Samuel Randazzo and Civil Aviation Safety Authority
[2012] AATA 266
•4 May 2012
[2012] AATA 266
| Division | GENERAL ADMINISTRATIVE DIVISION |
| File Numbers | 2011/3154 & 2012/1167 |
| Re | Samuel Randazzo |
| APPLICANT | |
| And | Civil Aviation Safety Authority |
| RESPONDENT |
DECISION
| Tribunal | Ms G Ettinger, Senior Member |
| Date | 4 May 2012 |
| Place | Sydney |
The Tribunal dismisses Mr Randazzo’s application for review of the decision of CASA made on 8 July 2011 suspending his Class 2 Medical Certificate (Matter 2011/3154).
The Tribunal affirms the decision under review, (Matter 2012/1167). The Tribunal affirms that the conditions imposed in Randazzo v Civil Aviation Safety Authority, (CASA) [2011] AATA 375 apply, (the Part A Conditions), as well as, additionally, the Part B Conditions imposed by CASA on 2 December 2011.
The existing Conditions, (Part A Conditions), on Mr Randazzo’s Class 2 Medical Certificate are affirmed, and are as follows:
“1. Concerning your atrial fibrillation; from 1 June 2011, you must provide CASA with progress reports every three months from your cardiologist detailing:
- any occurrence of atrial fibrillation;
- any symptoms;
- results of stress ECG including rate control;
- 48hr Holter;
- echocardiogram;
- treatment, response to treatment and side effects;
- confirmation of diagnosis; and,
- prognosis, including risk of adverse sequelae (including thromboembolism).
2. Concerning your GIST; from 1 June 2011 you must provide CASA with a (three monthly) report from your oncologist every three months updating:
- the diagnosis;
- results of any investigations (blood tests, scans, etc);
- treatment, response and any side-effects;
- prognosis; and,
- follow-up plan.
3. When your Medical Certificate becomes due for renewal, in addition to the standard renewal medical examination report, you must provide CASA:
- a progress report regarding the GIST from your oncologist including results of recent staging investigations, treatment, side-effects and prognosis;
- a progress report regarding the atrial fibrillation from your cardiologist including results of recent staging investigations, treatment, side-effects and prognosis;
- a copy of your GP medical records and reports for the previous 12 months.
4. You will be responsible for the costs of all the reports.
5. Your aviation medical certificate is to be endorsed Renew by CASA Only. This alerts the Designated Aviation Medical Examiners that only Aviation Medicine can revalidate the certificate after assessment of the required reports.
6. In addition to the above conditions, the other conditions of diabetes, sleep apnoea, dilated aortic root, renal colic require monitoring. CASA therefore requires at the time of your next medical that you provide reports that you usually provide in your application for a medical certificate with respect to these conditions, including:
- endocrinologist report and HbA1cs and ophthalmology report and blood glucose diary;
- sleep physician report;
- CT KUB
- Echocardiogram or CT measurement of the aortic dilation;
Part B additional Conditions relating to medical history since 1 June 2011 are:
7. You must fly with a safety pilot in an aircraft with functional dual controls. The safety pilot must be licensed and endorsed to fly the aircraft being flown by you.
8. Following each flight, the safety pilot must provide a report to CASA of your performance during that flight. The report must be received by CASA within 7 days of each flight which has been undertaken.
Note: The requirements set out in conditions 7 and 8 are due to your documented cognitive deficits on neuropsychological testing and the potential for impairment in such domains and consequent risk to aviation safety the deficits pose.
9. Also required at the time of recertification is an up-to-date neuropsychological report and copy of recent MRI Brain due to your condition of meningioma.
...............[sgd].............................................
Ms G Ettinger, Presiding Member
Catchwords
CIVIL AVIATION – Private pilot aged 74 years – Class 2 medical certificate subject to conditions – multiple health conditions – documented cognitive deficits on neuropsychological testing – Applicant is to fly with safety pilot – Decision under review is affirmed.
Legislation
Civil Aviation Act 1988 (Cth): s 9A
Civil Aviation Safety Regulations 1998 (Cth): Part 67, r.11.056
Civil Aviation Regulations 1988: r.5.04
Cases
Randazzo and Civil Aviation Safety Authority [2011] AATA 375
Re Hall and Civil Aviation Safety Authority [2004] AATA 21
Re Mullholland and Civil Aviation Safety Authority [2007] AATA 1952
Re Window v Civil Aviation Safety Authority (1999) 56 ALD 316
Re White and Civil Aviation Safety Authority (2009) 105 ALD 33.
REASONS FOR DECISION
BACKGROUND
Mr Samuel Randazzo, who is 74 years old, has held a private pilot’s licence since 1963 – that is, for approximately 47 years.
When it came to the attention of the Civil Aviation Safety Authority, (CASA), that on renewing his licence, Mr Randazzo had not disclosed various health conditions to it over a period of time, his application for a Class 2 Medical Certificate was refused. That was back on 13 September 2010.
The conditions which Mr Randazzo suffered at the time, and which it is accepted he suffers in 2012, are:
Obstructive sleep apnoea;
Type 2 Diabetes Mellitus;
Ischaemic Heart Disease;
Dilated Aortic Root;
Right Renal Calculus;
Cataract Extraction and intraocular Lens Placement;
Admission to Hospital with Chest Pain in 2006;
Gastrointestinal Stromal Tumour (GIST);
Atrial Fibrillation;
The medical conditions about which CASA was particularly concerned in 2010 were the possibility of recurrence of the gastrointestinal stromal tumour (GIST) which Mr Randazzo suffered in late 2009, and episodic atrial fibrillation which he has suffered since 1998.
However, on 2 December 2010, following the review of medical evidence, CASA issued Mr Randazzo a Class 2 Medical Certificate for a period of 12 months with various conditions, including the condition that Mr Randazzo only fly with a safety pilot.
The CASA imposed condition with which Mr Randazzo was most dissatisfied at the time, was that he was required, since CASA’s ameliorating decision on 2 December 2010, to fly with a safety pilot. He appealed to the Administrative Appeals Tribunal, which held a hearing, and decided on 1 June 2011, on the basis of the evidence before it, including the medical evidence, that Mr Randazzo could fly with certain conditions imposed. The Tribunal decided however, on the basis of the medical evidence before it, that Mr Randazzo could fly without a safety pilot.
