FAA Medical after ER visit due to Syncope

P

Pilot S.

Filing Flight Plan
Joined
Jun 5, 2024
Messages
4
Display Name
Display name:
Pilot S.
Hello everyone, I am new to the forum. I am currently a private pilot at a collegiate part 141 flight school and am very close to receiving my instrument rating. I had a few questions regarding a medical incident and subsequent ER visit I had.

Back in October, I had an incident where I unexpectedly started feeling nauseous and lightheaded while sitting down and eating dinner with some friends and I ended up passing out. I only passed out for a few seconds and felt fine after drinking some water. My friends then drove me to the ER where I informed the staff that I had passed out. My blood pressure and heart rate were then taken by a nurse. I waited in the ER for a long period of time and I eventually chose to leave the ER without being seen by a doctor since it was getting really late and I was feeling fine.

I recently opened my patient portal with my hospital and saw that my ER visit from October was logged on my medical record and the reason was listed as syncope. It also says in the ER visit record that I had left without being seen after triage. I have no history of passing out prior to this and I haven’t had any incidents since. I’m not sure why I passed out that evening, but I suspect it may have been either due to dehydration since I remember I didn't really drink much water throughout the day prior to dinner, or a reaction to something in the food, though I have no food allergies to my knowledge.

I have 3 more years until my medical fully expires and I have to reapply for a new medical. It is my understanding that any unexplained loss of consciousness is considered a disqualifying condition by the FAA. Do I have to report this visit on the medxpress form even though I wasn’t actually seen or officially diagnosed by a doctor? Was I supposed to have reported it to the FAA then or do I need to report it now? Will I lose my medical and have to get a special issuance? Should I consult with an AME prior to reapplying? As I stated before, I am about to receive my instrument rating, so as you can imagine, I have already put a lot of money and hours into my training. It has always been my dream to fly for an airline one day and I don’t want it to be ended by what seems to be an isolated freak incident. I am otherwise perfectly healthy.

Any advice on this would be greatly appreciated!
 
Keep in mind that you have to answer yes or no to a series of questions in the "have you ever in your life" box that includes "dizziness or fainting spell" as well as "unconsciousnes for any reason", both of which by your own statements did occur, and the listing of syncope on your hospital record records that in indelible ink. Unfortunately, the only mistake you made was to leave the ER and leave a trail with a coded diagnosis, and the nurse's recording of normal heart rate and blood pressure doesn't eliminate all of the many possible conditions you went there for.

Personally, with a career at stake I would not want that ER visit to turn up any time in your career, because it can undo everything you've worked for to get to that point. You definitely need to report it on your next physical (you didn't need to report it when it happened), and in the FAA's eyes you should have self-grounded between medicals until you were able to meet the qualifications of the medical you held at the time.

I think your question needs further unraveling by one of the AMEs on this board or elsewhere, but keep in mind those visits do also need to be reported, so you can hope for an explanation and documentation of the syncope that is acceptable to the FAA.
 
Thank you for your response. I plan to do a consultation with an AME at some point as I feel that may be my only option right now. I do regret leaving the ER before being seen because then at least it could have been cleared as something benign by a doctor, and it's likely I killed my flying career by doing that.
 
Google "FAA syncope disposition table" and that will tell you what the FAA is looking for.
 
I'm too lazy to look at the form, but if it merely asks if one has been dizzy, they should print the box as checked, because who hasn't?
 
Aviator4922 said:
Google "FAA syncope disposition table" and that will tell you what the FAA is looking for.
Click to expand...
I took a look at that and it looks like I might have to get a special issuance at best. How long do those usually take to get? Should I try to get it now or wait until my current medical lapses?
 
Needs: Stress treadmill to HR ((220-YourAge)*0.9) and nine minutes
Echocardiogram
24 hour rhythm monitor
Cardiologist's office visit in which he discusses the event.

Depending on circumstances and description of event per Cardiologist, you MIGHT still need a neurology Consult.

B
 
Posters are reminded that the use of anonymous accounts here is only permitted for the person asking questions. Anonymous responses will not be approved.
 
dans2992 said:
Apparently the FAA would prefer that you didn’t go to the hospital…. :/

Like it or not, that’s what this system is encouraging.
Click to expand...
The system really is broken. I am a young and perfectly healthy individual who was previously able to get an unrestricted first class medical and now I may be fighting for my career because of an isolated incident.
 
Pilot S. said:
The system really is broken. I am a young and perfectly healthy individual who was previously able to get an unrestricted first class medical and now I may be fighting for my career because of an isolated incident.
Click to expand...
Look at it as "punishment" for impulsive actions (like leaving the ER after syncopal episode) and be thankful that it wasn't an undiagnosed condition that could have killed you on the way home.

The FAA is not wild about impulsivity either, and lists it as one of the five hazardous attitudes.
 
Last edited:
dans2992 said:
Apparently the FAA would prefer that you didn’t go to the hospital…. :/

Like it or not, that’s what this system is encouraging.
Click to expand...
Totally false. The OP had a serious medical incident for which he did NOT seek treatment. How is he or the FAA to know that he's not going to have a syncopal episode behind the yoke?

And the incident would have been reportable regardless of whether he went to the ER.

However, if he'd been treated, and the cause was determined to be severe dehydration, this would be a nothing burger. BTDT.
 
Agree.There's dizziness from spinning around on a playground and there's dizziness from a serious underlying cause, like cardiac event, inner ear pathology, central nervous system pathology, medicinal side effect, etc., etc. The OP had the wisdom to seek medical attention to investigate those possibilities but not the wisdom to stick around when he did, and that uncertainty is a big concern to the FAA if and when they find it. But the visit does need to be reported on the next applicatiion for renewal of a medical certificate, and when CAMI requests additional documentation they hold your medical certificate until you comply.

One thing to remember is that even if you try to dodge the discovery this time, the visit may appear in some medical records for a future unrelated visit as past medical history, and that might not happen until you are a captain on an airliner, which puts your career in jeopardy at that point.

The FIRST thing I would do is get the actual medical record of your ER visit (the same record that the FAA might request), then take Dr. Chien's advice above. I don't think you'll need a career change if you handle this correctly now.
 
And if it is actually something medical, better to find out early then later to get it treated.
 
Back
Top