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#pensacola airport transportation
pcbshuttle · 1 year
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The Advantages Of Airport Taxi Services
Although several people choose to drive themselves or take the airport shuttle to get to the airport, there is something about hiring taxi service to Panama City Beach Airport, ECP. Most people might not even see these as benefits, but they indeed are. Here are some for the main benefits of hiring airport taxi services: • When you hire from a reputed taxi service, you can be sure that the car will arrive in time, at the location that you specify. The car will be clean and comfortable and you can even book in accordance with the size you want. So, if it is just you travelling, you can hire a small car and if you are travelling in a large group, you can even book a van! You will not have to go looking, because the service provider will take care of it all. • If you know who to contact, getting airport transportation to Northwest Florida Beaches International Airport, ECP should be super easy. The car that meets your requirement will arrive at a time you specify; the driver will assist you in stacking all the luggage in a neat and safe manner and then take you directly to the terminal. Once you reach, they will also help you unload the luggage and send you off with a smile! • Choose to hire airport transportation to Tallahassee International Airport, TLH from a reliable service provider and you can be assured of the safety. Even if women or children are travelling alone, with a reputed taxi service provider, there is generally nothing to worry about. • And then there is the most important aspect – when you hire a taxi service, you can just sit back and relax all the way to the airport. There is no worry about parking the vehicle or where to stop; the driver will ensure that you are dropped, exactly where you need to be! With PCB Shuttle, airport transportation to Pensacola International Airport, PNS will become a breeze, so try it out the next time you are off on a voyage!
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petnews2day · 2 years
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TSA Finds Gun Stuffed Inside Holiday Bird
New Post has been published on https://petnews2day.com/pet-news/bird-news/tsa-finds-gun-stuffed-inside-holiday-bird/
TSA Finds Gun Stuffed Inside Holiday Bird
At Fort Lauderdale’s airport, the TSA found a gun hidden inside a Kikiri Quirch baking hen.
getty
The holiday travel season has officially arrived, it seems. Transportation Security Administration (TSA) officers at Fort Lauderdale-Hollywood International Airport found a gun stuffed inside a raw baking hen.
Add it to the more than 700 firearms caught at security checkpoints in Florida airports so far in 2022 – over 120 of which were stopped at Fort Lauderdale’s airport. The Sunshine State, the nation’s most popular tourism destination, accounts for 14% — or about one in seven — of all firearms found at U.S. airports this year.
MORE FROM FORBESTSA: Florida Airports Are Setting Records For Loaded Guns This YearBy Suzanne Rowan Kelleher
“There’s a personal fowl here,” began the TSA’s pun-filled tweet. “The plot chickens as we barrel our way closer to Thanksgiving. For us, it’s a time to be thankful that our officers are always working around the cluck to keep you safe.”
When a TSA officer spots a handgun on the x-ray machine, the screening line comes to a halt while local law enforcement is notified. Local police then takes control of the firearm and removes the traveler and the weapon from the checkpoint.
Regardless of whether the police bring a criminal charge, getting caught with a firearm at an airport checkpoint carries a civil fine of $1,500, according to TSA guidance. If the gun is loaded, then the fine jumps to $3,000. Civil penalties can be much more onerous for repeat offenders, climbing to a potential maximum of $13,910.
Higher penalties can also meted out based upon aggravating factors, such as whether the firearm was carried on the violator’s person, whether the firearm is loaded or if the safety is off. TSA officers will also consider whether the violator took great pains to hide the gun, perhaps behind the lining of a suitcase or inside a hollowed-out bar of soap.
So far this year, the Transportation Security Administration (TSA) has levied more than $20 million in civil penalties against travelers caught with guns at security checkpoints, according to a TSA official. But that has done little to stem the tide of a record-breaking number of guns ending up at airport checkpoints. With the busy holiday travel season still ahead, the TSA has already caught more than 5,000 guns in 2022, which puts the agency on track to break last year’s record of 5,972 firearms detected at checkpoints.
The TSA regularly posts its “good catches” on social media, often tucked alongside corny jokes.
“Take for instance this ‘hen you believe it?’ find at Fort Lauderdale-Hollywood International Airport,” the tweet continued. “We hate to beak it to you here, but stuffing a firearm in your holiday bird for travel is just a baste of time. This idea wasn’t even half-baked; it was raw, greasy, and obviously unsupervised. The only roast happening here is this poor packing choice!”
With about eight weeks left in 2022, records have already been set at 12 Florida airports. Orlando International Airport (MCO), the gateway to the Disney World and Universal Orlando theme parks, tops the list with 129 intercepted guns to date this year. Last year, TSA found 124 guns at Orlando airport in the entire year, as Disney World also saw a spike in concealed firearms.
MORE FROM FORBES$52 Million In TSA Fines Hasn’t Stopped Travelers Bringing Loaded Guns To Airport SecurityBy Suzanne Rowan Kelleher
Among other major airports in the state, so far this year the TSA has stopped 102 guns at Tampa International (TPA), 83 guns at Miami International (MIA), 58 guns at Jacksonville International Airport (JAX), 37 guns at Southwest Florida International (RSW), 28 at Palm Beach International (PBI), and 24 at Pensacola International (PNS).
According to the TSA, “nearly every gun” stopped at Florida airport checkpoints was loaded and most had ammunition chambered.
Guns, ammunition and gun parts are prohibited beyond airport security checkpoints. Passengers may legally travel with their firearms, but only if they are packed, unloaded, in a locked hard-sided case in checked luggage and declared with the airline before the flight.
“Feather you like it or not, there are rules for traveling with guns and ammunition,” the agency counseled on Twitter. “So, don’t wing it.” The post included a link to the TSA’s guidance on how to legally transport firearms.
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pinerjournal · 2 years
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Warbirds over the beach 2016
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Warbirds over the beach 2016 how to#
Warbirds over the beach 2016 generator#
Whilst the Thunderbirds are based at Nellis AFB in Nevada, the Blue Angels are actually based at NAS Pensacola in Florida’s Panhandle. Two of America’s top military aerobatic display teams, the United States Air Force Thunderbirds flying Lockheed (General Dynamics) F-16 Fighting Falcons and the United States Navy Blue Angels flying Boeing (McDonnell Douglas) F/A-18E/F Super Hornets regularly perform at some of Florida’s Air Shows. Air Demonstration Teams visiting Florida in 20 There are plans to re-open as a much larger and more aviation themed attraction in the future. The nearby Fantasy of Flight museum at Polk City used to offer daily (Thursday through Sunday) aerial demonstrations subject to the weather but they shut the main museum to the general public on Apand are currently operating a seasonal interim museum with joy rides in vintage biplanes on the days the museum is open. In the end this was cancelled as well and it now looks like it has been replaced by the Space Coast International Air Show In October 2019 the Board of Directors of the Valiant Air Command museum voted on cost grounds to postpone the 43rd Space Coast Warbird Airshow to 2021 so there was no Space Coast Warbird Airshow in 2020. Air Shows at Florida Air MuseumsĪ couple of Florida’s air museums like the Valiant Air Command at Titusville (Space Coast Warbird Airshow, formerly TICO Warbird Airshow) and the Florida Air Museum in Lakeland (Sun 'n Fun Fly-In and Convention) host annual air shows each Spring. Experimental Aircraft Association (EAA) Ford-Tri-Motor Tourĭue to the COVID-19 pandemic, none of the vintage air tours came to Florida in 2021.Experimental Aircraft Association (EAA) Aluminium Overcast Tour.Commemorative Air Force (CAF) AirPower History Tour.Wings of Freedom Tour by the Collings Foundation.For a fee, you can often get a ride in one of them. This is an opportunity to see real vintage and World War II aircraft in flight rather than just as static museum exhibits. Over the space of a couple of months they visit a number of regional airports throughout the state. Though not air shows as such, there are a number of vintage and warbirds aircraft tours that often visit Florida in the spring. NAS Key West Southernmost Air Spectacular NAS Pensacola Open House, Blue Angels Homecoming Air Show NAS Jacksonville Air Show - Birthplace of the Blue Angels Up Up and Away Florida Hot Air Balloon Festival Wings Over Homestead ARB - POSTPONED UNTIL 2023 NAS Key West Southernmost Air Spectacular - POSTPONED UNTIL 2023 Gator Fly In and Armed Services Appreciation Day Favourite Things To Do In Central Florida.
Warbirds over the beach 2016 generator#
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Warbirds over the beach 2016 how to#
if you ever want to join the "rare and crazy breed" you can always attend one of our jump schools and we'll teach you how to do it! In the mean time look for us to perform at the Mid-Atlantic Air Museum's airshow in June in Reading, Pennsylvania and at the Warbirds Over Monroe event in November in Monroe North Carolina which is Tinker Belle's home town.Īnd. We have been treated very well by everyone at the museum these past years and look forward to returning next year. We were looking forward to a repeat appearance this year as well but it looks like the museum's budget won't allow it. So there is historical precedent for jumping from her. As I'm sure you know, the C-46 was used not only as a transport aircraft flying the "Hump" during WWII but also as a jump platform for the "Operation Varsity" jumps. Tinker Belle is a a great aircraft and her crew and owners are the best. That is why we were outfitted as Fallshirmjaeger but jumped a US aircraft. Last year we were scheduled to do it again but the aircraft had some difficulties so we jumped from Tinker Belle instead (the show must go on.). As far as I know, the only group to make static line parachute jumps from a Ju52 since the war. We do traditionally jump US but a few years ago had the rare privilege of jumping as Fallshirmjaeger from the Museum's Ju52. The same group that has been jumping at this show for several years now. I'm a member of the WWII Airborne Demonstration Team.
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nikkithehoe · 6 years
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Brandy, our newest employee. 
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zabeelinsti02 · 2 years
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The Interesting History of IATA Codes - Who Knew?
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Take a gander at your baggage tag or air waybill and you'll see air terminal codes rather than beginning and objective city names explained. IATA (International Air Transport Association) relegates a three-letter identifier code to each business air terminal on the planet. (Incidentally, articulate it "Eye-ah-ta,") It's no secret the way that IATA concocted BOS for Boston or STL for St. Louis. However, why in the world did it relegate MCI to Kansas City, IAD to Washington Dulles or EWR to IATA Training?
Turns out there was strategy to the frenzy. At the point when they began doling out IATA codes, certain prefixes were saved. The Navy got the "N" prefixes. Naval force pilots train at NPA (Navy Pensacola), for example. Remove the "N" from Newark and EWR appears to be legit. Nacogdoches, TX? OCH.
With few special cases, prefixes starting with "W" or "K" are by and large not utilized for USA air terminals in case they be mistaken for radio broadcast call letters. So IATA Foundation Diploma before Washington Dulles opened they were inclining in the direction of DIA (Dulles International Airport) however at that point understood that it very well may be excessively effectively mistaken for adjacent Reagan (DCA-District of Columbia Airport), particularly when harried cargo agents were jotting chalk letters on stuff trucks. Stick the D toward the end and International Airport Dulles doesn't appear to be so insane.
Some time before the Wright Brothers, the National Weather Service specked stations around the country with two letter city codes. Afterward, IATA embraced a portion of those by just adding a X. That is the reason we could transport from Portland, OR (PDX) to Los Angeles (LAX).
JFK Airport is a unique case in that it changed IATA code from IDL when it changed its name from Idlewild. Typically once a code is doled out, it stays relegated. So in the event that you jump on board a trip to Indianola, MS and have a truly old pilot, you should ensure he doesn't set out toward New York perceiving how Indianola assumed control over Idlewild's disposed of IDL.