Following an occurrence whilst Mr Randazzo was flying on 24 June 2011 which caused concern in regard to air safety, CASA suspended Mr Randazzo’s Class 2 Medical Certificate, on 8 July 2011. A new Class 2 Medical Certificate was issued to him on 2 December 2011 with conditions as imposed by the Administrative Appeals Tribunal in Randazzo and Civil Aviation Safety Authority [2011] AATA 375, being Part A Conditions, as well as further Conditions, the Part B Conditions, imposed by CASA having regard to developments in the Applicant’s medical history since 1 June 2011.
Mr Randazzo appealed both decisions of CASA to this Tribunal. Application 2011/3154 relates to the decision to suspend the Applicant’s Class 2 medical certificate. Matter 2011/3154 has been rendered nugatory by the further developments and the grant of a Class 2 Medical Certificate with Conditions to Mr Randazzo. That matter is dismissed.
In matter 2012/1167, which concerns the issue of a Class 2 Medical Certificate with Conditions to Mr Randazzo, we affirm the decision of CASA.
Our reasons follow.
By way of completeness, we note that Dr Austin of the Tribunal disclosed at the commencement of the hearing that he had been a medical officer and Designated Aviation Medical Examiner (DAME) for the Royal Australian Air Force (RAAF) between 1980 and 2008, and a decision maker in matters of a complex nature. Neither party objected to Dr Austin sitting as a Member of the Tribunal.
ISSUES BEFORE THE TRIBUNAL
In order to make the correct or preferable decision in relation to this matter the Tribunal must decide:
(a)whether the Applicant meets the medical standard for the issue of a Class 2 Medical Certificate; if not,
(b)whether the extent to which the Applicant fails to meet that standard is likely to endanger the safety of air navigation, and if so;
(c)whether any conditions could be imposed upon Medical Certificates which would ameliorate the threat posed to air safety by the Applicant's failure to meet the Class 2 medical standards.
THE RELEVANT LEGISLATIVE ENACTMENTS
CASA’s role, pursuant to section 9A of the Civil Aviation Act 1988 (the Act), is to ensure the safety of air navigation. Accordingly, the Tribunal, when carrying out this review and exercising powers under the Act and the Civil Aviation Safety Regulations 1998, (CASR) must treat the safety of air navigation as the most important consideration.
A pilot must, pursuant to the relevant regulations, hold a current medical certificate appropriate for the licence sought, in this case, Class 2.
The issuing of medical certificates is governed by Part 67 of the CASR. Regulation 67.180 provides for the issuing of medical certificates, and prevents CASA from issuing a medical certificate unless the Applicant meets the relevant medical standard or, if the Applicant does not meet that medical standard – the extent to which the Applicant does not meet that standard is not likely to endanger the safety of air navigation.
Regulation 67.195 allows CASA to issue a medical certificate to a person subject to any condition that is necessary in the interests of the safety of air navigation, having regard to the medical condition of the person.
For the purposes of Part 67 of the CASR, in particular regulation 67.015, a medically significant condition is safety-relevant if it reduces, or is likely to reduce, the ability of someone who has that condition to exercise a privilege conferred or to be conferred, or perform a duty imposed or to be imposed, by a licence that he or she holds or has applied for. Regulation 67.015, sets out the meaning of safety-relevant as follows:
For the purposes of this Part, a medically significant condition is safety-relevant if it reduces, or is likely to reduce, the ability of someone who has it to exercise a privilege conferred or to be conferred, or perform a duty imposed or to be imposed, by a licence that he or she holds or has applied for.
Regulation 5.04(1) of the Civil Aviation Regulations 1988 (CAR) provides that the holder of a flight crew licence must not perform a duty authorised by that licence if the person does not hold a current medical certificate that is appropriate to the licence.
Subsection 20AB(1) of the Act provides that a person must not perform any duty that is essential to the operation of an Australian aircraft during flight times if the person does not hold a current civil aviation authorisation that authorises the performance of that duty.
Regulation 67.010 provides that the relevant medical standard for a Class 2 Medical Certificate is Medical Standard 2, which is defined in that regulation to mean the standards set out in Table 67.155.
In respect of the Applicant's medical conditions, which have been identified since 1 June 2011, the relevant items of the Class 2 medical standard set out in Table 67.155 of the CASR are:
Abnormalities, disabilities and functional capacity
2.1 Has no safety-relevant condition of any of the following
kinds that produces any degree of functional incapacity or a risk of incapacitation:
(a) an abnormality;
(b) a disability or disease (active or latent);
(c) an injury;
(d) a sequela of an accident or a surgical operation2.2Has no physical conditions or limitations that are safety-relevant
EVIDENCE REGARDING THE INCIDENT ON 24 JUNE 2011
Mr Randazzo produced a written statement dated 20 December 2011 which was Exhibit A1 before the Tribunal. In it he stated that the incident (which led to the suspension of his medical certificate), occurred on 6 July 2011. However, we noted that there was no dispute the incident occurred on 24 June 2011 while Mr Randazzo’s was flying from Brisbane to Wedderburn. He stated that at approximately 1430 he was flying on IFR flight plan at FL 180 north of Singleton heading to Wedderburn when two Air Force Skyhawks came up beside him, and after two or three passes, hand signalled him to descend. Mr Randazzo said he thought at first that the pilots were training, and enjoyed looking at them.
Mr Randazzo stated that after receiving the signal, he attempted to call Brisbane Centre but could not make contact, and changed to his number two radio, and frequency 12345. He said that he later realised that he was not aware Brisbane Centre had been trying to contact him for perhaps approximately an hour, because his number one radio had not been operating. He said he also realised after speaking to Brisbane Centre that they had a concern he may have been suffering hypoxia, but that he was certain that was not the case. He said that because he was flying at an altitude of more than 10,000 feet, he was wearing a cannular which delivered oxygen, but that the Skyhawk pilots may not have seen that.
Mr Randazzo said that at the time of the incident he was preoccupied with a mechanical fault that he had discovered in the navigation system during the flight. He said that a circuit breaker related to the navigation system had popped. He stated that after the flight, he had the problem investigated, and discovered that when the aircraft was serviced by Complete Avionics on the Gold Coast, the circuit breaker had popped, but had not been discovered as it was under the console.
In that connection we had before us an unsigned report of Complete Avionics Pty Ltd dated 19 October 2011 in which it was stated that a satisfactory service check had been completed as noted on the log book entry, job number HA1009. The Representative of the company also stated in the report that it had checked VH-XCG after Mr Randazzo’s flight to Sydney from the Gold Coast, and found that a circuit breaker had been pulled and not pushed back in, causing HSI issues in flight. We reset the C/B and everything tested serviceable.
