John Stevens, English Psychiatrist, initially reluctant to help ill passenger on flight – then billed American Airlines four hours for his time

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ILL British Medical Journal
Doctor demands payment for helping airline passenger
By Clare Dyer
September 12, 1998

Psychiatrist John Stevens

A doctor who answered an emergency call on a transatlantic flight will break new legal ground next month when he goes to court in a bid to force
the airline to pay for his services.

John Stevens, a consultant psychiatrist and psychotherapist, was returning with his family from a holiday in California in January 1997 when the call for a doctor went out over the American Airlines jet’s public address system.

Dr Stevens, who divides his time between Springfield Hospital in south London and Surrey Oaklands Hospital in Redhill, said that he was initially reluctant to respond to the call, which came just 20 minutes into the flight. “I sat on my hands because I felt the best doctor would be one who deals with emergency medicine all the time. Then I heard a kerfuffle a few rows behind, so I couldn’t ignore it. The second call went out, and I felt impelled to act.”

He said that the passenger, a former nurse from the Republic of Ireland, “looked grim [and] had chest pains and breathlessness.” She had a history of repeated leg thromboses and had been taking anticoagulants, but the treatment had been stopped.

Dr Stevens believed she had had a pulmonary embolism as she was boarding the aircraft. She was given oxygen and initially rallied, but when she had a further attack, he advised an emergency landing for hospital treatment in Chicago, rather than risk a long flight over the north Atlantic, where landing would have been impossible.

At the end of the flight, Dr Stevens was presented with a bottle of “cheap champagne” by the crew, and he said that a $50 (£30) travel voucher, excluding all the main holiday periods, arrived a month later. The airline says that the voucher was for $250, but Dr Stevens, who took a photocopy before returning it to the company’s solicitor, insists it was for only $50.

In the meantime, he sent the airline a bill for £540, charging for four and a half hours of his time at £120 an hour. The airline refused to pay, claiming that it was not company policy, so Dr Stevens, with advice from legal friends, brought a small claims action in Central London County
Court.

The airline tried to have the claim struck out, but a judge ruled that it could go ahead. The hearing is set for 7 October.
Under the small claims rules, Dr Stevens will not be liable for the airline’s costs if he loses.

A spokeswoman for American Airlines said: “We have a strict company policy that we don’t pay doctors in circumstances such as this. Our position
is that it’s a matter between the doctor and the patient, and the fact that treatment was on our aircraft is incidental.”

But Dr Stevens points out that his services were sought by the crew rather than the patient, who told him she was not consulted before the call for a doctor was broadcast. He says that had anything gone wrong, he could have faced a large malpractice claim for which he had since learned he would not have been covered.

The BMA, which wants to clarify the position of doctors who give in-flight help, has had informal discussions with several airlines and hopes to raise the issue with an international aviation advisory body, a spokeswoman said.

John Stevens