An IATA code that beginnings with Y presumably implies your cargo is likely set out toward Canada. In a real sense many Canadian air terminal codes start with Y.
Who needs to be FAT? Fresno Air Terminal wouldn't fret. IATA Training Centre Dubai How would they get CMH out of Columbus? From Columbus Municipal Hangar. Astounded on CVG being Cincinnati? Cincinnati's air terminal really sits across the Ohio River in Covington, KY.
Record MCI for Kansas City under "past the point of no return now." Because of the underlying letter K limitations, the first Kansas City air terminal was MKC (Missouri Kansas City). At the point when they began arranging a major new air terminal somebody concluded that Mid-Continent International sounded pretty darned extravagant and got the MCI assignment. Before the air terminal opened, nearby legislators chose to change the name to Kansas City International so explorers would perceive their fair city. Interim, it was past the time to change the MCI code.
Alright, I've kept you in tension sufficiently long. You're pondering ORD for Chicago O'Hare, right? Halfway (MDW), its cross town rival, was blasting at the creases as the world's most active air terminal in the beginning of business jets. Authorities chose to construct a colossal new air terminal northwest of town where a small airstrip that had been renamed for gallant Navy pilot, Lt. Cmdr. Butch O'Hare. As MCI will vouch, when you get an IATA code transforming it is extremely difficult.
Zabeel Institute isaccredited by KHDA and fully endorsed by students as the best training institute in Dubai
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orbemnews · 3 years
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United Airlines Adds Flights as Travel Demand Rises: Live Business Updates Here’s what you need to know: Most of United’s new flights will connect cities in the Midwest to tourist destinations.Credit…Sebastian Hidalgo for The New York Times United Airlines plans to add more than two dozen new flights starting Memorial Day weekend, the latest sign that demand for leisure travel is picking up as the national vaccination rate moves higher. Most of the new flights will connect cities in the Midwest to tourist destinations, such as Charleston, Hilton Head and Myrtle Beach in South Carolina; Portland, Maine; Savannah, Ga.; and Pensacola, Fla. United also said it planned to offer more flights to Mexico, the Caribbean, Central America and South America in May than it did during the same month in 2019. The airline has seen ticket sales rise in recent weeks, according to Ankit Gupta, United’s vice president of domestic network planning and scheduling. Customers are booking tickets further out, too, he said, suggesting growing confidence in travel. “Over the past 12 months, this is the first time we are really feeling more bullish,” Mr. Gupta said. Airports have been consistently busier in recent weeks than at any point since the coronavirus pandemic brought travel to a standstill a year ago. Well over one million people were screened at airport security checkpoints each day over the past two weeks, according to the Transportation Security Administration, although the number of screenings is down more than 40 percent compared with the same period in 2019. Most of the new United flights will be offered between Memorial Day weekend and Labor Day weekend aboard the airline’s regional jets, which have 50 seats. The airline said it would also add new flights between Houston and Kalispell, Mont.; Washington and Bozeman, Mont.; Chicago and Nantucket, Mass.; and Orange County, Calif., and Honolulu. All told, United said it planned to operate about 58 percent as many domestic flights this May as it did in May 2019 and 46 percent as many international flights. Most of the demand for international travel has been focused on warm beach destinations that have less-stringent travel restrictions. “That is one of the strongest demand regions in the world right now,” Mr. Gupta said. “A lot of the leisure traffic has sort of shifted to those places and it’s actually seen a boom in bookings.” Delta Air Lines issued a similar update last week, announcing more than 20 nonstop summer flights to mountain, beach and vacation destinations. Both airlines have said in recent weeks that they have made substantial progress toward reducing how much money they are losing every day. An outdoor seating area at a Bronx restaurant. The hospitality industry has been hit especially hard by job losses during the pandemic.Credit…Michael Young for The New York Times The labor market’s ability to improve as the economy recovers and the virus recedes will be tested Thursday morning when the government reports the latest data on unemployment claims. Although the pace of vaccinations, as well as passage of a $1.9 trillion relief package this month, has lifted economists’ expectations for growth, the labor market has lagged behind other measures of recovery. At 6.2 percent, the unemployment rate is still nearly three percentage points above where it was in February 2020, before the coronavirus arrived in force. Initial claims, counting regular unemployment insurance and emergency programs, have been at more than one million a week since the fall, partly because some workers have been laid off more than once. Still, the easing of restrictions on indoor dining areas, health clubs, movie theaters and other gathering places offers hope for the millions of workers who were let go in the last 12 months. And the $1,400 checks going to most Americans as part of the relief bill should help spending perk up in the weeks ahead. “We’re expecting to see sharp declines in jobless claims in the coming weeks as the service sector comes back online,” said Rubeela Farooqi, chief U.S. economist for High Frequency Economics. “The labor market will benefit from a reopening, but it will take time for a complete recovery.” Esther George, the president of the Federal Reserve Bank of Kansas City, said she expected inflation to “firm,” given time.Credit…Ann Saphir/Reuters Esther George, the president of the Federal Reserve Bank of Kansas City, says that although the outlook for growth has improved as vaccinations increase and the government rolls out relief packages, the path of the pandemic remains a major question hanging over the U.S. and global economies. “We’re not out of this yet,” Ms. George said in an interview on Wednesday. “It’s hard to know what the dynamics will be on the other side.” Ms. George said she was focused on labor force participation as a sign of the job market’s strength more than the headline unemployment rate, which has fallen to 6.2 percent from a 14.8 percent peak but misses many people who aren’t looking for new jobs after losing theirs during the pandemic. Participation, the share of people working or looking, remains a hefty two percentage points below its prepandemic levels. “That might be the thing I really watch in the coming months,” she said. Ms. George expects inflation to “firm,” but that the process is likely to take a while, she said, and it is “too soon to say” whether it will end with a more meaningful rise. Some prominent economists have begun to warn that prices, which have been low for decades, could rise rapidly as the government spends big and the Fed keeps rates at rock bottom to support the economic recovery. “Wages are a very telling factor in a story about inflation,” Ms. George said. Many economists look for faster growth in compensation as a signal that inflation is sustainable, not just driven by short-lived supply constraints or temporary quirks in the data. Ms. George’s colleagues, including Jerome H. Powell, the Fed chair, have been clear that they expect prices to move higher this year but will not necessarily see that as an achievement of their inflation goal. The Fed redefined its target last year and now aims for 2 percent annual price gains, on average, over time. Ms. George did not venture a guess of when the Fed will hit its three criteria for raising interest rates: full employment, 2 percent realized price gains and the expectation of higher inflation for some time. Some Fed officials expect to raise rates next year or in 2023, but most of them expect the initial increase to come even later. “We are here to help our small businesses, and that is why I’m proud to more than triple the amount of funding they can access,” said Isabella Casillas Guzman, the Small Business Administration’s administrator.Credit…Anna Moneymaker for The New York Times Companies harmed by the coronavirus pandemic can soon borrow up to $500,000 through the Small Business Administration’s emergency lending program, raising a cap that has frustrated many applicants. “The pandemic has lasted longer than expected,” Isabella Casillas Guzman, the agency’s administrator, said on Wednesday. “We are here to help our small businesses, and that is why I’m proud to more than triple the amount of funding they can access.” The change to the Economic Injury Disaster Loan program — known as EIDL and pronounced as idle — will take effect the week of April 6. Those who have already received loans but might now qualify for more money will be contacted and offered the opportunity to apply for an increase, the agency said. The Small Business Administration has approved $200 billion in disaster loans to 3.8 million borrowers since the program began last year. Unlike the forgivable loans made through the larger and more prominent Paycheck Protection Program, the disaster loans must be paid back. But they carry a low interest rate and a long repayment term. Normally, the decades-old disaster program makes loans of up to $2 million, and in the early days of the pandemic, the agency gave some applicants as much as $900,000. But it soon capped loans at $150,000 because it feared exhausting the available funding. That limit — which the agency did not tell borrowers about for months — angered applicants who needed more capital to keep their struggling ventures alive. The agency has $270 billion left to lend through the pandemic relief program, James Rivera, the head of the agency’s Office of Disaster Assistance, told senators at a hearing on Wednesday. Jane Fraser in 2019. “The blurring of lines between home and work and the relentlessness of the pandemic workday have taken a toll on our well-being,” she told Citigroup employees.Credit…Erin Scott/Reuters Complaints of “Zoom fatigue” have emerged across industries and classrooms in the past year, as people confined to working from home faced schedules packed with virtual meetings and often followed up by long video catch-ups with friends, reports Anna Schaverien of The New York Times. But Citigroup, one of the world’s largest banks, is trying to start a new end-of-week tradition meant to combat that fatigue: Zoom-free Fridays. The bank’s new chief executive, Jane Fraser, announced the plan for in a memo sent to employees on Monday. Recognizing that workers have spent inordinate amounts of the past 12 months staring at video calls, Citi is encouraging its employees to take a step back from Zoom and other videoconferencing platforms for one day a week, she said. “The blurring of lines between home and work and the relentlessness of the pandemic workday have taken a toll on our well-being,” Ms. Fraser wrote in the memo, which was seen by The New York Times. No one at the company would have to turn their video on for any internal meetings on Fridays, she said. External meetings would not be affected. The bank outlined other steps to restore some semblance of work-life balance. It recommended employees stop scheduling calls outside of traditional working hours and pledged that when employees can return to offices, a majority of its workers would be given the option to work from home up to two days a week. Tribune Publishing’s board recommended that shareholders approve a purchase offer from the hedge fund Alden Global Capital over a higher bid from a Maryland hotel executive, according to a securities filing Tuesday. Alden, Tribune’s largest shareholder, agreed last month to buy the rest of the company at $17.25 per share and take it private in a deal that would value the company at $630 million. Last week, Stewart W. Bainum Jr., a hotel magnate, made an $18.50 per share offer for the whole company. Source link Orbem News #adds #airlines #Business #demand #flights #Live #rises #Travel #United #Updates
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bisrsrch · 4 years
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In North America, the U.S. is a prominent country in North America which is actively looking to modernize/upgrade the aircraft that can address a range of missions; this in turn, provide MRO service providers with new revenue streams over the next decade. North America is poised to maintain noteworthy aviation traffic growth, especially in domestic markets which enable MRO and network operators to continuously invest in hub strength in the form of increased capacity and airport improvements. For instance, in June 2018, ST Engineering Aerospace introduced a new airframe MRO facility in Pensacola, Florida, U.S at a cost of $46 million, in order to carry out heavy and line maintenance along with aircraft modification work.
MRO providers and airlines generally purchase used serviceable material (USM) from various traders at distinct prices, and many times, the cost of a used part may exceed that of a new component depending on the supply and demand for a particular component or part at the time of the transaction. Thus, there is no formal mechanism existing to access the value of used parts today. In order to deal with such circumstances, the International Air Transport Association (IATA) has taken initiatives to prepare a web-based pricing model which provide aftermarket players and airlines to real-time access to transparent market values for aircraft components, considering availability and delivery times for different parts and equipment. Such model enables the airlines and MRO providers to save material cost up to 10-15% and hence provide more opportunities for MRO providers to retain significant value from cost-effective and regular services.
