., Canada, approximately 50 nautical miles away with an expedited descent.

But even with two pilots on the flight deck able to perform flight duties, Lee and Dawkins still had their hands full. There wasn’t much time to get the airplane down within the allotted distance, and the workload had increased significantly. And with Clark still unconscious and occupying the right control seat, Lee was essentially flying as a single pilot while Dawkins tended to Clark.

“When we reached Moncton, I was off-loaded by paramedics and taken to a hospital,” said Clark. “I spent four days on life support, sedated in a medically induced coma. I was in the hospital a total of two weeks before being released.”

This incident and others raise concerns about a proposed plan by some aircraft manufacturers and air carriers to eventually reduce flight crew staffing on some flights. They argue that automation has progressed to the point that, during some phases of flight, only one pilot on the flight deck is necessary. Furthermore, they suggest that this reduces the opportunity for human error.

But what if Clark had been alone on the flight deck operating as a single pilot? Presumably, there would be some way to monitor his performance while at the controls, but would his fellow pilots have noticed that he’d become incapacitated? Would they have gotten to him in time to resuscitate him? And if not, would the airplane’s automation alone really have ensured the continued safe conduct of the flight?

In Europe, there’s already an aggressive lobbying campaign under way to persuade the International Civil Aviation Organization and the European Union Aviation Safety Agency to consider allowing reduced-crew operations. Initially, this would probably only apply to long-haul cargo flights, but would likely be expanded at some point to include passenger flights as well. A slippery slope, some suggest, for a future that might one day include remotely piloted or fully automated flight service.

ALPA, along with the global pilot community as members of the International Federation of Air Line Pilots’ Associations, adamantly rejects any proposals for reduced-crew operations, maintaining that there will always be a need for at least two fully qualified, highly trained, and well-rested pilots on the flight deck, regardless of advances in automation. Obviously, pilots value technology, which helps them to better perform the duties of their profession, but technology is there to support pilots as they do the work necessary to maintain a safe air transportation system. Visit

While incidents like the one that occurred on Flight 3343 don’t happen often, they do happen. There have been several notable incidents in recent years.

In March 2017, American Airlines Flight 1353 was on approach, two miles from Albuquerque International Airport, when the first officer experienced a medical emergency and became incapacitated during the last phases of landing. The captain was able to land safely, and paramedics met the aircraft at the gate. They performed CPR for approximately 40 minutes before the first officer was pronounced dead.

In September 2017, the captain of Etihad Airways Flight EY-927, a cargo flight from Abu Dhabi to Amsterdam, died enroute. The first officer declared an emergency and was diverted to Kuwait, where he landed safely.

In November 2022, a captain-in-training aboard Envoy Air Flight 3556 from Chicago, Ill., to Columbus, Ohio, became incapacitated shortly after departure. A check pilot took control of the aircraft and notified ATC of the emergency. He was cleared back to Chicago O’Hare International Airport where he landed safely. The aircraft was met by first responders who administered medical assistance. The pilot later died at the hospital.

On March 22, 2023, the captain of Southwest Airlines Flight 6013, flying from Las Vegas, Nev., to Columbus, Ohio, suffered a medical emergency. The captain was removed to the back of the aircraft where he was looked after by a flight attendant. An off-duty pilot from another airline happened to be on board and assisted with radio communication while the first officer flew the aircraft back to Las Vegas and landed safely. The captain was taken to a medical facility.

Fortunately, in the case of Flight 3343, Clark received the medical attention he needed and survived the incident.

“The fact that I’m alive today is remarkable,” said Clark. According to the American Heart Association, 90 percent of the people who experience an out-of-hospital cardiac arrest die. However, CPR administered immediately after cardiac arrest can double or possibly triple a person’s chance of survival.

Clark is now fully recovered and doesn’t have any limitations. He’s able to exercise and do basically everything he was able to do before. In addition, he lives with an implantable cardioverter-defibrillator and pacemaker as a precaution in case he ever has another cardiac arrest. The one restriction he has, unfortunately, is that he’s legally prohibited from flying.

As difficult as that’s been for Clark, he views it as a tradeoff. Although he’s had to give up something that he truly loves, he’s thankful for the second chance he’s received.

“As a pilot, I’ve regularly undergone annual EKG testing as part of my physical. Nothing was ever detected. And there was nothing in my medical history that would suggest a problem. This was just completely out of the blue.

“I’m incredibly fortunate. Thankfully, my fellow pilots knew CPR and there was an AED readily available.”

This article was originally published in the April 2023 issue of Air Line Pilot.

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