Mr Randazzo stated that after he landed at Williamtown, he was examined by way of an ECG and by a doctor, and permitted to continue (flying), on his way.
CASA’S POSITION REGARDING THE EVENTS OF 24 JUNE 2011
CASA stated that on 24 June 2011, the Applicant was the pilot in command of a Lancair aircraft with Australian registration mark VH-XCG, and alleged that during this flight Mr Randazzo failed to respond to the instructions issued by Air Traffic Control. It noted that Electronic Safety Incident Report (ESIR) 2591 sets out the details of this flight, and that a transcript of the ESIR tape is before the Tribunal at T5.
CASA considered that the behaviour displayed by the Applicant during this flight, raised concerns that he was suffering from a medical condition which may have posed a risk to aviation safety if he continued to fly. It was for that reason his Medical Certificate had been suspended on 8 July 2011.
Following the suspension of Mr Randazzo’s Class 2 Medical Certificate, CASA required Mr Randazzo to undergo medical testing which we have discussed below. Meanwhile, we have considered the reports at T5 and T6 which were the basis of the suspension of the Medical Certificate on 8 July 2011.
We have noted that the ESIR records at T5 record the concerns of air traffic controllers:
Out of communications for extended period Detresfa – Suspected Oxygen starvation … XCG not in normal communications, observed random tracking =/- 20 degrees from normal track. XCG levels off at cleared level (FL180) still no communications. OXYGEN calls made. 0321:xcg overshoots turn at GBA (Apprehension increased) 2 x Hawks tasked to intercept (Bobcat) (Mr Randazzo) … Intercept achieved. Initial reports of pilot looks OK. Still no communications. No indication that pilot is aware of the Hawks in very close proximity. … Initial call sounds OK but subsequent questioning and responses are wrong, not relevant and irrational. … (After landing) Absence from frequency for 56 minutes was not explained. Called on 123.4 to talk with the Hawk pilots. … ATC also advised medical checks were OK.
We have noted that the transcript relevantly expresses the concern of the air traffic controllers regarding Mr Randazzo’s tracking and his non-communication. They were also clearly directing other commercial aircraft at the time of the incident with Mr Randazzo. Conversations such as:
No, Jumbo … I was just thinking there’s a couple of BOBCATS out there. There would be a three minute diversion for them just to check out and make sure this guy is not slumped over the controls or something.
…
… thank you sir. The situation – got an aircraft at flight level 180 as unreported. We’re concerned that he may be having difficulties with oxygen.
…
… I can see movement in the cockpit. Looks like the occupants are okay.
…
… Are you happy to escort the aircraft to Williamtown if you can?
…
He definitely acknowledged the – we were giving him the biggest arrows downwards pointing downwards.
…
X-ray Charlie Golf, this is Brisbane Centre. How do you read now?
Read you clear at 9. Can I cancel that flight for a while?
Just stand by 1. You’ve been out of comms for about the last 40 minutes or so. We’ve just been chasing you up. Just confirm operations normal.
Operations normal. Just trying to get a clearance.
…
… What would you like to do?
Like to get - leave the flight plan for a while.
…
… did you hear what he said? He wants to …. I think doesn’t really know what he wants to do.
…
X-ray Charlie Golf. Thank you. And what’s your intentions now? I copied you on descent now at 5137. What’s your intentions?
Just going to do a few manoeuvres.
X-ray Charlie Golf, Roger. Could you keep me updated with your intentions please. Call me when you’re going to be turning left or right.
…
At T6, is a record of a conversation with one of the pilots of the Hawks involved in the incident of 24 June 2011. Relevant parts of that note were:
C, (the Hawk pilot), observed the pilot in the cockpit who appeared to be conscious and did not look sleepy. Sam was fiddling with something, possibly navigation equipment. Sam had not seen the Hawks until moved forward of the wing. Sam then acknowledged their presence.
…
C said that Sam was cooperative and seemed a little confused as to their presence. … He said he could not see a mask. … He said that Sam told him he was using a Cannular system which is certified for use up to FL 180.
…
The events as described by C corroborate the explanation provided by Sam Randazzo. It is not known whether Sam was suffering from Hypoxia.
MEDICAL EVIDENCE
As already noted, a result of the incident of 24 June 2011 was that the Applicant's Medical Certificate was suspended on 8 July 2011. The reasons for the suspension, and directions to Mr Randazzo were set out in the reviewable decision, and included:
·There is evidence during the incident [the Applicant] appeared/behaved
in a confused manner
·[the Applicant was] using an approved oxygen system and [the Applicant] maintained there was no problem in the oxygen system
·The incident may have been related to hypoxia
·There may be another reason for [the Applicant's] apparent confused state.
The Applicant was asked to provide the following medical reports:
· A work up by a respiratory physician including hypoxia challenge test, and a report detailing:
o any diagnosis of respiratory or other condition affecting gas transfer
o results of hypoxia challenge test
· A neurospsychiatric assessment by a clinical neuropsychologist with testing to determine whether [the Applicant is] suffering from any neurocognitive deficits, including test for but not limited to:
o reasoning and problem solving ability
o ability to understand and express language
o working memory and attention
o short and long-term memory
o processing speed
o visuospatial organization
o visual-motor coordination
o planning, synthesizing and organising abilities.
Mr Randazzo supplied medical reports in response to the suspension decision, on the basis of which CASA made the reviewable decision of 2 December 2011.
The medical reports before the Tribunal were as follows:
Dr D Fitzgerald, Senior Medical Officer, Aviation Medicine, CASA, dated 23 January 2012 (Exhibit R2);
Dr J Stewart, Clinical Neuropsychologist, dated 16 August 2011 (T13);
Dr S Eggleton, Mr Randazzo’s Cardiologist, dated 10 October 2011 (Exhibit R3), and 2 November 2011, (Exhibit R4);
Dr A Keller, Physician, dated 5 October 2011 (Exhibit A2);
Associate Professor T Rosenfeld, Consultant Geriatrician and Physician, dated 22 March 2012 (Exhibit A4);
Dr R Parkinson, Neurosurgeon, dated 17 August 2011, (T18);
Dr Fitzgerald, Senior Medical Officer, Aviation Medicine
Dr Fitzgerald made the reviewable decision of 8 July 2011 suspending Mr Randazzo’s Medical Certificate, and also issued the Medical Certificate with Conditions dated 2 December 2011. He prepared a report dated 23 January 2012, and also gave oral evidence before the Tribunal. He had relied on documents at T5, including the ESIR, and T6, the Record of a Conversation with C, one of the Hawk pilots, for the suspension decision. Then subsequently, in issuing a Class 2 Medical Certificate with Conditions to Mr Randazzo, he relied upon the medical reports of Drs Stewart, Keller and Parkinson.