For Sample Report, Click here: https://bisresearch.com/requestsample?id=841&type=download
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sentinelchicken · 7 years
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Several years ago visiting Pensacola, the door to one of the restoration hangars was open so I peeked in and got this shot of the Consolidated PB2Y Coronado under restoration- today it’s on display inside the National Naval Aviation Museum. Note the four-bladed props inboard and three bladed ones on the outboard engine. The first PB2Y Coronados had three bladed propellers on all four engines. However, operational experience had shown that the inboard props were subject to more pitting and corrosion caused by the spray thrown up by the Coronado’s hull on landings and takeoffs. Since the outboard engines were further away, they weren’t as badly damaged by repeated spray exposure. As a result, the inboard engines on the Coronado fleet were refitted with four bladed props that were several inches shorter and less impacted by the spray. A smaller propeller with a fourth blade generated the same propulsive force as the larger original three bladed propellers which remained on the outboard engines. Note also the bomb bays in the wings behind the engine nacelles. In January and February 1944, the PB2Ys of VP-13 and VP-102 were assigned to conduct bombing raids on Wake Island which was occupied by the Japanese. VP-13 would attack with 13 Coronado aircraft at low level followed 25 minutes later by VP-102’s Coronados attacking from 8000 feet. Four such attacks were made the by the PB2Ys of both squadrons. For the most part, though, the Coronado fleet was used as transports as their range was actually shorter than that of the aircraft they were supposed to replace, the PBY Catalina. Ten PB2Ys were sold to the RAF, but they found the Short Sunderland to have better range and those RAF Coronados served in transport roles during the war. The Coronado on display at the National Naval Aviation Museum is the sole surviving example. | October Aviation Photo Challenge | @kjdphoto1971 | #1017planes | “Night at the Museum” | Day 13 | #avgeek #aviation #aircraft #planeporn #KNPA #NPA #NASPensacola #Pensacola #NationalNavalAviationMuseum #airport #Florida #Consolidated #PB2Y #Coronado #flyingboat #mil_aviation_originals #instaaviation #Avgeekery #AvgeekSchoolofKnowledge (at National Naval Aviation Museum)
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technologyinfosec · 5 years
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Flight returns because woman wanted better seat
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An American Eagle flight from Florida to Miami was forced to return to the airport after a woman passenger faked an illness mid-air to get a better seat. The woman was taken off the plane and into custody, reported CNN. Within an hour of take-off, from Pensacola in Florida, at 6:26 am on Friday the woman began demanding that she be given a bigger seat, the Pensacola Police Department said. However, when the cabin crew told her they could not offer her better accommodations, the woman became ill. The plane had to return to the airport for emergency medical assistance, according to a statement from the airlines. However, upon arrival it was revealed the woman was pretending to be ill and was asked to get off the plane, police said. The flight to Miami finally departed at 7:41 am while the woman was taken into custody and transported to a mental health facility for evaluation. She was detained under Florida's Baker Act that allows officials to take people into custody who may be impaired due to mental illness. Read the full article
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stephenmccull · 5 years
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How Lifesaving Organs For Transplant Go Missing In Transit
When a human heart was left behind by mistake on a Southwest Airlines plane in 2018, transplant officials downplayed the incident. They emphasized that the organ was used for valves and tissues, not to save the life of a waiting patient, so the delay was inconsequential.
“It got to us on time, so that was the most important thing,” said Doug Wilson, an executive vice president for LifeNet Health, which runs the Seattle-area operation that processed the tissue.
That high-profile event was dismissed as an anomaly, but a new analysis of transplant data finds that a startling number of lifesaving organs are lost or delayed after being shipped on commercial flights, the delays often rendering them unusable.
In a nation where nearly 113,000 people are waiting for transplants, scores of organs — mostly kidneys — are discarded after they don’t reach their destination in time.
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Between 2014 and 2019, nearly 170 organs could not be transplanted and almost 370 endured “near misses,” with delays of two hours or more, after transportation problems, according to an investigation by Kaiser Health News and Reveal from the Center for Investigative Reporting. The media organizations reviewed data from more than 8,800 organ and tissue shipments collected voluntarily and shared upon request by the United Network for Organ Sharing, or UNOS, the nonprofit government contractor that oversees the nation’s transplant system. Twenty-two additional organs classified as transportation “failures” were ultimately able to be transplanted elsewhere.
Surgeons themselves often go to hospitals to collect and transport hearts, which survive only four to six hours out of the body. But kidneys and pancreases — which have longer shelf lives — often travel commercial, as cargo. As such, they can end up missing connecting flights or delayed like lost luggage. Worse still, they are typically tracked with a primitive system of phone calls and paper manifests, with no GPS or other electronic tracking required.
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Transplant surgeons around the country, irate and distressed, told KHN they have lost the chance to transplant otherwise usable kidneys because of logistics.
“We’ve had organs that are left on airplanes, organs that arrive at an airport and then can’t get taken off the aircraft in a timely fashion and spend an extra two or three or four hours waiting for somebody to get them,” said Dr. David Axelrod, a transplant surgeon at the University of Iowa.
One contributing factor is the lack of a national system to transfer organs from one region to another because they match a distant patient in need.
Instead, the U.S. relies on a patchwork of 58 nonprofit organizations called organ procurement organizations, or OPOs, to collect the organs from hospitals and package them. Teams from the OPOs monitor surgeries to remove organs from donors and then make sure the organs are properly boxed and labeled for shipping and delivery.
From there, however, the OPOs often rely on commercial couriers and airlines, which are not formally held accountable for any ensuing problems. If an airline forgets to put a kidney on a plane or a courier misses a flight because he got lost or stuck in traffic, there is no consequence, said Ginny McBride, executive director of OurLegacy, an OPO in Orlando, Florida.
Ginny McBride, executive director of OurLegacy, an OPO in Orlando, Florida(JoNel Aleccia/KHN)
In an era when consumers can precisely monitor a FedEx package or a DoorDash dinner delivery, there are no requirements to track shipments of organs in real time — or to assess how many may be damaged or lost in transit.
“If Amazon can figure out when your paper towels and your dog food is going to arrive within 20 to 30 minutes, it certainly should be reasonable that we ought to track lifesaving organs, which are in chronic shortage,” Axelrod said.
For years, organs were distributed locally and regionally first, a system that resulted in wide disparities in organ waiting times across the country. In recent years, UNOS officials and the transplant community, with federal urging, have been working, organ by organ, to restructure how it’s done.
Amid those ongoing efforts to allocate organs more fairly — and, recently, a Trump administration effort to overhaul kidney care — the waste of some of these precious resources donated by good Samaritans has been overlooked. Last year, an average of nine people a day died while waiting for a new kidney.
Donor families and waiting patients may never know what’s happened to an organ provided by a loved one or why a surgery is canceled at the last minute.
“We have been unaware of how many kidneys have been waylaid,” said McBride, of the Orlando procurement agency. “That’s not a number that’s been transparent to us.”
But, she added, she’s aware of the risk: “I say a prayer and hold my breath every time a kidney leaves our office.”
46 Minutes To Spare
In October, a kidney en route from McBride’s OPO in Florida to a patient in North Carolina missed its connection in Atlanta. The box was prominently marked as a human organ and displayed a phone number to call. Apparently unaware of the urgency, a Delta cargo worker merely set it aside for a later flight.
The waiting transplant surgeon in Greensboro, North Carolina, “was having a fit,” said Kim Young, the OurLegacy organ recovery coordinator. If the kidney didn’t get to the hospital by 7 a.m., he wouldn’t be able to use it. Both the risk of organ failure and the chance of death increase with every hour a kidney is out of the body.
McBride had to decide whether to charter a plane at a cost of $15,000 — or to find a courier to drive the kidney through the night. She settled on the road trip, and the organ arrived at 6:14 a.m. — with just 46 minutes to spare.
Four months later, the transplant appears to have been a success, McBride said.
Delta Air Lines officials declined repeated requests to comment on its organ transport service or the specific incident McBride described.
Several domestic airlines, including Delta, United, American, Southwest and Alaska, provide special cargo services for organs with priority boarding, handling and monitoring. They all declined to comment on organ transportation.
The traveling public may not realize it, but thousands of transplant organs — mostly kidneys, but some pancreases — fly on commercial flights each year. Roger Brown, who runs the Organ Center at UNOS, estimates that as many as 10 organs for transplant are on the move this way every day.
Roger Brown, who runs the Organ Center at UNOS, estimates that up to 10 organs for transplant fly commercially every day.(Courtesy of UNOS)
UNOS handles about 1,800 of these organ and tissue shipments a year, of which 1,400 are kidneys. That’s a fraction of the nearly 40,000 organs transplanted in the U.S. last year, including more than 23,000 kidneys. About 1 in every 6 transplanted kidneys is shipped nationally, UNOS figures show.
Most of the time, the organs get where they’re going without incident, Brown said.
“We’re never going to get rid of flight delays. We’re never going to get rid of human error,” he said. “We’re never going to get rid of the person who’s [trying to be] a little too helpful and perhaps puts it someplace special, which then maybe creates issues downstream.”
Troubling Reports
Reports of trouble abound. In August, transplant officials at Medical City Dallas reported in a public forum that they’d lost three kidneys just that month because of problems with commercial flights.
“One organ was delayed due to weather and the next available flight wasn’t till the next day,” the report said. “Another organ made it to the airport, but was never placed on the intended flight. The third organ was mistakenly taken to the wrong airport and missed the intended flight.”
In Kentucky, transplant surgeon Dr. Malay Shah said a kidney traveling on Delta from Pensacola, Florida, via Atlanta, on Oct. 1 sat in the Lexington airport for three hours before he was notified it was there. No one had noticed the box with the label that said “human organ for transplant,” he said.
“It’s scary,” Shah said. “Organs traveling by this mechanism are treated as simply ‘baggage’ or ‘cargo.’”
Before the 9/11 terror attacks in 2001, OPO workers could take organs through airport security and see them loaded onto the plane from the passenger gate, McBride said. Because of changes in security protocol, airline employees now load organs on the tarmac, where they fly in pressurized cargo holds.
While anecdotes like Shah’s are common, there’s little data to show how often these transportation problems occur. No federal agency, including the Health Resources and Services Administration, or HRSA, which contracts with UNOS, requires monitoring of transportation for transplant organs.
“Matters involving the transportation methods used by organ procurement organizations (OPOs) are arranged directly between OPOs and transplant centers,” HRSA spokesperson David Bowman said in an email.
Airlines log organ shipments in internal booking systems and on cargo manifests, but those documents aren’t public and no summary is available, said Katherine Estep, communications director for Airlines for America, an industry trade group.
“Live human organs receive the highest priority designation,” she said in a statement.
UNOS researchers noted the impact of transportation problems in 2014. They found 30 organs discarded and 109 “near misses” between July 2014 and June 2015.
But the agency didn’t begin formally tracking transportation errors until 2016, when a new computer system came online. Before that, Organ Center staff kept track of problems informally, with pencil and paper, and the information wasn’t verified, Brown said.
Teams from organ procurement organizations, or OPOs, monitor surgeries to remove organs from donors and then make sure the organs are properly boxed and labeled for shipping and delivery.(Hannah Norman/KHN Illustration; labels courtesy of Ginny McBride)
Calls for closer tracking from within the system have been met with defensiveness — or apathy, said Brianna Doby, an organ transplant community consultant for the Johns Hopkins School of Medicine.
“If you talk out loud about organ issues, they say it will drive down donation rates,” Doby said. “It’s not OK for us to say, ‘Well, shipping is hard.’ That’s not an acceptable answer.”
