SAN JOSE, California — A federal jury in San Jose has ordered American Airlines to pay $9.6 million to a California couple after determining that cabin and cockpit crews failed to follow company medical procedures during a November 2021 flight from Miami to Madrid. The high-profile verdict, handed down late Thursday, instantly became one of the largest recent personal-injury awards linked to in-flight medical care—and it offers a stark reminder for travelers departing the Bay Area and beyond that even routine trans-Atlantic journeys can turn into life-altering events.
What happened on Flight AA 685?
Court documents show that 67-year-old chef Jesús Plasencia experienced a transient ischemic attack—often called a “mini stroke”—just minutes before boarding the overnight Miami–Madrid service. His wife, Ana María Marcela Tavantzis, alerted a gate agent, a flight attendant, and eventually the aircraft’s captain. The couple’s lawsuit alleges the captain signed off on departure without requesting airport medical assistance, despite an American Airlines policy that instructs crews to consult doctors on the ground via a medical hotline. Roughly halfway over the Atlantic, Plasencia suffered a second, more devastating stroke, leaving him unable to speak or write. Because the crew never contacted the captain about diverting, the wide-body jet continued to Spain, where paramedics met the aircraft on landing. Plasencia spent three weeks in a Madrid hospital before being medically repatriated to the United States. He now requires round-the-clock home care and intensive rehabilitation therapy, the jury was told.
Why the jury said American Airlines was liable
The verdict hinges on the Montreal Convention, an international treaty that governs airline liability for injuries occurring on international flights. By failing to follow its own emergency protocols, jurors concluded, the carrier deprived Plasencia of timely care that might have reduced the severity of his stroke. Although lawyers for Plasencia argued that “every minute matters” when treating a stroke, American Airlines’ defense team maintained that no medical expert could guarantee a different outcome had the flight been diverted. After deliberating less than a full day, the eight-person panel disagreed and awarded $9.6 million to cover medical bills, future care, and emotional distress. In a statement, the airline said, “The safety and well-being of our passengers is our highest priority … we disagree with the verdict and are currently evaluating next steps.” — In a statement, the company said.
Flashback: a history of in-flight medical controversies
This is not the first time the Fort Worth–based carrier has faced scrutiny over the handling of a traveler showing neurological distress. In 2017, American was sued after an elderly passenger at New York’s John F. Kennedy International Airport apparently wandered away from a gate area and into traffic following a suspected stroke-like episode. She was later found unharmed but disoriented. Industry-wide, the Aerospace Medical Association estimates that one medical “event” occurs for every 604 commercial flights worldwide. Most are minor—fainting, mild respiratory issues—but strokes, heart attacks, and severe allergic reactions account for about 7 percent of cases and may require diversion.
What the verdict means for globetrotters
For the average traveler, the San Jose judgment underscores the critical importance of self-advocacy and preparedness. Here are key takeaways if you or a companion experiences a health scare before or during a flight:
- Declare symptoms early. Airlines rely on passenger information to decide whether to call airport medics or activate a telemedicine hotline. Speak up at the first sign of trouble.
- Know the “return to gate” window. Once the doors close, the captain has fewer options. Reporting concerns at the gate, not after push-back, increases the odds of medical evaluation.
- Request ground-based consultation. Major U.S. carriers contract with 24/7 physician hotlines; ask crew to patch through if symptoms escalate.
- Carry medical documents. A summarized history of chronic conditions and prescriptions can help flight surgeons make diversion decisions faster.
- Purchase travel insurance. Overseas hospital stays and medical evacuations can cost well into six figures. Policies that cover pre-existing conditions may offset those expenses.
Understanding the Montreal Convention
Signed by 136 countries, the 1999 Montreal Convention sets uniform rules for air carriers’ liability in cases of death or bodily injury on international routes. While the treaty caps “strict liability” at 128,821 Special Drawing Rights—about $171,000 at current exchange rates—higher awards are possible if negligence is proven, as jurors ruled here. Travelers must file suit within two years of the incident and may choose among several jurisdictions, including the airline’s home base, destination country or the passenger’s primary residence.
FAQ: Airborne medical emergencies
Will a pilot always divert for a serious health crisis?
Not necessarily. Captains weigh the passenger’s condition, proximity to suitable airports, fuel, weather and operational impacts. However, carriers’ manuals typically instruct crews to err on the side of caution when neurological symptoms such as stroke are suspected.
How common is professional medical help on board?
Data from MedAire indicate that about 48 percent of in-flight emergencies involve a volunteer health professional—often a physician traveling as a passenger—before the plane lands.
Are flight attendants trained to spot strokes?
U.S. regulations require annual recurrent training in first aid, CPR and use of onboard emergency equipment. Recognizing stroke symptoms, however, is covered mainly through carrier-specific protocols rather than federal mandates.
Broader implications for airline policy
Aviation-safety consultants say the $9.6 million verdict could spur carriers to tighten training around the shorthand mnemonic “FAST” (Face drooping, Arm weakness, Speech difficulty, Time to call emergency services) and to reinforce the obligation to contact ground physicians before crossing the Atlantic “point of no return.” David Henderson, a Dallas-based pilot and former accident investigator not involved in the case, believes the jury’s finding “will resonate in every chief pilot’s office.” He added that stroke recognition is “eminently teachable” but sometimes downplayed amid security and service priorities.
Looking ahead
Both sides have 30 days to file post-trial motions; American Airlines could appeal to the U.S. Court of Appeals for the Ninth Circuit. For now, the judgment stands as a cautionary tale for the airline industry and for travelers who assume medical backup is automatic once they step aboard a long-haul flight. Whether you are jetting from San Jose to Tokyo or Miami to Madrid, the Plasencia case reminds everyone that medical contingencies begin on the ground—and that a few informed questions at the gate could prove priceless at 35,000 feet. — as a prepared statement from the company said.