Dr Fitzgerald told the Tribunal that in coming to the decisions he did, he relied upon Dr Stewart’s findings that Mr Randazzo’s information processing was slower than it should have been, and that in a high pressure environment such as in aviation, that was of overarching concern. He also said that in order to make quick decisions, cognitive ability and capacity beyond that Mr Randazzo exhibited was required. He reiterated that slow processing of information was Dr Stewart’s prime finding and that in aviation that was of primary importance.
Dr Fitzgerald noted that Dr Stewart and Associate Professor Rosenfeld had taken different approaches in their reporting.
Dr Fitzgerald also acknowledged that he is not a neuropsychologist, but that he has some knowledge of that field, and told us that he has an in depth knowledge of aviation medicine, which we accept.
Dr Fitzgerald also accepted that whilst it had been suspected that Mr Randazzo suffered hypoxia on the flight of 24 June 2011, that was no longer of concern, and was not pressed. He added however, that the cause of the incident was unclear, and that the overriding concerns of safety in aviation, led to the condition of imposing a safety pilot to fly with Mr Randazzo. He also told the Tribunal that at the time of making the decision, the transcript at T5 had not yet been available. The Members of the Tribunal were however concerned with Dr Fitzgerald’s admission that he had not read the transcript before attending the hearing.
Dr Glennon who appeared for Mr Randazzo was at pains to get Dr Fitzgerald to agree that the decision to suspend had been taken without adequate basis, given that Mr Randazzo had obeyed the direction of the Hawks, and waited to be cleared for descent. Further, that having been examined when he landed at Williamtown, he had been cleared to continue his flight. We make no comment on Dr Glennon’s submissions above except to observe that decisions such as Dr Fitzgerald’s decision to suspend Mr Randazzo’s Medical Certificate are made in the context of the safety of aviation. What followed was, as we all know, a further decision on the basis of the medical evidence which Mr Randazzo provided, restoring the Medical Certificate with Conditions.
THE APPLICANT’S SUBMISSIONS
Dr Glennon submitted that the decision maker who made the initial decision to suspend Mr Randazzo on the basis of documents T5 and T6, (discussed above), was biased, and that he had insufficient or no credible evidence to do so.
Dr Glennon referred to the transcript at T5, submitting that the transcript supported the view that Mr Randazzo was behaving in a totally rational way when he communicated with the Hawk pilots and the air traffic controller.
Dr Glennon submitted also that Mr Randazzo had been out of contact for 40 minutes or so, and not the 56 minutes previously suggested.
In his written submissions Dr Glennon also made submissions about the issue of hypoxia, but as Dr Fitzgerald agreed Mr Randazzo had not been hypoxic, and we accept that on the basis of the evidence before us, we have not pursued that argument in these Reasons for Decision.
Dr Glennon also made submissions about the report of Dr Stewart. He submitted that the Respondent was not able in any real sense to formulate how the findings relied upon, being slowed information processing speed, memory function and executive functioning, related to flying aircraft. He submitted that Dr Fitzgerald was not an expert in neuropsychology, had not done testing in that field, and could not, in any real sense say how the results of the tests might impact on the Applicant’s flying ability.
Dr Glennon also submitted that Dr Stewart’s evidence is that of a non-expert in aviation medicine, and that she could not offer an opinion of how her findings translated to the Applicant’s flying ability. He perceived that Dr Stewart reported the Applicant had considerable strengths in some areas.
Dr Glennon submitted that similarly, Associate Professor Rosenfeld was a non-expert in aviation medicine. He submitted however, that Associate Professor Rosenfeld is expert in cognitive issues and functioning in the elderly. He noted that Associate Professor Rosenfeld has found the Applicant’s working memory not impaired, and further that Dr Stewart had found Mr Randazzo’s executive functioning unimpaired.
Amongst other matters, Dr Glennon raised the positive comments of the pilots who accompanied Mr Randazzo on flights during late 2011 and early 2012 (which we have noted below).
In summary, Dr Glennon submitted that the Applicant had undergone extensive testing as required by CASA, both medically and as to his flying. He submitted that the events leading to the suspension of his Medical Certificate on 8 July 2011 were simply due to a communications breakdown because of a radio malfunction, and that hypoxia was not an issue.
Dr Glennon submitted that CASA, in relying on Dr Stewart’s report had imposed additional and draconian conditions without being able to base the impact of whatever weakness was found on Mr Randazzo’s function in the air.
Dr Glennon submitted that Mr Randazzo accepted the conditions as imposed by the Tribunal in its June 2011 decision, and agreed to an annual test of his cognitive state.
THE RESPONDENT’S SUBMISSIONS
Ms Bennett submitted that the Respondent relied on its Statement of Facts and Contentions supplemented by her oral submissions. She told the Tribunal that the incident of 24 June 2011, on the basis of which the decision was made to suspend Mr Randazzo’s Medical Certificate, was taken on the basis of the ESIR safety report, and was the catalyst for a number of medical reports which CASA requested of the Applicant. She noted there had been a delay in Mr Randazzo providing reports, (the cardiologist’s reports had still not been updated), and that the decision to restore the Medical Certificate with further Conditions was made on the basis of the medical evidence provided by the Applicant.
In doing so, Ms Bennett referred to the Respondent’s Statement of Facts and Contentions at paragraph 8, where CASA had detailed the areas to be reported by the neuropsychologist, and also requested a report regarding the meningioma (paragraph 16).
Ms Bennett noted that neither Dr Stewart nor Associate Professor Rosenfeld were experts in aviation, and that there was no disagreement between them that Mr Randazzo was fit for day-to-day life on the ground. She submitted that by contrast, Dr Fitzgerald was an aviation medicine specialist.
Ms Bennett submitted that the Applicant’s complaints of difficulties in arranging safety pilots to fly with him, and the cost arising from such a condition, were not relevant, as the safety of aviation was the primary concern. She submitted that Mr Randazzo does not meet the medical standards outlined in regulation 67.150 and 67.155.
THE TRIBUNAL’S CONCLUSIONS
CASA’s role, pursuant to section 9A of the Civil Aviation Act 1988 (the Act), is to ensure the safety of air navigation. Accordingly, the Tribunal, when carrying out this review and exercising powers under the Act, the CASR and CAR, to make the correct or preferable decision in this matter, must treat the safety of air navigation as the most important consideration.