A National Network
UNOS was established in 1984 after Congress enacted the National Organ Transplant Act to address a critical shortage of donor organs and to improve organ matching and placement. It called for a national network to ensure that organs that couldn’t be used in the area where they were donated would be transplanted to save lives elsewhere. Before that, many organs were lost simply because transplant teams couldn’t find compatible recipients in time.
The act established the national Organ Procurement and Transplantation Network and called for the OPTN to be operated by a private, nonprofit organization under federal contract. UNOS, which has held the contract since the inception of OPTN, is overseen by HRSA, an agency of the U.S. Department of Health and Human Services.
Today, UNOS typically handles organs with conditions that can make them hard to place. That can include organs from older donors or those with medical or other characteristics that make them difficult to match.
Overall, about 7% of shipments handled by UNOS from July 2014 to November 2019 encountered transportation problems, the data obtained by KHN and Reveal showed. UNOS wouldn’t release details about individual shipments, including dates or places shipped or causes of the transportation failures or delays.
But Brown, of the UNOS Organ Center, said an internal analysis showed that more than half of the transportation problems were related to commercial airlines or airports. Of those, two-thirds were caused by weather delays, mechanical delays and flight cancellations.
About one-third of transportation problems were related to logistics providers or ground couriers, mostly delays of package pickups. The rest were related to the sender or receiver of the shipments. The most common issue was the package not being ready for pickup at the designated time.
However, Brown said, poor outcomes can’t be blamed directly on transportation problems, even when they do occur.
“The delay could be the primary reason an organ wasn’t transplanted,” he said. “It could be a contributing factor or it could have nothing to do with the reason that the organ is not transplanted.”
Other transplant experts downplay the impact of transportation problems. Kelly Ranum, president of the Association of Organ Procurement Organizations, said she’s “surprised at how low” UNOS’ failure numbers are, considering the volume of kidneys shipped.
Nearly 40,000 organs were transplanted in the U.S. last year, including more than 23,000 kidneys.(Photographer's Choice RF/Getty Images)
Dr. Kevin O’Connor, chief executive of LifeCenter Northwest, an OPO based in Seattle, said transportation problems are “minimal” compared with the other reasons organs — including about 3,500 donated kidneys — are discarded each year. These typically include biopsy findings, the inability to find a recipient and poor organ function.
“For over 30 years and literally tens of thousands of organs being transported,” he said, “I can count on the fingers of one hand the number of times that, because of a transportation glitch, an organ was ultimately not transplanted.”
Still, O’Connor acknowledged that “even one kidney being thrown away because of transportation errors is unacceptable.”
Part of the problem lies with the way organs are transported now, said Axelrod, who also represents the American Society of Transplant Surgeons.
“We don’t have an end-to-end unified transportation system,” Axelrod said. “We don’t have a FedEx for transplant. We have a cobbled-together system of OPOs and couriers and private aircraft and commercial aircraft.”
In recent years, several courier companies have emerged to meet the market for transplant organs. Don Jones, chief executive of the Nationwide Organ Recovery Transport Alliance, or NORA, contracts with more than 15 OPOs and oversees about 400 organs a year on commercial flights.
“I would say 99.8% of our transports on commercial airlines go perfectly fine,” Jones said based on his estimate. Jones noted that his firm ships organs only on direct flights and uses GPS tracking to monitor them.
However, GPS tracking isn’t universal — or required by UNOS or HRSA. Some couriers and airlines use it; many don’t. Many OPOs monitor organs through a combination of verbal handoffs, automation and label scans, Brown said.
In Ginny McBride’s misadventure last fall, she contracted with a courier, Sterling Global Aviation Logistics, which used Delta Air Lines to ship the kidney.
Delta uses GPS trackers on its Dash Critical shipments, promising fast, guaranteed delivery of human organs. But on that night in October, the kidney was shipped from Orlando to Atlanta without a GPS tracker. In Atlanta, a cargo worker couldn’t find a GPS device to put on the box containing the kidney, so the worker held the organ for a later flight. That would have pushed it far beyond the window of viability.
An internal Delta report, obtained by McBride, found that Delta didn’t have enough GPS devices available in Atlanta that night. “Destination stations are not returning the devices in a timely manner,” according to the report. “One way to mitigate this from reoccurring is to have a larger inventory of GPS devises (sic) at each station.”
Delta declined to comment on the report.
The average wait time for a kidney varies widely nationwide, from less than three years to more than a decade. One proposal to put more organs to use called for eliminating the 58 donation service areas and 11 regions now used to allocate kidneys and replacing them with a zone of up to 500 nautical miles from the donor hospital.
In December, OPTN cut that range in half — to 250 nautical miles — in part because of an outcry about problems shipping kidneys via commercial air.
“There are certainly no technological barriers to doing GPS and to actually requiring it,” Brown said.
A UNOS committee is considering whether to collect data on transportation methods and outcomes, but, so far, the question remains under review.
“If the community wants it, they should ask for it,” Brown said. “We can help facilitate and get it done for them.”
McBride, who discussed solutions with her colleagues, hopes the transplant organizations will come together to solve transportation problems, to make sure every eligible donated kidney gets transplanted.
“Any organ that’s wasted, in my opinion, is a loss to the patient and to the community,” said Paul Conway, of the American Association of Kidney Patients, an advocacy group, who is himself a kidney recipient. “With all of the advances going on with drugs, with medical procedures, how can you have a logistics error be the barrier?”
This investigation and a related podcast represent a collaboration between Kaiser Health News and Reveal, from The Center for Investigative Reporting (CIR), a nonprofit news organization. Reveal, from CIR and PRX, is a nationally broadcast public radio show and investigative reporting podcast. Kaiser Health News (KHN) is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.
How Lifesaving Organs For Transplant Go Missing In Transit published first on https://smartdrinkingweb.weebly.com/
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dinafbrownil · 5 years
Text
How Lifesaving Organs For Transplant Go Missing In Transit
When a human heart was left behind by mistake on a Southwest Airlines plane in 2018, transplant officials downplayed the incident. They emphasized that the organ was used for valves and tissues, not to save the life of a waiting patient, so the delay was inconsequential.
“It got to us on time, so that was the most important thing,” said Doug Wilson, an executive vice president for LifeNet Health, which runs the Seattle-area operation that processed the tissue.
That high-profile event was dismissed as an anomaly, but a new analysis of transplant data finds that a startling number of lifesaving organs are lost or delayed after being shipped on commercial flights, the delays often rendering them unusable.
In a nation where nearly 113,000 people are waiting for transplants, scores of organs — mostly kidneys — are discarded after they don’t reach their destination in time.
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Between 2014 and 2019, nearly 170 organs could not be transplanted and almost 370 endured “near misses,” with delays of two hours or more, after transportation problems, according to an investigation by Kaiser Health News and Reveal from the Center for Investigative Reporting. The media organizations reviewed data from more than 8,800 organ and tissue shipments collected voluntarily and shared upon request by the United Network for Organ Sharing, or UNOS, the nonprofit government contractor that oversees the nation’s transplant system. Twenty-two additional organs classified as transportation “failures” were ultimately able to be transplanted elsewhere.
Surgeons themselves often go to hospitals to collect and transport hearts, which survive only four to six hours out of the body. But kidneys and pancreases — which have longer shelf lives — often travel commercial, as cargo. As such, they can end up missing connecting flights or delayed like lost luggage. Worse still, they are typically tracked with a primitive system of phone calls and paper manifests, with no GPS or other electronic tracking required.
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Transplant surgeons around the country, irate and distressed, told KHN they have lost the chance to transplant otherwise usable kidneys because of logistics.
“We’ve had organs that are left on airplanes, organs that arrive at an airport and then can’t get taken off the aircraft in a timely fashion and spend an extra two or three or four hours waiting for somebody to get them,” said Dr. David Axelrod, a transplant surgeon at the University of Iowa.
One contributing factor is the lack of a national system to transfer organs from one region to another because they match a distant patient in need.
Instead, the U.S. relies on a patchwork of 58 nonprofit organizations called organ procurement organizations, or OPOs, to collect the organs from hospitals and package them. Teams from the OPOs monitor surgeries to remove organs from donors and then make sure the organs are properly boxed and labeled for shipping and delivery.
From there, however, the OPOs often rely on commercial couriers and airlines, which are not formally held accountable for any ensuing problems. If an airline forgets to put a kidney on a plane or a courier misses a flight because he got lost or stuck in traffic, there is no consequence, said Ginny McBride, executive director of OurLegacy, an OPO in Orlando, Florida.
Ginny McBride, executive director of OurLegacy, an OPO in Orlando, Florida(JoNel Aleccia/KHN)
In an era when consumers can precisely monitor a FedEx package or a DoorDash dinner delivery, there are no requirements to track shipments of organs in real time — or to assess how many may be damaged or lost in transit.
“If Amazon can figure out when your paper towels and your dog food is going to arrive within 20 to 30 minutes, it certainly should be reasonable that we ought to track lifesaving organs, which are in chronic shortage,” Axelrod said.
For years, organs were distributed locally and regionally first, a system that resulted in wide disparities in organ waiting times across the country. In recent years, UNOS officials and the transplant community, with federal urging, have been working, organ by organ, to restructure how it’s done.
Amid those ongoing efforts to allocate organs more fairly — and, recently, a Trump administration effort to overhaul kidney care — the waste of some of these precious resources donated by good Samaritans has been overlooked. Last year, an average of nine people a day died while waiting for a new kidney.
Donor families and waiting patients may never know what’s happened to an organ provided by a loved one or why a surgery is canceled at the last minute.
“We have been unaware of how many kidneys have been waylaid,” said McBride, of the Orlando procurement agency. “That’s not a number that’s been transparent to us.”
But, she added, she’s aware of the risk: “I say a prayer and hold my breath every time a kidney leaves our office.”
46 Minutes To Spare
In October, a kidney en route from McBride’s OPO in Florida to a patient in North Carolina missed its connection in Atlanta. The box was prominently marked as a human organ and displayed a phone number to call. Apparently unaware of the urgency, a Delta cargo worker merely set it aside for a later flight.
The waiting transplant surgeon in Greensboro, North Carolina, “was having a fit,” said Kim Young, the OurLegacy organ recovery coordinator. If the kidney didn’t get to the hospital by 7 a.m., he wouldn’t be able to use it. Both the risk of organ failure and the chance of death increase with every hour a kidney is out of the body.
McBride had to decide whether to charter a plane at a cost of $15,000 — or to find a courier to drive the kidney through the night. She settled on the road trip, and the organ arrived at 6:14 a.m. — with just 46 minutes to spare.
Four months later, the transplant appears to have been a success, McBride said.
Delta Air Lines officials declined repeated requests to comment on its organ transport service or the specific incident McBride described.
Several domestic airlines, including Delta, United, American, Southwest and Alaska, provide special cargo services for organs with priority boarding, handling and monitoring. They all declined to comment on organ transportation.
The traveling public may not realize it, but thousands of transplant organs — mostly kidneys, but some pancreases — fly on commercial flights each year. Roger Brown, who runs the Organ Center at UNOS, estimates that as many as 10 organs for transplant are on the move this way every day.
Roger Brown, who runs the Organ Center at UNOS, estimates that up to 10 organs for transplant fly commercially every day.(Courtesy of UNOS)
UNOS handles about 1,800 of these organ and tissue shipments a year, of which 1,400 are kidneys. That’s a fraction of the nearly 40,000 organs transplanted in the U.S. last year, including more than 23,000 kidneys. About 1 in every 6 transplanted kidneys is shipped nationally, UNOS figures show.
