AOPA Pilot Magazine - August 2023 - 26

FLIGHT MD
Review your
medical records
Uncorrected errors may haunt you
BY DR. BRENT BLUE
I HAVE BEEN WORKING with a pilot who is in a world of hurt with
the FAA because of mistakes made on his medical record by his
treating physicians, advanced practice providers, and nurses. He
is not the only pilot with this problem.
The pilot, who is a social drinker at best, was purported
in his medical record to drink 84 beers a week without any
documentation as to where that number came from and without
any abnormalities in his lab work that would suggest
alcohol abuse of any amount. He was also reported to be unconscious
after an accident; however, there is no documentation of
that and, in fact, first responders reported no loss of consciousness.
Once errors are in the computerized medical record
(electronic health record or EHR), they are there permanently
and will keep populating the diagnosis list forever. Incredibly,
most patients never see this list until the FAA or an insurance
company denies a medical certificate or refuses to insure.
I had one pilot who had the erroneous diagnosis of
opioid dependency on his record without
any documentation whatsoever of how this
was determined.
What one can do is ask for a copy of their medical record
immediately upon discharge from a hospital and read it. The
printed EHR is impossible to decipher, but the narratives and
the diagnosis list can be read. A friendly health professional also
may review a record for errors.
If an error is found, one can ask the hospital to have the record
corrected immediately. The hospital will not want to do this and
may offer to have the physician write an amendment. Do not accept
this. An amendment does not remove erroneous information but
just says it was incorrect. That reminds me of when I had an
embezzlement that trashed my credit score. It did not make any
difference that there was an amendment on the credit report from
law enforcement stating there was an embezzlement that caused
late payments; the score was still trashed.
26
AOPA PILOT / August 2023
I had one pilot who had the erroneous diagnosis of opioid
dependency on his record without any documentation
whatsoever of how this was determined. His hospitalization
was something benign. The hospital refused to remove it until
a lawyer was hired and threatened to sue.
I can assure you that a record with this type of erroneous
information will cause great difficulty with the FAA, costing the
pilot a lot of time and money. If the FAA sees a diagnosis, wrong
or not, it must ask the pilot to explain. A simple explanation will
not work. The pilot will need providers to write letters and will
probably need testing and evaluations by a specialist to prove a
negative, which is always harder than proving a positive. The pilot
who allegedly drank 84 beers a week is two years into the process.
Review your records. It is a pain but will save you a lot
of heartache.
.....
I really like helping student pilots get their medical certificate,
and some of them have issues such as having used hyperactivity
medicine or antidepressants in the past. Many times, even most,
the use of the medications was inappropriate. For instance, the
diagnosis of hyperactivity (ADD/ADHD) initially had to be made
prior to age 6. However, a committee that contained a majority
of members with conflicts of interest, raised that age to 12. The
subsequent effect was the significant increase in the use of ADD/
ADHD medications to the benefit of the pharmaceutical industry.
As above, proving the negative is hard.
My pet peeve in the process is working with parents. I will
only work with the pilot applicant. If the prospective pilot wants
a medical, he or she can call me or see me in the office to work
out how to fill out the medical form correctly or find out what
they will have to do to fix the issue. If a student pilot needs their
parent to ask me the questions and fill out the FAA medical form
for their child, perhaps that child does not really want to be a
pilot, or maybe should not
be a pilot. After all, are the
parents going to check the
weather for their child before
every flight?
brent@brentblue.com
DR. BRENT BLUE is a senior
AME based at the Driggs,
Idaho (DIJ), near Jackson
Hole. He flies a Cessna 185
and a Noorduyn Norseman.
AOPA Pilot Magazine - August 2023

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