In order to make the correct or preferable decision, the Tribunal must decide:
a) whether the Applicant meets the medical standard for the issue of a Class 2 Medical Certificate; if not,
b) whether the extent to which the Applicant fails to meet that standard is likely to endanger the safety of air navigation, and if so;
c) whether any conditions could be imposed upon Medical Certificates which would ameliorate the threat posed to air safety by the Applicant's failure to meet the Class 2 medical standards.
In doing so, we have accepted that neither the Applicant nor the Respondent take issue with the fact that the medical conditions discussed in the Tribunal’s previous decision, and the Conditions imposed by the Tribunal in 2011, referred to as Part A – Existing Conditions on the Class 2 Medical Certificate, should be affirmed.
Whether the Applicant meets the medical standard for the issue of a Class 2 Medical Certificate, and whether the extent to which the Applicant fails to meet that standard is likely to endanger the safety of air navigation
We have already dealt above, and in Randazzo v CASA (supra), with the Part A Conditions imposed by the Tribunal on 1 June 2011. There was no argument that Mr Randazzo did not, on the basis of existing medical conditions in 2011, meet the standard for the issue of a Class 2 Medical Certificate. What we needed to consider was the effect of the further medical conditions identified following 1 June 2011.
The medical standard for the issue of a Class 2 Medical Certificate in respect of the Applicant's medical conditions, which have been identified since 1 June 2011, being impaired neuropsychological functioning, (and possibly meningioma), follow as relevant (Table 67.155 of the CASR):
Abnormalities, disabilities and functional capacity
2.1 Has no safety-relevant condition of any of the following
kinds that produces any degree of functional incapacity or a risk of incapacitation:
(e) an abnormality;
(f) a disability or disease (active or latent);
(g) an injury;
(h) a sequela of an accident or a surgical operation2.2Has no physical conditions or limitations that are safety-relevant
In that regard, we refer to the medical evidence before us which Mr Randazzo submitted as a result of CASA’s request. Dr Stewart, a Clinical Neuropsychologist, examined Mr Randazzo, and reported at T13. Associate Professor Rosenfeld, Geriatrician and Physician produced a report (Exhibit A4). He also gave oral evidence at the hearing. Dr Keller, a DAME, produced a report which was Exhibit A2.
Dr Stewart, Clinical Neuropsychologist
Dr Stewart’s report was at T13. She did not give oral evidence. She reported that on interview, Mr Randazzo was alert, cooperative, and fully orientated in time, place and person. She recounted Mr Randazzo’s medical history in her report, and described the tests she carried out, being 10 subtests of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). Dr Stewart reported in summary that on tests making up the Brief Cognitive Status Exam (BCSE), that is orientation, naming, mental control, planning/visual perceptual processing, verbal productivity, and inhibitory control, Mr Randazzo’s performance was well within the average range.
Other significant findings in the report included:
Paragraph 5.2 – His neuropsychological performance was characterised by slowed information processing speed. This fell well below expectations based on general ability, general intellectual ability and in comparison with individuals of his own age. He performed better on a test of language processing speed, and in comparison with individuals who were 10 years younger, speed of language processing was rated as falling in the low average range.
Paragraph 5.3 – Immediate memory functioning was performed at a below average range in comparison with age matched normative samples. Similarly, his overall visual memory index was well below expectations in comparison to his general intellectual function and cognitive ability. Poorer performance was apparent on tests of delayed recall for both verbal and visual based tasks.
Paragraph 5.4 – Tests of executive functioning, whilst being generally performed within the average range, were inconsistent. … On other tasks, however, his performance was unimpaired and he performed well on a more challenging test involving strategy formation, abstract thinking and response generation.
Paragraph 5.5 – Working memory was considered a significant strength and well above the performance of age matched normative controls. This suggests that he should not have significant difficulty multi-tasking on divided attention tasks as long as there is not speeded element within the task.
Paragraph 5.6 – There were no other deficits noted on assessment and verbal and non-verbal intellectual functions were within expectations.
Paragraph 5.8 – In the context of no prior complaints of cognitive dysfunction, and none reported by family members, the results alone are suggestive of mild cognitive impairment.
Paragraph 5.9 – Caution must be exercised when predicting flying performance from measures of neuropsychological functioning alone. There is limited documented evidence correlating outcome based on neuropsychological measures with flying (in recreational pilots). There is little therefore known about the predictive ability of current methods. Evidence from high performance and commercial pilots suggests that length and experience of flying can mitigate against the negative effects of some age related changes. The results would be best correlated with real life measures such as simulator trials (if available), records pertaining to recent flying history, neurosurgical opinion and/or other aviation related evidence based measures.
Associate Professor Rosenfeld, Geriatrician and Physician
Associate Professor Rosenfeld’s report dated 22 March 2012 was before the Tribunal as Exhibit A4. He gave oral evidence by telephone. He too mentioned Mr Randazzo’s personal and medical history. Associate Professor Rosenfeld reported that on examination, he found Mr Randazzo alert and oriented. He also stated in his report that he found Mr Randazzo’s cognitive function well preserved and on his testing, there was no evidence of significant problems or functional issues.
Associate Professor Rosenfeld referred to the MMSE which had been carried out, and stated that he was only able to identify mild dysfunction that in his opinion was likely to be of no clinical or functional significance in day-to-day activity or function. He also noted that the mild dysfunction together with Mr Randazzo’s history and MRI findings were likely however, to be indicative of early, subclinical brain disease, which although not clinically or functionally significant at the present time, could presage the presence of early progressive brain disease. In Mr Randazzo’s case, he considered that would likely be on the basis of underlying vascular disease. In his oral evidence, Associate Professor Rosenfeld reiterated that Mr Randazzo exhibited evidence of some underlying vascular disease, emphasised that any effects did not presently cause functional problems, and postulated that perhaps the fact of being 75 years old was significant.
Associate Professor Rosenfeld was asked about hypoxia, but as that was excluded as a cause of concern for what occurred on 24 June 2011, we have not made further comment about that in these Reasons for Decision.
In cross-examination Associate Professor Rosenfeld was referred to Dr Stewart’s report on which he had made comment in his report. In that regard we noted Dr Stewart’s findings on Mr Randazzo in relation to speed of processing information being borderline in paragraph 4.11 of her report, and Associate Professor Rosenfeld’s comments in paragraph 6.2.1 of his report. We noted that understandably Associate Professor Rosenfeld had selected the more positive findings in regard to the qualities Mr Randazzo exhibited when tested.
