GENERAL INFORMATION
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KEYWORDS
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Category 3 aviation medical certificate, subdural hematoma, head injury
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FILE NO.
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O-4598-01
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SECTOR (Marine or Aviation)
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Aviation
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SPECIFIC JOB
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---
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DIAGNOSIS (Primary, Secondary, etc.)
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Subdural haematoma
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REVIEW
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DATE OF DETERMINATION
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March 30, 2022
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MEMBER
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Dr. Colin MacKay
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DETERMINATION
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The member confirms the Minister of Transport’s decision to suspend the aviation medical certificate of the applicant.
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REASONS FOR THE DETERMINATION
Suspension of the applicant’s category 3 aviation medical certificate — In March 2019, the applicant had a skiing accident and suffered head trauma that resulted in a subdural haematoma which led to neurological signs and symptoms and required urgent craniotomy and decompression. A post‑surgical complication included a subdural empyema that required a re‑do craniotomy and wound washout. Following an assessment by Transport Canada Civil Aviation Medicine (CAM), the applicant was notified by letter that he was assessed to be medically unfit to hold any aviation licence or permit due to the injury and post‑surgical complication he experienced. CAM determined that given the neurological pathology of the applicant’s head injury, a class 4 incapacitating event, with the occurrence of a seizure, with a likelihood of greater than 2% per year, leads to an assessment of unfit for any medical category. Subsequently, the applicant’s case was also reviewed by the Aviation Medical Review Board and that the earlier unfit assessment was sustained, primarily because the empyema over the left frontal lobe significantly increases the risk for seizure to a level that is not acceptable for safety of aviation. Chapter 10, paragraphs 10.4.10, 10.4.13 and 10.4.14 of the International Civil Aviation Organization Manual of Civil Aviation Medicine does indicate the potential for certification following traumatic brain injury after observation periods of 2 to 5 years. In the applicant’s case, with the risk of seizure of greater than 2% being assessed as permanent, the member finds than an observation period will not alter the assessment for the applicant’s suitability for certification. The applicant’s traumatic brain injury, with permanent risk of seizure greater than 2%, does constitute a non‑progressive disease of the nervous system and history of serious head injury, with the potential to interfere with the safe operation of an aircraft, as identified in Canadian Aviation Regulations Standard 424.17(4), Physical and Mental Requirement Table, Medical Category 3, paragraphs 3.4(a) and 3.4(d) and Medical Category 4, paragraph 4.1.
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APPEAL
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DATE OF DECISION
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MEMBERS
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DECISION
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REASONS FOR THE DECISION
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OTHER/COMMENTS
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