Most of the time, the organs get where they’re going without incident, Brown said.
“We’re never going to get rid of flight delays. We’re never going to get rid of human error,” he said. “We’re never going to get rid of the person who’s [trying to be] a little too helpful and perhaps puts it someplace special, which then maybe creates issues downstream.”
Troubling Reports
Reports of trouble abound. In August, transplant officials at Medical City Dallas reported in a public forum that they’d lost three kidneys just that month because of problems with commercial flights.
“One organ was delayed due to weather and the next available flight wasn’t till the next day,” the report said. “Another organ made it to the airport, but was never placed on the intended flight. The third organ was mistakenly taken to the wrong airport and missed the intended flight.”
In Kentucky, transplant surgeon Dr. Malay Shah said a kidney traveling on Delta from Pensacola, Florida, via Atlanta, on Oct. 1 sat in the Lexington airport for three hours before he was notified it was there. No one had noticed the box with the label that said “human organ for transplant,” he said.
“It’s scary,” Shah said. “Organs traveling by this mechanism are treated as simply ‘baggage’ or ‘cargo.’”
Before the 9/11 terror attacks in 2001, OPO workers could take organs through airport security and see them loaded onto the plane from the passenger gate, McBride said. Because of changes in security protocol, airline employees now load organs on the tarmac, where they fly in pressurized cargo holds.
While anecdotes like Shah’s are common, there’s little data to show how often these transportation problems occur. No federal agency, including the Health Resources and Services Administration, or HRSA, which contracts with UNOS, requires monitoring of transportation for transplant organs.
“Matters involving the transportation methods used by organ procurement organizations (OPOs) are arranged directly between OPOs and transplant centers,” HRSA spokesperson David Bowman said in an email.
Airlines log organ shipments in internal booking systems and on cargo manifests, but those documents aren’t public and no summary is available, said Katherine Estep, communications director for Airlines for America, an industry trade group.
“Live human organs receive the highest priority designation,” she said in a statement.
UNOS researchers noted the impact of transportation problems in 2014. They found 30 organs discarded and 109 “near misses” between July 2014 and June 2015.
But the agency didn’t begin formally tracking transportation errors until 2016, when a new computer system came online. Before that, Organ Center staff kept track of problems informally, with pencil and paper, and the information wasn’t verified, Brown said.
Teams from organ procurement organizations, or OPOs, monitor surgeries to remove organs from donors and then make sure the organs are properly boxed and labeled for shipping and delivery.(Hannah Norman/KHN Illustration; labels courtesy of Ginny McBride)
Calls for closer tracking from within the system have been met with defensiveness — or apathy, said Brianna Doby, an organ transplant community consultant for the Johns Hopkins School of Medicine.
“If you talk out loud about organ issues, they say it will drive down donation rates,” Doby said. “It’s not OK for us to say, ‘Well, shipping is hard.’ That’s not an acceptable answer.”
A National Network
UNOS was established in 1984 after Congress enacted the National Organ Transplant Act to address a critical shortage of donor organs and to improve organ matching and placement. It called for a national network to ensure that organs that couldn’t be used in the area where they were donated would be transplanted to save lives elsewhere. Before that, many organs were lost simply because transplant teams couldn’t find compatible recipients in time.
The act established the national Organ Procurement and Transplantation Network and called for the OPTN to be operated by a private, nonprofit organization under federal contract. UNOS, which has held the contract since the inception of OPTN, is overseen by HRSA, an agency of the U.S. Department of Health and Human Services.
Today, UNOS typically handles organs with conditions that can make them hard to place. That can include organs from older donors or those with medical or other characteristics that make them difficult to match.
Overall, about 7% of shipments handled by UNOS from July 2014 to November 2019 encountered transportation problems, the data obtained by KHN and Reveal showed. UNOS wouldn’t release details about individual shipments, including dates or places shipped or causes of the transportation failures or delays.
But Brown, of the UNOS Organ Center, said an internal analysis showed that more than half of the transportation problems were related to commercial airlines or airports. Of those, two-thirds were caused by weather delays, mechanical delays and flight cancellations.
About one-third of transportation problems were related to logistics providers or ground couriers, mostly delays of package pickups. The rest were related to the sender or receiver of the shipments. The most common issue was the package not being ready for pickup at the designated time.
However, Brown said, poor outcomes can’t be blamed directly on transportation problems, even when they do occur.
“The delay could be the primary reason an organ wasn’t transplanted,” he said. “It could be a contributing factor or it could have nothing to do with the reason that the organ is not transplanted.”
Other transplant experts downplay the impact of transportation problems. Kelly Ranum, president of the Association of Organ Procurement Organizations, said she’s “surprised at how low” UNOS’ failure numbers are, considering the volume of kidneys shipped.
Nearly 40,000 organs were transplanted in the U.S. last year, including more than 23,000 kidneys.(Photographer's Choice RF/Getty Images)
Dr. Kevin O’Connor, chief executive of LifeCenter Northwest, an OPO based in Seattle, said transportation problems are “minimal” compared with the other reasons organs — including about 3,500 donated kidneys — are discarded each year. These typically include biopsy findings, the inability to find a recipient and poor organ function.
“For over 30 years and literally tens of thousands of organs being transported,” he said, “I can count on the fingers of one hand the number of times that, because of a transportation glitch, an organ was ultimately not transplanted.”
Still, O’Connor acknowledged that “even one kidney being thrown away because of transportation errors is unacceptable.”
Part of the problem lies with the way organs are transported now, said Axelrod, who also represents the American Society of Transplant Surgeons.
“We don’t have an end-to-end unified transportation system,” Axelrod said. “We don’t have a FedEx for transplant. We have a cobbled-together system of OPOs and couriers and private aircraft and commercial aircraft.”
In recent years, several courier companies have emerged to meet the market for transplant organs. Don Jones, chief executive of the Nationwide Organ Recovery Transport Alliance, or NORA, contracts with more than 15 OPOs and oversees about 400 organs a year on commercial flights.
“I would say 99.8% of our transports on commercial airlines go perfectly fine,” Jones said based on his estimate. Jones noted that his firm ships organs only on direct flights and uses GPS tracking to monitor them.
However, GPS tracking isn’t universal — or required by UNOS or HRSA. Some couriers and airlines use it; many don’t. Many OPOs monitor organs through a combination of verbal handoffs, automation and label scans, Brown said.
In Ginny McBride’s misadventure last fall, she contracted with a courier, Sterling Global Aviation Logistics, which used Delta Air Lines to ship the kidney.
Delta uses GPS trackers on its Dash Critical shipments, promising fast, guaranteed delivery of human organs. But on that night in October, the kidney was shipped from Orlando to Atlanta without a GPS tracker. In Atlanta, a cargo worker couldn’t find a GPS device to put on the box containing the kidney, so the worker held the organ for a later flight. That would have pushed it far beyond the window of viability.
An internal Delta report, obtained by McBride, found that Delta didn’t have enough GPS devices available in Atlanta that night. “Destination stations are not returning the devices in a timely manner,” according to the report. “One way to mitigate this from reoccurring is to have a larger inventory of GPS devises (sic) at each station.”
Delta declined to comment on the report.
The average wait time for a kidney varies widely nationwide, from less than three years to more than a decade. One proposal to put more organs to use called for eliminating the 58 donation service areas and 11 regions now used to allocate kidneys and replacing them with a zone of up to 500 nautical miles from the donor hospital.
In December, OPTN cut that range in half — to 250 nautical miles — in part because of an outcry about problems shipping kidneys via commercial air.
“There are certainly no technological barriers to doing GPS and to actually requiring it,” Brown said.
A UNOS committee is considering whether to collect data on transportation methods and outcomes, but, so far, the question remains under review.
“If the community wants it, they should ask for it,” Brown said. “We can help facilitate and get it done for them.”
McBride, who discussed solutions with her colleagues, hopes the transplant organizations will come together to solve transportation problems, to make sure every eligible donated kidney gets transplanted.
“Any organ that’s wasted, in my opinion, is a loss to the patient and to the community,” said Paul Conway, of the American Association of Kidney Patients, an advocacy group, who is himself a kidney recipient. “With all of the advances going on with drugs, with medical procedures, how can you have a logistics error be the barrier?”
This investigation and a related podcast represent a collaboration between Kaiser Health News and Reveal, from The Center for Investigative Reporting (CIR), a nonprofit news organization. Reveal, from CIR and PRX, is a nationally broadcast public radio show and investigative reporting podcast. Kaiser Health News (KHN) is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.
from Updates By Dina https://khn.org/news/how-lifesaving-organs-for-transplant-go-missing-in-transit/
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jacewilliams1 · 4 years
Text
Flying with the famous and infamous
Flying Boeings and Bells was how I crossed paths with Charles Lindbergh, Mustapha Chafik, the Shah of Iran’s nephew, Mohamed Ali, Leonard Bernstein, and Richard Nixon. Geopolitics and the ups and downs of the airline business played a hand as well.
A Chat with Lindbergh
The year was 1968 and Charles Lindbergh was “non-reving “ (the airline term for flying free) in first class on our flight from Rome to New York’s J.F. Kennedy Airport. He was on the Pan Am board of directors and frequently flew to Europe, taking advantage of the company’s travel perks.
No longer the instantly recognizable flyer of his early years, he was a quiet, unpretentious traveler, indistinguishable from the other conservatively dressed older gentlemen seated in first class. Technology had long since moved beyond his expertise. By then Pan Am’s Stratorcruisers and Connies, planes he would have been more familiar with, were long gone and 707s and DC-8s routinely crisscrossed the globe. Doppler and inertial navigation systems had replaced navigators on most routes and main frame computers did the flight planning. Yet his relationship with Pan Am was mutually beneficial. He was a prominent personality on the board of directors and the company’s travel privileges were a convenient and economical way for him to maintain overseas relationships, some of which (the world later learned after his death) might have raised some eyebrows.
Charles Lindbergh, still dapper at 66, was a frequent Pan Am passenger.
We were advised before departure that he’d be with us and the captain passed word back that he was welcome to visit the cockpit in cruise flight. It was years before reinforced cockpit doors and captains had more latitude about who could visit the cockpit. I was the relief copilot, not scheduled for cockpit duty until later in the flight, but I hung around after my mandatory presence in the cockpit for the takeoff and initial climb, knowing that he’d be coming up soon. He came forward as the flight approached Paris. Lean and tall with thin gray hair, he moved easily into the jump seat behind the captain. Having long since left behind cockpit routines, and largely out of his element, he sat quietly as the captain and first officer went about cockpit chores.
With Paris passing below in clear skies, the captain pointed to Le Bourget airfield saying, “I guess you’re familiar with that place.” Lindbergh nodded with a smile. He then told us about an early flying experience in Mexico before World War II.
Navigating with spotty charts, he was unsure of his position so he flew low following railroad tracks hoping to read a town’s name on the side of a railroad station. He said: “As I flew by at rooftop level, the only sign I saw was CABALLEROS [men’s restroom] on a side door.” We all got a good chuckle. We shook hands and I left the cockpit, headed for my crew rest seat in first class. A few minutes later, he returned to his seat, settling in for a meal and a nap.