Associate Professor Rosenfeld referred in his report, to Dr Stewart’s report and findings, as follows:
As indicated in Dr Stewart’s report the prediction of flying performance from neuropsychological testing is imprecise and specifically that ‘Caution must be exercised when predicting flying performance from measures of neuropsychological functioning alone’. I am in agreement with her views in this regard.
Associate Professor Rosenfeld gave analogies between testing older citizens for driving motor vehicles by testing them on the road, and comparing that single test to an occupational therapist who might also assess the person in the home which was a more complete way of observing and testing.
Dr Keller, DAME
Dr Keller, a DAME noted Mr Randazzo’s previously dealt with physical conditions in his report. He mentioned age related ischaemic gliosis and the results of the neuropsychological assessment in particular. In regard to the latter, he observed that it was characterised by: slowed information processing speed, immediate memory functioning was performed at a below average range, poorer performance was apparent on tests of delayed recall for both verbal and visual based tasks. Dr Keller noted that the results of both the ischaemic gliosis and the neuropsychological assessment were not surprising given Mr Randazzo’s age, although he noted that some of his areas of functioning are below those expected for the population average.
Dr Keller remarked that both the ischaemic gliosis and neuropsychological assessment were carried out at sea level, but that the effects are likely to be increased at altitude or with increasing age, and noted that annual testing may be required.
In replying to the question that he consider whether the effects of altitude would be wholly overcome by an adequate oxygen supply, Dr Keller opined that as the medical conditions did not clearly make Mr Randazzo incapable of flying, a practical test of performance under all the expected conditions could add clarification on fitness to fly.
The Tribunal
In coming to a view about Mr Randazzo’s cognitive situation, we have addressed the questions we need to answer regarding whether Mr Randazzo meets the medical standard for the issue of a Class 2 Medical Certificate, and if not, whether the extent to which he fails to meet that standard is likely to endanger the safety of air navigation.
In the Tribunal’s previous decision, the Part A Conditions were imposed because Mr Randazzo did not meet the medical standard for the issue of a Class 2 Medical Certificate. Those Conditions were not the subject of discussion at this hearing. They remain in place, and have been referred as the Part A Conditions.
For purposes of this matter, we must now consider whether the extent to which Mr Randazzo fails to meet the standard is likely to endanger the safety of air navigation, and whether further Conditions need to be imposed. In order to consider Mr Randazzo’s cognitive situation, we have taken into account the opinions and findings of Dr Stewart, Associate Professor Rosenfeld, Dr Keller and Dr Fitzgerald. Of the four practitioners, only Dr Fitzgerald, who readily agreed that he is not a neuropsychologist, is, however, the only medical practitioner before us who is a specialist in aviation medicine.
Dr Stewart and Associate Professor Rosenfeld agreed upon Mr Randazzo’s medical background, and found him alert, cooperative, and fully orientated in time, place and person.
It is important to also note that both Dr Stewart and Associate Professor Rosenfeld agreed that the prediction of flying performance from neuropsychological testing is imprecise, and both specifically noted that caution must be exercised when predicting flying performance from measures of neuropsychological functioning alone. We noted that Dr Keller agreed with Dr Stewart and Associate Professor Rosenfeld that a practical test of performance under all expected conditions could add clarification on fitness to fly.
In that regard we noted that Mr Randazzo recently underwent testing in the air pursuant to regulation 5.81 of the CAR, and passed his licence renewal test, flying with a CASA approved check pilot. The test was conducted at 8,000 feet, so no oxygen was required. We also had recent reports from accompanying safety pilots, which are mentioned elsewhere in these Reasons for Decision, finding Mr Randazzo’s performance in the air, satisfactory.
We noted that Associate Professor Rosenfeld gave analogies between testing older citizens for driving motor vehicles by testing them on the road, and comparing that single test to an occupational therapist who might also assess the person in the home, which was a more complete way of observing and testing. We were interested to hear Associate Professor Rosenfeld’s views, but are satisfied that the risks associated with driving a car, even on a highway at high speed cannot be compared directly with flying, where an ability to respond quickly to novel and unusual situations is essential.
We moved then to consider the findings of the neuropsychological testing. The detailed results are in Dr Stewart’s report, and a summary of her findings are above. In summary Dr Stewart has found that on tests making up the Brief Cognitive Status Exam (BCSE), that is orientation, naming, mental control, planning/visual perceptual processing, verbal productivity, and inhibitory control, Mr Randazzo’s performance was well within the average range.
She also found significantly that:
Mr Randazzo’s neuropsychological performance was characterised by slowed information processing speed which fell well below expectations based on general ability, general intellectual ability and in comparison with individuals of his own age.
Immediate memory functioning was performed at a below average range in comparison with age matched normative samples, and overall visual memory index was well below expectations in comparison to his general intellectual function and cognitive ability.
Tests of executive functioning, whilst being generally performed within the average range, were inconsistent, although on other tasks his performance was unimpaired and he performed well on a more challenging test involving strategy formation, abstract thinking and response generation.
Working memory was considered a significant strength and well above the performance of age matched normative controls, suggesting that he should not have significant difficulty multi-tasking on divided attention tasks as long speed was not a factor.
Verbal and non-verbal intellectual functions were within expectations.
Dr Stewart found that the results were suggestive of mild cognitive impairment. Associate Professor Rosenfeld’s view of the results was that he was only able to identify mild dysfunction that in his opinion was likely to be of no clinical or functional significance in day-to-day activity or function. He also noted that the mild dysfunction together with Mr Randazzo’s history and MRI findings were likely to be indicative of early, subclinical brain disease, which although not clinically or functionally significant at the present time, could presage the presence of early progressive brain disease. In Mr Randazzo’s case, he considered that would likely be on the basis of underlying vascular disease.
Dr Fitzgerald told the Tribunal that in coming to the decisions he did, he relied upon Dr Stewart’s findings that Mr Randazzo’s information processing was slower than it should have been, and that in a high pressure environment such as in aviation, that was of overarching concern. He also said that in order to make quick decisions, cognitive ability and capacity beyond that Mr Randazzo exhibited was required. He reiterated that slow processing of information was Dr Stewart’s prime finding, and that in aviation that was of primary importance.
