According to a recent article published in the Wall Street Journal, air carriers are facing substantial new liability from a soaring number of "economy class syndrome" lawsuits. Air Travel: Leave Your Swiss Army Knife at Home but Bring Your
Medical Records

It’s getting more difficult and time consuming to board a plane these days. With increased security measures and random passenger searches, the lines are longer and so is the wait to get on board. It may soon get even worse — not because of terrorist threats or NTSB regulations, but, rather, because of trial lawyers.

According to a recent article published in the Wall Street Journal, air carriers are facing substantial new liability from a soaring number of "economy class syndrome" lawsuits. These cases blame passenger leg blood clots on coach seating, attempting to link pulmonary embolisms to sitting in cramped spaces for extended periods of time. Citing a three-year-old study published in the New England Journal of Medicine, plaintiffs’ lawyers are now flying into courtrooms seeking to hold the airline industry liable.

The already financially crippled airline industry cannot afford to just park itself at the gate on this one. Rather, it must aggressively arm and defend itself.

What this could mean for frequent fliers is that, after being interrogated by ticket agents, baggage screeners and the Transportation Security Administration, you may still be sent off to health monitors, who will request that you complete questionnaires about your travel history and risk factors such as age, medical problems and family history to ensure you are flying with a clotless record. The health monitors’ job will be to identify and deny air travel to passengers who have patent foramen ovale or other risk factors associated with blood clots and long term air travel. After all, why board a lawsuit waiting to happen.

Patent foramen ovale is an opening between two chambers in the heart and is a known risk factor for stroke. Recent studies indicate that the opening is present in about 30 percent of the general population, many of whom fly on airplanes daily. Patent foramen ovale is a congenital problem, not one caused by or associated with airline travel.

As it turns out, the reality is that seat size is probably the lowest risk factor for airline passengers concerned about blood clots. Greater risk factors, most of which are under the control of the passenger, and not the airline, include prolonged immobilization, dehydration from infrequent supply of beverages and/or dehydrating beverages, as well as consuming alcohol, caffeine and salty snacks. Also, increasing the risk of blood clots are age (being over 40), obesity, excess estrogen during pregnancy or from birth control pills or hormone therapy, an inherited tendency for sticky, clot-prone blood and chronic diseases such as high blood pressure, heart disease or cancer.

One risk factor admittedly under the exclusive control of the airline is air quality, including circulation of dry air, low air pressure increasing the risk of coagulation, and high altitudes that can decrease oxygen absorption in the blood, lowering oxygen saturation to less than 85 percent. How can all this be avoided? Essentially, only one way — don’t fly!

The debate surrounding blood clots and air travel is not new and dates back as long ago as the 1980s, with science on the issue being at best mixed. Relatively new, however, is the obsession with digging into deeper pockets in search of big bucks. But even that is growing old quickly.

Personal responsibility left America long before the last Concorde flight. Without it, corporate America simply must seek ways to reduce, if not eliminate, liability that too often is generated by greed and anger than real attributable harm.

What that could mean for airline passengers, if the airlines decide to fight back against scapegoating, is no more coffee, tea or alcohol, a mandated mile-high stretch and beverage carts filled with compression stockings. Pre-flight announcements will likely be longer too, advising passengers to drink lots of water and exercise in flight — not to mention a lengthy disclaimer of the high altitude, low air pressure and thinner oxygen.

Regardless of the volume of warnings given by the airlines, leg blood clots will continue to occur unless the airlines refuse service to passengers boarding with pre-existing risk factors.

But that’s okay with the trial lawyers, too, because such a move will, of course, only clear the path for discrimination lawsuits to take off.

May 20, 2004
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