Instructing the Shah’s nephew
Well beyond my purview as a new hire copilot in 1968, Pan Am’s chairman, Juan Trippe, was gearing up for a major expansion of world air travel. In the mid 1960s he convinced Boeing to build the 747 and initially ordered 25. Trippe’s timing was years off the mark. The first Pan Am 747 arrived at New York’s JFK Airport in January 1970, about a year into what would become a major worldwide downturn in airline traffic. My furlough letter arrived by registered mail in December 1969, along with thousands of others sent to junior pilots at all the major airlines.
The Shah’s nephew was an avid, if not always diligent, pilot.
I returned to active military duty for two years as a standards instructor at Helicopter Training Squadron Eight in Pensacola. Iranian Lieutenant Mustapha Chafik, nephew of the Shah of Iran, was among my international flight students. He was comfortable in the ways of the west, had a cheerful manner, a ready smile and got on well with instructors and fellow flight students. Yet, Chafik was a product of the time in 1970s Iran. Savvy in the country’s politics and intrigues, he was careful to follow the iron-fisted dictates of his uncle, the Shah, who came to power following a US- and British-engineered coup of then Prime Minister Mosaddegh.
In Iran, Chafik occasionally flew helicopters but mainly commanded a flotilla of 14 high speed, armed hovercraft. My job as a standards instructor was to make him a competent helicopter instrument flyer. He progressed satisfactorily but shrugged off what he considered the details of air traffic control, flight planning and fuel tracking. The squadron’s UH-1H and TH-1L Huey helicopters had endurance of about 2 hours 40 minutes cruising at 110 to 120 knots. Consuming 8 to 10 pounds of JP 4 per minute, depending on the model, flight planning with attention to even small head and tailwind components and enroute fuel tracking was especially important. Computing groundspeed on the E6B, he’d smile and say, “If Allah wills it, it will be.” Same with holding pattern entries, NDB, VOR, and TACAN approaches. To him, terms like minimum enroute altitude, minimum off route altitude, and minimum sector altitude were esoteric abstractions he accommodated to get through the program. Smiling, he’d say, “In Iran, we follow camel tracks.”
Chafik completed the syllabus and returned to his hovercraft unit in Iran. Seven years later in what became known as the Islamic Revolution, the Shah was ousted and fled the country with his immediate family. Chafik, by then an Iranian Navy captain, was detained but managed to escape in an Iranian Navy hovercraft, eventually settling in his mother’s Paris apartment.
According to The New York Times, he hadn’t requested special security. On December 7, 1979, about a month after arriving, he was assassinated by an Iranian agent on a Paris street while carrying groceries home.
My seat by the Champ (Muhammad Ali)
Returning to Pan Am by the mid-70s, I did mainly flight safety projects at the company’s JFK flight operations headquarters and occasional special mission flying.
You never know who you’ll sit next to on an airplane.
Part of the job was representing Pan Am at the International Air Transport Association (IATA) on operational and safety issues. I was returning from a European IATA meeting in the late 1970s when Muhammad Ali bounded onto the plane just before the doors closed and sat down next to me. He was sweaty and had obviously been running to catch the flight. The plane was a Pan Am 747-100, with its spacious, open cabin and large first class seats. By then passengers were seated and settled in with their drinks so when Ali hustled into the cabin, they all noticed.
As time passed we started chatting. He had no pretensions and a kind of simple acceptance of his place on the world stage. As an aside, pointing to the Rolex watch on his wrist, he said, “People give me things.”
When I mentioned that I was a pilot and worked for Pan Am, he had lots of questions mostly about the working lives of airline pilots and their compensation. I explained that salaries were largely based on a plane’s payload and crew position and for that reason 747 captains were paid the most. He mulled the numbers and said, “That don’t seem like that much.”
I thought, but didn’t say… the Airline Pilots Association (which represented Pan Am pilots) would be pleased to hear you say that! But my response was: “Yes, you get a lot for fights but when you step into the ring you can get your head knocked off.”
He looked me in the eye and said, “Now you’re talking, man!” Then our midday meal was served. As the flight progressed, passengers sheepishly approached asking Mr. Ali to autograph their menus. He’d nod and sign.
The Maestro and the kids
The Israeli-Egyptian peace treaty was signed in March 1979, normalizing relations between the two countries. In 1980, an enterprising but overly optimistic Egyptian tour operator started Nefertiti Airlines and acquired N893PA, a Pan Am 707-321, to capitalize on anticipated cross border travel. It was a shoestring charter operation and ground to a halt two years later. On its final flight, the ill-maintained 707 landed at Tel Aviv’s Ben Gurion Airport, where it was abandoned, impounded, and locked up with the last flight’s catering still on board.
It sat baking in the sun for months as Pan Am arranged to repossess it. By April 1982 most legalities were complete and as first officer I dead-headed from JFK with the captain and flight engineer to retrieve it. That’s how I crossed paths with Leonard Bernstein, shepherding a group of high school boys to Israel in upper deck first class on an El Al 747, from London to Tel Aviv.
Leonard Bernstein was all business during rehearsal.
Years earlier, in college, I attended a New Haven rehearsal where Bernstein was a visiting conductor at Yale. With the players seated and tuned up, wearing a sweat shirt and jeans, he walked in from the stage, stepped onto the conductor’s stand with his baton and began the rehearsal. He was serious and meticulous, directing with stops and repeats, all business, not the smooth beginning to end concert goers would later hear. It brought to mind the remark by Kaiser Wilhelm that if one likes sausage don’t watch how it’s made. Now in El Al first class, attired in business casual, laid back and at ease, he doted over his charges, chatting amiably in what seemed to me the drawn out speech affectations of New York’s art world. A long way, I thought, from the Boston accents of his childhood.
The next day, checking out N893PA, it was obvious the plane was in no shape to fly even under rules less stringent than FAR Part 121. Its moldy galley food trays were just an exclamation mark on the whole sorry scene. Several legal formalities remained as well. Meanwhile, mechanics from Israeli Aircraft Industries towed the N893PA into a hangar, where it was jacked up, hydraulic pumps activated, flight controls exercised, and the landing gear cycled and checked for leaks. With repairs underway and no prospect of departing for at least a couple of days we rented a car, drove to Jerusalem, and took in the sights.
On April 21, 1982, with enough repairs to make the plane airworthy for the ferry flight, we took off for London’s Stansted Airport. The captain recalled we departed with one of the four engine-driven generators inoperative, wing anti-ice system inoperative, and pages of inoperative components totaling about two dozen write-ups. Routing to London was as direct as possible, over lightly traveled airways of then Soviet-controlled Eastern Europe.
Eight months later, the Chinese government purchased N893PA for their Tianjin technical school. See Flying an Old Boeing to China For Christmas.
Gregarious Richard Nixon
In the early 1990s, La Guardia’s Marine Air Terminal was the bustling base of Delta’s 727 air shuttle operation, flying passengers to Boston Logan Airport and Washington National Airport. Savvy flyers preferred it because it was on LGA’s west side, away from the main terminals, allowing easier access and often less delays for takeoff and landing. Perhaps for those reasons Richard Nixon chose Delta for his trip to DCA that day in 1992.
By the 1990s, Nixon was long removed from politics, and perhaps more jovial because of it.
It was a morning flight and we were strapped in—making our cockpit nests, positioning Jepp pages on the 727’s side window clipboard, setting nav radios, RMI heading bugs, VOR courses, and engine EPR bugs—when a flight attendant popped in to say former President Nixon would be coming on board. By then he was living in Bergen County New Jersey, across the Hudson River from New York City.
Passenger boarding was delayed for a few minutes while gate agents blocked off seats for him and his Secret Service detail. Next, a phalanx of Secret Service agents took positions around where the President would be seated in the forward cabin. Then Nixon walked briskly on board, heading straight for the cockpit.
He wasn’t the dour man I remember in the 1972 photo giving a victory sign from the helicopter the day he left the White House. Rather, he was animated and smiling. “Good morning, how ya doing,” was what I recall as he leaned in over the control pedestal to shake hands. Nixon’s trip that day provided a new insight about the man who was so hobbled by his dark temperament, yet who ended the draft, negotiated the end of the Vietnam war, established the EPA, and began friendly relations with China. That cockpit visit told me he still wanted to be in the game.
The post Flying with the famous and infamous appeared first on Air Facts Journal.
from Engineering Blog https://airfactsjournal.com/2020/06/flying-with-the-famous-and-infamous/
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gordonwilliamsweb · 5 years
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How Lifesaving Organs For Transplant Go Missing In Transit
When a human heart was left behind by mistake on a Southwest Airlines plane in 2018, transplant officials downplayed the incident. They emphasized that the organ was used for valves and tissues, not to save the life of a waiting patient, so the delay was inconsequential.
“It got to us on time, so that was the most important thing,” said Doug Wilson, an executive vice president for LifeNet Health, which runs the Seattle-area operation that processed the tissue.
That high-profile event was dismissed as an anomaly, but a new analysis of transplant data finds that a startling number of lifesaving organs are lost or delayed after being shipped on commercial flights, the delays often rendering them unusable.
In a nation where nearly 113,000 people are waiting for transplants, scores of organs — mostly kidneys — are discarded after they don’t reach their destination in time.
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Between 2014 and 2019, nearly 170 organs could not be transplanted and almost 370 endured “near misses,” with delays of two hours or more, after transportation problems, according to an investigation by Kaiser Health News and Reveal from the Center for Investigative Reporting. The media organizations reviewed data from more than 8,800 organ and tissue shipments collected voluntarily and shared upon request by the United Network for Organ Sharing, or UNOS, the nonprofit government contractor that oversees the nation’s transplant system. Twenty-two additional organs classified as transportation “failures” were ultimately able to be transplanted elsewhere.
Surgeons themselves often go to hospitals to collect and transport hearts, which survive only four to six hours out of the body. But kidneys and pancreases — which have longer shelf lives — often travel commercial, as cargo. As such, they can end up missing connecting flights or delayed like lost luggage. Worse still, they are typically tracked with a primitive system of phone calls and paper manifests, with no GPS or other electronic tracking required.
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Transplant surgeons around the country, irate and distressed, told KHN they have lost the chance to transplant otherwise usable kidneys because of logistics.
“We’ve had organs that are left on airplanes, organs that arrive at an airport and then can’t get taken off the aircraft in a timely fashion and spend an extra two or three or four hours waiting for somebody to get them,” said Dr. David Axelrod, a transplant surgeon at the University of Iowa.
One contributing factor is the lack of a national system to transfer organs from one region to another because they match a distant patient in need.
Instead, the U.S. relies on a patchwork of 58 nonprofit organizations called organ procurement organizations, or OPOs, to collect the organs from hospitals and package them. Teams from the OPOs monitor surgeries to remove organs from donors and then make sure the organs are properly boxed and labeled for shipping and delivery.
From there, however, the OPOs often rely on commercial couriers and airlines, which are not formally held accountable for any ensuing problems. If an airline forgets to put a kidney on a plane or a courier misses a flight because he got lost or stuck in traffic, there is no consequence, said Ginny McBride, executive director of OurLegacy, an OPO in Orlando, Florida.
Ginny McBride, executive director of OurLegacy, an OPO in Orlando, Florida(JoNel Aleccia/KHN)
In an era when consumers can precisely monitor a FedEx package or a DoorDash dinner delivery, there are no requirements to track shipments of organs in real time — or to assess how many may be damaged or lost in transit.
“If Amazon can figure out when your paper towels and your dog food is going to arrive within 20 to 30 minutes, it certainly should be reasonable that we ought to track lifesaving organs, which are in chronic shortage,” Axelrod said.