Based on Dr Stewart’s findings, and the opinions of Drs Stewart, Fitzgerald, and Associate Professor Rosenfeld, we were satisfied to conclude that Mr Randazzo’s mild cognitive impairment characterised by slowed information processing which is likely, given his age, to progress, did not impair his day to day living. However, in a high pressure environment such as in aviation, that was of overarching concern in that unusual and unexpected situations arise rapidly which require quick reaction by the pilot. Conditions to address that situation had to be considered.
The Atrial Fibrillation
Dr Eggleton has been Mr Randazzo’s cardiologist for some years. His most recent reports of 10 October 2011 (Exhibit R3), and 2 November 2011 (Exhibit R4), were before us. As Mr Randazzo has experienced atrial fibrillation for approximately thirteen years, and as that had been an issue before the Tribunal on the last occasion, his reports were of significance. We are mindful of Ms Bennett’s submission that Mr Randazzo had not provided an updated three monthly report from Dr Eggleton as required pursuant to the Part A Conditions imposed by the Tribunal on 1 June 2011.
We noted in the Tribunal’s previous decision dated 1 June 2011 that the last episode of atrial fibrillation which Mr Randazzo suffered before the hearing which resulted in that decision, was in February 2010.
In his report of 10 October 2011, Dr Eggleton noted that since last reviewed (date not supplied, but given the Conditions, probably within the three months prior to October 2011), Mr Randazzo had experienced one episode of fibrillation. He noted that Mr Randazzo reported this occurred after he had consumed alcohol and caffeine, and that it settled after a few hours. As well as the brief episode of atrial fibrillation, Dr Eggleton mentioned Mr Randazzo experienced mild exertional dyspnoea.
We noted Dr Eggleton’s evidence from the June 2011 Reasons for Decision where he explained that a change in alcohol and caffeine consumption could reduce, but would not eliminate, the risk of Mr Randazzo suffering atrial fibrillation.
We noted also from the June 2011 Reasons for Decision, the evidence of Drs Eggleton and Drane (of CASA), that the risk of suffering atrial fibrillation increases with age, and that the symptoms of atrial fibrillation increase as altitude increases.
Dr Eggleton noted that Mr Randazzo mentioned that he was suspected of having suffered hypoxia in the air on 24 June 2011, but told Dr Eggleton that it was a malfunctioning radio which had caused the concern.
A month later in November 2011, Dr Eggleton reviewed Mr Randazzo, stating that he was satisfied with his progress. He mentioned a change in medication, and his intention to review Mr Randazzo again in six months.
On the basis of the above medical evidence, we saw no reason to alter the Condition in the Part A Conditions in relation atrial fibrillation except to caution Mr Randazzo to comply with supplying medical reports as directed by the Condition.
The Meningioma
Dr Parkinson is a Neurosurgeon, whose report at T18, was dated 17 August 2011, and dealt with Mr Randazzo’s meningioma. Dr Parkinson reported that the MRI demonstrated a very small 9 mm right temporal convexity dura meningioma which was not producing any significant temporal lobe compression. He reported that there was moderate white matter small vessel disease, a common finding. Dr Parkinson was satisfied that Mr Randazzo was, according to him, neurologically completely normal, with normal cranial nerve examination, and no long tract signs. His view was that Mr Randazzo’s speech was normal, he was alert, oriented and appropriate. He stated that risk of seizure was very low given the lack of cerebral compression and recommended review, and a repeat MRI in a year.
We accepted that recommendation.
We are satisfied in coming to a decision, regarding whether Mr Randazzo meets the medical standard for the issue of a Class 2 Medical Certificate that, based on the above medical evidence, he does not. Accordingly we had to decide whether the extent to which he fails to meet that standard is likely to endanger the safety of air navigation. From the above conclusions we have drawn, we find that the meningioma is causing no present impairment, but requires monitoring, and that Mr Randazzo’s atrial fibrillation is spasmodic und apparently under control, but that the Conditions regarding the atrial fibrillation as documented in the Part A Conditions must remain.
The further concern is in regard to the condition of impaired neuropsychological functioning which we accept from Associate Professor Rosenfeld, is likely to be progressive. We are satisfied from the evidence that the incident on 24 June 2011 arose because Mr Randazzo did not respond to Brisbane Centre for quite a period of time, and that his course altered. We were concerned, but accepted that his non-response is likely to have been as a result of a faulty radio.
However, any impaired neuropsychological functioning, which is likely to be progressive, is of concern. Accordingly, we have considered what if any Conditions should be imposed on Mr Randazzo’s Class 2 Medical Certificate which would ameliorate the threat posed to air safety by his failure to meet the Class 2 medical standards.
Whether any conditions could be imposed upon Mr Randazzo’s Medical Certificate which would ameliorate the threat posed to air safety by the Applicant's failure to meet the Class 2 medical standard
The above consideration brings us to consider the likelihood of any situation arising during flight which would be impacted by Mr Randazzo’s mild cognitive impairment as found by Dr Stewart as a result of her testing, and discussed also by Associate Professor Rosenfeld. As already stated above, Mr Randazzo’s tests showed this was characterized by slowed information processing and other deficits. Working memory, on the other hand, was considered a significant strength, and well above the performance of age matched normative controls. Dr Stewart suggested that Mr Randazzo should not have significant difficulty multi-tasking on divided attention tasks as long as there is not speeded element within the task. We were mindful that speed of reaction in aviation was emphasised by Dr Fitzgerald as an important function.
In coming to a decision, we have taken into account the term likely which when used in the context of aviation Medical Certificates pursuant to Part 67 of the CASR is understood to be reference to a substantial or real and not remote risk of a particular event occurring. We are mindful of a number of decisions where the term has been considered, Re Window v Civil Aviation Safety Authority (1999) 56 ALD 316, Re Hall and Civil Aviation Safety Authority [2004] AATA 21, Mulholland and Civil Aviation Safety Authority [2007] AATA 1952 and White and Civil Aviation Safety Authority (2009) 105 ALD 33.
By way of example, we noted that in Re Window v Civil Aviation Safety Authority, the Tribunal stated:
Having regard to the need to protect public safety while having regard to a person’s entitlement to pursue his or her ambitions, we consider that the word “likely” means “a substantial or real and not a remote chance”. That is not a matter which can be assessed on statistical likelihood and certainly does not mean “more likely than not”, “odds on” or “a more than 50% chance of a thing happening”. To adopt those latter three meanings would, in our view, be to place too little weight on the protection of public safety and too much on an individual’s entitlements.
