Patient flown 23 hours from US to Chennai for medical treatment, critically ill Bengaluru woman suffered a cardiac failure

 A 67-year-old critically ill woman was being treated at Chennai's Apollo Hospital on Wednesday, after 23 tense hours in an air ambulance that flew her from Portland in the United States to the Tamil Nadu capital with stops in Reykjavik and Istanbul.

It is the longest medical transfer that the International Critical-Care Air Transfer Team has undertaken, said ICAAT's Shalini Nalwad who supervised the complex evacuation that cost about Rs 1 crore.

The woman, whose identity has not been disclosed, was treated in Chennai by Apollo Hospital's senior interventional cardiologist Dr Sai Satish and a team of doctors on arrival in the city, sources told PTI.

The woman from Bengaluru suffered a cardiac failure whilst she was in the US with her family and was admitted to a tertiary hospital there.

"Her health subsequently deteriorated further affecting other organ systems. She went into renal failure and was stabilised on dialysis," Nalwad, who founded ICATT along with Dr Rahul Singh Sardar, told PTI in Bengaluru.

Recapping the details of the medical evacuation, Nalwad said there was a lot of discussion and planning between the treating doctors in the US, their counterparts in Chennai and ICATT members.

"This was going to be a complex ICU management, away from any help at 41,000 feet in most of the journey of 23 hours," she said.

After meticulous planning, July 17 was fixed for flying the woman out of the US and the ICATT sent its flying Intensivist on July 15 to Portland. A thorough bedside assessment was carried out and a transport strategy laid out.

"The biggest challenge in this operation was that the kidneys were completely dialysis-dependent and this therapy cannot be provided in transit. The transit time that they were facing was 23 hours in total, including 19.5 hours on flight alone," the doctor said.

ICATT had been contacted by Apollo's Dr Satish for the transfer.

The operation to shift the patient from Portland to Chennai began at 2.30 pm local time there.

Two super-midsized private jets were involved in flying the woman to India. She was first put on Challenger 605 aircraft which was developed as an intensive care unit (ICU) where three doctors and two paramedics accompanied her to ensure she safely arrived in the country.

She had a halt at Iceland's capital Reykjavik for refuelling and then again took off from there to Istanbul in Turkey to be shifted to another Challenger 605 aircraft. It took off to take a brief halt at Diyarbakir in Turkey and finally reached Chennai, the ICATT founder said.

There was a change in crew at Istanbul on the way and the patient landed at 2 am on July 19 in Chennai. She was handed over at the receiving hospital in the city by ICATT's medical team where her further management immediately commenced, Nalwad said.

According to her, the ICATT has a track record of transferring highly-critical patients, domestically and internationally, over the past five years.

"The ICATT had also transferred the longest air ambulance transfer with a single set of crew during the lockdown from Johannesburg (South Africa) to Chennai. Now, we broke our own record by successfully transferring a critical patient from USA to India," Nalwad said.

During the pandemic, ICATT also transferred the first COVID-19-positive patient by air in a specialized isolation pod from Afghanistan to Hyderabad when there was a global aviation lockdown, she said.

As many as 148 ECMO (extra-corporeal membrane oxygenation) initiation and transfers were done over 18 months where more than 500 COVID-positive critical patients were airlifted.

Shifting patients back from the US to India shows that the latter is rapidly becoming the preferred destination for medical treatment, especially in heart, lung, liver, and kidney management and Chennai has one of the best hospitals in the country, she explained.