For years, organs were distributed locally and regionally first, a system that resulted in wide disparities in organ waiting times across the country. In recent years, UNOS officials and the transplant community, with federal urging, have been working, organ by organ, to restructure how it’s done.
Amid those ongoing efforts to allocate organs more fairly — and, recently, a Trump administration effort to overhaul kidney care — the waste of some of these precious resources donated by good Samaritans has been overlooked. Last year, an average of nine people a day died while waiting for a new kidney.
Donor families and waiting patients may never know what’s happened to an organ provided by a loved one or why a surgery is canceled at the last minute.
“We have been unaware of how many kidneys have been waylaid,” said McBride, of the Orlando procurement agency. “That’s not a number that’s been transparent to us.”
But, she added, she’s aware of the risk: “I say a prayer and hold my breath every time a kidney leaves our office.”
46 Minutes To Spare
In October, a kidney en route from McBride’s OPO in Florida to a patient in North Carolina missed its connection in Atlanta. The box was prominently marked as a human organ and displayed a phone number to call. Apparently unaware of the urgency, a Delta cargo worker merely set it aside for a later flight.
The waiting transplant surgeon in Greensboro, North Carolina, “was having a fit,” said Kim Young, the OurLegacy organ recovery coordinator. If the kidney didn’t get to the hospital by 7 a.m., he wouldn’t be able to use it. Both the risk of organ failure and the chance of death increase with every hour a kidney is out of the body.
McBride had to decide whether to charter a plane at a cost of $15,000 — or to find a courier to drive the kidney through the night. She settled on the road trip, and the organ arrived at 6:14 a.m. — with just 46 minutes to spare.
Four months later, the transplant appears to have been a success, McBride said.
Delta Air Lines officials declined repeated requests to comment on its organ transport service or the specific incident McBride described.
Several domestic airlines, including Delta, United, American, Southwest and Alaska, provide special cargo services for organs with priority boarding, handling and monitoring. They all declined to comment on organ transportation.
The traveling public may not realize it, but thousands of transplant organs — mostly kidneys, but some pancreases — fly on commercial flights each year. Roger Brown, who runs the Organ Center at UNOS, estimates that as many as 10 organs for transplant are on the move this way every day.
Roger Brown, who runs the Organ Center at UNOS, estimates that up to 10 organs for transplant fly commercially every day.(Courtesy of UNOS)
UNOS handles about 1,800 of these organ and tissue shipments a year, of which 1,400 are kidneys. That’s a fraction of the nearly 40,000 organs transplanted in the U.S. last year, including more than 23,000 kidneys. About 1 in every 6 transplanted kidneys is shipped nationally, UNOS figures show.
Most of the time, the organs get where they’re going without incident, Brown said.
“We’re never going to get rid of flight delays. We’re never going to get rid of human error,” he said. “We’re never going to get rid of the person who’s [trying to be] a little too helpful and perhaps puts it someplace special, which then maybe creates issues downstream.”
Troubling Reports
Reports of trouble abound. In August, transplant officials at Medical City Dallas reported in a public forum that they’d lost three kidneys just that month because of problems with commercial flights.
“One organ was delayed due to weather and the next available flight wasn’t till the next day,” the report said. “Another organ made it to the airport, but was never placed on the intended flight. The third organ was mistakenly taken to the wrong airport and missed the intended flight.”
In Kentucky, transplant surgeon Dr. Malay Shah said a kidney traveling on Delta from Pensacola, Florida, via Atlanta, on Oct. 1 sat in the Lexington airport for three hours before he was notified it was there. No one had noticed the box with the label that said “human organ for transplant,” he said.
“It’s scary,” Shah said. “Organs traveling by this mechanism are treated as simply ‘baggage’ or ‘cargo.’”
Before the 9/11 terror attacks in 2001, OPO workers could take organs through airport security and see them loaded onto the plane from the passenger gate, McBride said. Because of changes in security protocol, airline employees now load organs on the tarmac, where they fly in pressurized cargo holds.
While anecdotes like Shah’s are common, there’s little data to show how often these transportation problems occur. No federal agency, including the Health Resources and Services Administration, or HRSA, which contracts with UNOS, requires monitoring of transportation for transplant organs.
“Matters involving the transportation methods used by organ procurement organizations (OPOs) are arranged directly between OPOs and transplant centers,” HRSA spokesperson David Bowman said in an email.
Airlines log organ shipments in internal booking systems and on cargo manifests, but those documents aren’t public and no summary is available, said Katherine Estep, communications director for Airlines for America, an industry trade group.
“Live human organs receive the highest priority designation,” she said in a statement.
UNOS researchers noted the impact of transportation problems in 2014. They found 30 organs discarded and 109 “near misses” between July 2014 and June 2015.
But the agency didn’t begin formally tracking transportation errors until 2016, when a new computer system came online. Before that, Organ Center staff kept track of problems informally, with pencil and paper, and the information wasn’t verified, Brown said.
Teams from organ procurement organizations, or OPOs, monitor surgeries to remove organs from donors and then make sure the organs are properly boxed and labeled for shipping and delivery.(Hannah Norman/KHN Illustration; labels courtesy of Ginny McBride)
Calls for closer tracking from within the system have been met with defensiveness — or apathy, said Brianna Doby, an organ transplant community consultant for the Johns Hopkins School of Medicine.
“If you talk out loud about organ issues, they say it will drive down donation rates,” Doby said. “It’s not OK for us to say, ‘Well, shipping is hard.’ That’s not an acceptable answer.”
A National Network
UNOS was established in 1984 after Congress enacted the National Organ Transplant Act to address a critical shortage of donor organs and to improve organ matching and placement. It called for a national network to ensure that organs that couldn’t be used in the area where they were donated would be transplanted to save lives elsewhere. Before that, many organs were lost simply because transplant teams couldn’t find compatible recipients in time.
The act established the national Organ Procurement and Transplantation Network and called for the OPTN to be operated by a private, nonprofit organization under federal contract. UNOS, which has held the contract since the inception of OPTN, is overseen by HRSA, an agency of the U.S. Department of Health and Human Services.
Today, UNOS typically handles organs with conditions that can make them hard to place. That can include organs from older donors or those with medical or other characteristics that make them difficult to match.
Overall, about 7% of shipments handled by UNOS from July 2014 to November 2019 encountered transportation problems, the data obtained by KHN and Reveal showed. UNOS wouldn’t release details about individual shipments, including dates or places shipped or causes of the transportation failures or delays.
But Brown, of the UNOS Organ Center, said an internal analysis showed that more than half of the transportation problems were related to commercial airlines or airports. Of those, two-thirds were caused by weather delays, mechanical delays and flight cancellations.
About one-third of transportation problems were related to logistics providers or ground couriers, mostly delays of package pickups. The rest were related to the sender or receiver of the shipments. The most common issue was the package not being ready for pickup at the designated time.
However, Brown said, poor outcomes can’t be blamed directly on transportation problems, even when they do occur.
“The delay could be the primary reason an organ wasn’t transplanted,” he said. “It could be a contributing factor or it could have nothing to do with the reason that the organ is not transplanted.”
Other transplant experts downplay the impact of transportation problems. Kelly Ranum, president of the Association of Organ Procurement Organizations, said she’s “surprised at how low” UNOS’ failure numbers are, considering the volume of kidneys shipped.
Nearly 40,000 organs were transplanted in the U.S. last year, including more than 23,000 kidneys.(Photographer's Choice RF/Getty Images)
Dr. Kevin O’Connor, chief executive of LifeCenter Northwest, an OPO based in Seattle, said transportation problems are “minimal” compared with the other reasons organs — including about 3,500 donated kidneys — are discarded each year. These typically include biopsy findings, the inability to find a recipient and poor organ function.
“For over 30 years and literally tens of thousands of organs being transported,” he said, “I can count on the fingers of one hand the number of times that, because of a transportation glitch, an organ was ultimately not transplanted.”
Still, O’Connor acknowledged that “even one kidney being thrown away because of transportation errors is unacceptable.”
Part of the problem lies with the way organs are transported now, said Axelrod, who also represents the American Society of Transplant Surgeons.
“We don’t have an end-to-end unified transportation system,” Axelrod said. “We don’t have a FedEx for transplant. We have a cobbled-together system of OPOs and couriers and private aircraft and commercial aircraft.”
In recent years, several courier companies have emerged to meet the market for transplant organs. Don Jones, chief executive of the Nationwide Organ Recovery Transport Alliance, or NORA, contracts with more than 15 OPOs and oversees about 400 organs a year on commercial flights.
“I would say 99.8% of our transports on commercial airlines go perfectly fine,” Jones said based on his estimate. Jones noted that his firm ships organs only on direct flights and uses GPS tracking to monitor them.
However, GPS tracking isn’t universal — or required by UNOS or HRSA. Some couriers and airlines use it; many don’t. Many OPOs monitor organs through a combination of verbal handoffs, automation and label scans, Brown said.
In Ginny McBride’s misadventure last fall, she contracted with a courier, Sterling Global Aviation Logistics, which used Delta Air Lines to ship the kidney.
Delta uses GPS trackers on its Dash Critical shipments, promising fast, guaranteed delivery of human organs. But on that night in October, the kidney was shipped from Orlando to Atlanta without a GPS tracker. In Atlanta, a cargo worker couldn’t find a GPS device to put on the box containing the kidney, so the worker held the organ for a later flight. That would have pushed it far beyond the window of viability.
An internal Delta report, obtained by McBride, found that Delta didn’t have enough GPS devices available in Atlanta that night. “Destination stations are not returning the devices in a timely manner,” according to the report. “One way to mitigate this from reoccurring is to have a larger inventory of GPS devises (sic) at each station.”
Delta declined to comment on the report.
The average wait time for a kidney varies widely nationwide, from less than three years to more than a decade. One proposal to put more organs to use called for eliminating the 58 donation service areas and 11 regions now used to allocate kidneys and replacing them with a zone of up to 500 nautical miles from the donor hospital.
In December, OPTN cut that range in half — to 250 nautical miles — in part because of an outcry about problems shipping kidneys via commercial air.
“There are certainly no technological barriers to doing GPS and to actually requiring it,” Brown said.
A UNOS committee is considering whether to collect data on transportation methods and outcomes, but, so far, the question remains under review.
“If the community wants it, they should ask for it,” Brown said. “We can help facilitate and get it done for them.”
McBride, who discussed solutions with her colleagues, hopes the transplant organizations will come together to solve transportation problems, to make sure every eligible donated kidney gets transplanted.
“Any organ that’s wasted, in my opinion, is a loss to the patient and to the community,” said Paul Conway, of the American Association of Kidney Patients, an advocacy group, who is himself a kidney recipient. “With all of the advances going on with drugs, with medical procedures, how can you have a logistics error be the barrier?”
This investigation and a related podcast represent a collaboration between Kaiser Health News and Reveal, from The Center for Investigative Reporting (CIR), a nonprofit news organization. Reveal, from CIR and PRX, is a nationally broadcast public radio show and investigative reporting podcast. Kaiser Health News (KHN) is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.
How Lifesaving Organs For Transplant Go Missing In Transit published first on https://nootropicspowdersupplier.tumblr.com/
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itsfinancethings · 5 years
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November 19, 2019 at 07:00PM
Federal safety officials say Boeing should redesign part of the casing on some engines to prevent the kind of accident that occurred when engine debris blew out a window on a Southwest Airlines plane and killed a passenger.