We have noted Mr Randazzo’s submissions that it is difficult and inconvenient to negotiate a safety pilot, and for that pilot to provide a report to CASA on each occasion, and that it is potentially expensive to do so. Unfortunately the safety of aviation is the paramount consideration, and whilst we are mindful of potential difficulties, we cannot take that submission into account. We note as summarized below that the reports we have regarding Mr Randazzo’s flying were all positive.
Evidence of other pilots, Messrs Ciarliero, Handley, Wordsworth & Greig
Mr Conrad Cesar Ciarliero’s report of conducting an aeroplane flight review with Mr Randazzo pursuant to regulation 5.81 of the CAR was Exhibit A3 dated 15 March 2012. He noted that Mr Randazzo was required to fly as per Appendix B to CAAP 5.81-1(1), and that Mr Randazzo performed all of the required tasks satisfactorily.
We noted that Mr Ciarliero is an appropriate person for the purposes of regulation 5.81 of the CAR.
Mr Bill Handley’s report dated 23 March 2012 was Exhibit A6. He is a well-qualified private pilot and owner of aircraft, and stated that he had flown with Mr Randazzo on a number of occasions during which time he had found his flying skills to be above average.
Mr P Wordsworth provided letters reporting on flying with Mr Randazzo, dated 13 December 2011, 21 December 2011, and 29 December 2011 (T20 & T21). He was positive in all his comments including:
13 December 2011 – In my flying career I have sat in on pilots undergoing flight tests so I have some idea as to the standard required by examiners. I formed the opinion that if Sam was undergoing a flight test that his performance would have been satisfactory to an examiner.
21 December 2011 – (regarding flights on 18 and 19 December 2011) - … satisfactory in all respects.
29 December 2011 – flight encountering some problems - … Sam showed good judgment by aborting the first landing approach due to strong gusty crosswind which at times would have been 17Kts. The subsequent landing was uneventful.
Mr R Greig, also a well-qualified pilot who also acted as a safety pilot for Mr Randazzo produced a report dated 6 March 2012 which was Exhibit A7. He stated that he flew with Mr Randazzo on 24 February 2012 and 25 February 2012. He reported that Mr Randazzo handled the aircraft and all procedures including radio calls without incident. He stated that on both occasions he felt completely safe and comfortable with Mr Randazzo’s flying and procedures.
We were able to conclude from the above, that Mr Randazzo is a competent pilot which has not, in fact, come into question.
We have also noted Mr Ciarliero’s testing of Mr Randazzo for purposes of regulation 5.81 of the CAR. We were mindful that the flight was not conducted above the level of 8,000 feet, and that this is in fact not a requirement.
However, the medical evidence and neuropsychological testing has satisfied us that Mr Randazzo has mild cognitive impairment which is likely to progress with age, and taking into account his vascular condition. We are therefore satisfied that the Conditions imposed on Mr Randazzo’s Class 2 Medical Certificate, being the Part A and Part B Conditions would ameliorate the threat posed to air safety by Mr Randazzo’s failure to meet the Class 2 medical standard.
Accordingly the Tribunal affirms the decision under review.
DECISION
The Tribunal dismisses Mr Randazzo’s application for review of the decision of CASA made on 8 July 2011 suspending his Class 2 Medical Certificate (Matter 2011/3154).
The Tribunal affirms the decision under review, (Matter 2012/1167). The Tribunal affirms that the conditions imposed in Randazzo v Civil Aviation Safety Authority, (CASA) [2011] AATA 375 apply, (the Part A Conditions), as well as, additionally, the Part B Conditions imposed by CASA on 2 December 2011.
THE CONDITIONS
The existing Conditions, (Part A Conditions), on Mr Randazzo’s Class 2 Medical Certificate are affirmed, and are as follows:
“1. Concerning your atrial fibrillation; from 1 June 2011, you must provide CASA with progress reports every three months from your cardiologist detailing:
- any occurrence of atrial fibrillation;
- any symptoms;
- results of stress ECG including rate control;
- 48hr Holter;
- echocardiogram;
- treatment, response to treatment and side effects;
- confirmation of diagnosis; and,
- prognosis, including risk of adverse sequelae (including thromboembolism).
2. Concerning your GIST; from 1 June 2011 you must provide CASA with a (three monthly) report from your oncologist every three months updating:
- the diagnosis;
- results of any investigations (blood tests, scans, etc);
- treatment, response and any side-effects;
- prognosis; and,
- follow-up plan.
3. When your Medical Certificate becomes due for renewal, in addition to the standard renewal medical examination report, you must provide CASA:
- a progress report regarding the GIST from your oncologist including results of recent staging investigations, treatment, side-effects and prognosis;
- a progress report regarding the atrial fibrillation from your cardiologist including results of recent staging investigations, treatment, side-effects and prognosis;
- a copy of your GP medical records and reports for the previous 12 months.
4. You will be responsible for the costs of all the reports.
5. Your aviation medical certificate is to be endorsed Renew by CASA Only. This alerts the Designated Aviation Medical Examiners that only Aviation Medicine can revalidate the certificate after assessment of the required reports.
6. In addition to the above conditions, the other conditions of diabetes, sleep apnoea, dilated aortic root, renal colic require monitoring. CASA therefore requires at the time of your next medical that you provide reports that you usually provide in your application for a medical certificate with respect to these conditions, including:
- endocrinologist report and HbA1cs and ophthalmology report and blood glucose diary;
- sleep physician report;
- CT KUB
- Echocardiogram or CT measurement of the aortic dilation;
Part B additional Conditions relating to medical history since 1 June 2011 are:
7. You must fly with a safety pilot in an aircraft with functional dual controls. The safety pilot must be licensed and endorsed to fly the aircraft being flown by you.
8. Following each flight, the safety pilot must provide a report to CASA of your performance during that flight. The report must be received by CASA within 7 days of each flight which has been undertaken.
Note: The requirements set out in conditions 7 and 8 are due to your documented cognitive deficits on neuropsychological testing and the potential for impairment in such domains and consequent risk to aviation safety the deficits pose.
9. Also required at the time of recertification is an up-to-date neuropsychological report and copy of recent MRI Brain due to your condition of meningioma.
| I certify that the preceding 114 (one hundred and fourteen) paragraphs are a true copy of the reasons for the decision herein of. |
.......[sgd].................................................................
Associate
Dated 4 May 2012
| Dates of hearing | 26 & 27 March 2012 |
| Counsel for the Applicant | Dr B Glennon |
| Solicitors for the Applicant | Mr D English, Paul A. Curtis & Co Solicitors |
| Solicitors for the Respondent | Ms G Bennett, Legal Branch CASA |
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