The National Transportation Safety Board determined Tuesday that the April 2018 accident was caused by a cracked fan blade that broke off in flight, hitting the engine case at a critical location. Parts of the engine turned into shrapnel, striking the fuselage.
After a harrowing emergency descent from 32,000 feet (9,750 meters), with one passenger blown partly out of the plane, the pilots of Southwest flight 1380 were able to land the crippled Boeing 737 in Philadelphia.
Safety board Chairman Robert Sumwalt said engine and aircraft manufacturers should develop stronger designs for engine casing to prevent broken fan blades from ever causing such catastrophic damage again.
“That translates to a better chance that damage to the aircraft will be minimized during a (broken fan blade) event, improving the safety of the flying public,” Sumwalt said.
The events of flight 1380 led to more frequent and intensive inspections of fan blades on certain engines made by CFM International, a joint venture between General Electric Co. and France’s Safran SA. Those checks at Southwest and other airlines turned up about 15 other fan blades with slowly spreading cracks from fatigue or wear during normal use.
A Southwest 737 suffered a similar engine break-up in 2016, but pilots landed safely in Pensacola, Florida. NTSB investigator Pierre Scarfo said the board found no evidence to believe that the fan blade problem was unique to maintenance or operations at Southwest, which has the world’s largest 737 fleet. However, earlier this year the Transportation Department’s inspector general cited the Philadelphia incident among the reasons that it was reviewing government oversight of the airline.
On Tuesday, the NTSB recommended that the Federal Aviation Administration require Boeing to determine the most vulnerable locations on the engine fan case on certain planes if a fan blade breaks loose, and to redesign the cowling for better structural integrity. The board also recommended that airlines be required to retrofit many older Boeing 737s with the redesigned engine-housing part.
Southwest said it would review the recommendations.
The recommendations apply to “Next Generation” or NG versions of the 737, thousands of which have been built since the early 1990s. They do not cover the grounded Boeing 737 MAX, which uses different engines.
Boeing spokesman Peter Pedraza said all NG planes are safe because “the issue is completely mitigated by the fan blade inspections,” but that Boeing is working on a “design enhancement” to address the safety board’s recommendations.
FAA spokeswoman Marcia Alexander-Adams said the agency will review and respond to the NTSB recommendations. She noted that the agency has already required airlines to step up fan blade inspections.
CFM International said it would comply with any changes that might be made because of the NTSB recommendations.
The CFM56-7B engine was certified by the FAA in 1996 and is currently on 14,600 planes. The Southwest incidents in 2016 and 2018 are the only reported cases of a broken fan blade causing such damage to those engines, according to the NTSB.
The 24 blades in the left engine of flight 1380 were made in 2000 and used on more than 32,000 flights before the fateful flight left New York’s LaGuardia Airport, bound for Dallas.
The NTSB concluded that fan blade No. 13 was already cracked at the time of its last overhaul, but the damage wasn’t spotted using methods then in use, which relied heavily on visual inspections. The FAA later required inspections using electrical current and ultrasound.
As detailed during an investigative hearing into flight 1380 last November, when debris from the engine struck the plane, it caused a window to blow out and created an immediate decompression of the cabin — oxygen masks dropped, debris swirled, the air temperature plunged, and the noise was deafening. The plane rolled sharply to the left.
Jennifer Riordan, a 43-year-old banker and mother of two from Albuquerque, New Mexico, was blown halfway out of the plane. Two passengers helped bring her back inside, but she died from the injuries — the first passenger killed on a U.S. airline flight in more than nine years. Eight others suffered minor injuries. There were 144 passengers and five crew members on the plane.
The captain, former Navy pilot Tammie Jo Shults, and the first officer, former Air Force pilot Darren Ellisor, donned oxygen masks and began an emergency descent. The safety board found that they didn’t perform every checklist for an engine failure or fire, and they used unusual settings for the plane’s flaps because they were worried about losing control if they flew too slowly.
“Basically, she used airmanship, she used judgment, because she felt that was the safest thing to do,” Sumwalt said of Shults. He said the incident showed the value of well-trained and experienced pilots.
Flight attendants put on portable oxygen systems and moved around the cabin, helping passengers. They tried to aid Riordan. Safety board members praised their bravery, although adding that they should have returned to their jump seats for the landing.
A passenger took a selfie that showed three people who had put their oxygen masks on the wrong way despite diagrammed instructions and a pre-takeoff demonstration by flight attendants.
“It’s very difficult, unfortunately, to get passengers to pay attention to the safety briefings,” said NTSB staffer Jason Fedok. “We see that repeatedly.”
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orbemnews · 3 years
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United Airlines will add more than two dozen flights as leisure travel picks up. United Airlines plans to add more than two dozen new flights starting Memorial Day weekend, the latest sign that demand for leisure travel is picking up as the national vaccination rate moves higher. Most of the new flights will connect cities in the Midwest to tourist destinations, such as Charleston, Hilton Head and Myrtle Beach in South Carolina; Portland, Maine; Savannah, Ga.; and Pensacola, Fla. United also said it planned to offer more flights to Mexico, the Caribbean, Central America and South America in May than it did during the same month in 2019. The airline has seen ticket sales rise in recent weeks, according to Ankit Gupta, United’s vice president of domestic network planning and scheduling. Customers are booking tickets further out, too, he said, suggesting growing confidence in travel. “Over the past 12 months, this is the first time we are really feeling more bullish,” Mr. Gupta said. Airports have been consistently busier in recent weeks than at any point since the coronavirus pandemic brought travel to a standstill a year ago. Well over one million people were screened at airport security checkpoints each day over the past two weeks, according to the Transportation Security Administration, although the number of screenings is down more than 40 percent compared with the same period in 2019. Most of the new United flights will be offered between Memorial Day weekend and Labor Day weekend aboard the airline’s regional jets, which have 50 seats. The airline said it would also add new flights between Houston and Kalispell, Mont.; Washington and Bozeman, Mont.; Chicago and Nantucket, Mass.; and Orange County, Calif., and Honolulu. All told, United said it planned to operate about 58 percent as many domestic flights this May as it did in May 2019 and 46 percent as many international flights. Most of the demand for international travel has been focused on warm beach destinations that have less-stringent travel restrictions. “That is one of the strongest demand regions in the world right now,” Mr. Gupta said. “A lot of the leisure traffic has sort of shifted to those places and it’s actually seen a boom in bookings.” Delta Air Lines issued a similar update last week, announcing more than 20 nonstop summer flights to mountain, beach and vacation destinations. Both airlines have said in recent weeks that they have made substantial progress toward reducing how much money they are losing every day. Source link Orbem News #Add #airlines #dozen #flights #leisure #Picks #Travel #United
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marymosley · 5 years
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Top Cities in United States for Lawyers to work
In this study, Advisorsmith ranked 332 cities of United States to determine the most attractive cities where lawyers may want to pursue their careers. 
Study found that the best cities for lawyers are large cities, with 9 of the top 10, and 38 of the top 50 cities being cities with populations of 500,000 or higher. Major cities have higher concentrations of businesses and organizations in need of legal assistance, which also leads to higher concentrations of jobs for attorneys.
Best Cities for Lawyers
1. Washington, DC
As the nation’s capital, Washington, D.C. ranked as the number one city for lawyers in our study. Located along the Potomac River, the city is home to the federal government of the United States, as well as major international organizations such as the World Bank and the International Monetary Fund. Besides government functions, the city also hosts major universities including Georgetown University and George Washington University as well as several major medical facilities.
Lawyers in Washington, D.C. earn an average salary of $179,980, which is 25% above the national average. The presence of the federal government, rulemaking bodies, and lobbying associations creates many jobs for attorneys in the city. Washington, D.C. had the highest location quotient of all the cities in our study, having over 3 times as many lawyers as the average U.S. city on a per-capita basis. Some of the largest law firms in Washington, D.C. include Covington & Burling LLP, Hogan Lovells U.S. LLP, Arnold & Porter Kaye Scholer LLP, Latham & Watkins LLP, and Morgan, Lewis & Bockius LLP.
2. Houston, TX
Located near the Gulf of Mexico, Houston is the 5th largest metropolitan area in the United States by population. Houston’s rise began as a trading center, with an important port and the bustling railroad industry, followed by the discovery of oil resources in Beaumont, not far from Houston. Oil and gas continues to be a major driver of the city’s economy today. Later, the city continued to diversify its economy with the establishment of the Texas Medical Center and NASA’s Johnson Space Center, leading to growth associated with the aerospace industry.
Houston’s lawyers earn salaries of $175,380 on average, which is 22% above the national average. The cost of living in Houston is also modest, with a cost of living index ranking Houston 7% below the national average, meaning lawyers in Houston can enjoy comfortable lifestyles. Several of the largest law firms in Houston include Vinson & Elkins LLP, Baker Botts LLP, Norton Rose Fulbright US LLP, Bracewell LLP, and Locke Lord LLP.
3. Tallahassee, FL
Tallahassee is the capital of the state of Florida and also home to Florida State University. Located in the northern part of the state in the Florida Panhandle, Tallahassee was chosen as the state capital as a compromise in the 1820s because it was located halfway between the other primary contending cities, Pensacola and St. Augustine. Today, the city’s economy is driven primarily by its role in state government, as well as by the major public universities that it hosts.
Attorneys in Tallahassee had salaries of $118,010 on average. Although this is below the national average salary, attorneys in the city benefit from a cost of living that is 7% below the national average. Jobs for lawyers in Tallahassee are plentiful, as the city has a location quotient of 2.85, meaning there are 185% more jobs for lawyers on a per-capita basis compared with the U.S. average. Several notable law firms in Tallahassee include Baker Donelson, Gunster, and Akerman LLP.
4. Chicago, IL
As the third largest metropolitan area in the country, Chicago is the most important city in the Midwest. The Chicago metro area has a population of almost 10 million people, and the city is a global hub for finance, technology, and transportation. Located on the shores of Lake Michigan, Chicago was an important trading city linking the Great Lakes and the Mississippi River. Today, the city hosts financial trading markets such as the Chicago Board of Trade, one of the busiest airports in the world at Chicago O’Hare, and the largest amount of railroad freight in the country.
Lawyers in Chicago earn an above average salary of $159,900 compared with the national average. Additionally, Chicago has a location quotient of 1.30, which means that the city hosts 30% more jobs for attorneys compared with the average U.S. city. In total, Chicago has 26,860 jobs for lawyers. Some of the largest law firms in Chicago include Kirkland & Ellis, Sidley Austin, Mayer Brown, Jenner & Block, and Winston & Strawn.
5. Miami, FL
The city of Miami, located in South Florida, is a dense metropolitan area that features beautiful sandy beaches and numerous high rises. The metropolitan area has a population of over 6 million people and is a major finance, international trade, and tourism hub. Miami attracts many residents relocating from the Northeast and Latin America, attracted by its pleasant climate, low taxes, and stable economic and political environment.
Miami has 20,140 lawyers, which is 75% more on a per-capita basis than the average U.S. city, making employment easy to find. Attorneys in Miami earned an average salary of $145,430, which is about the national average. Some of the largest law firms in Miami include Greenberg Traurig, Akerman LLP, Holland & Knight, Shutts & Bowen LLP, and Gunster.
Rank City City Size Average Annual Salary Total Jobs Location Quotient Cost of Living
1 Washington, DC Large $179,980 43,900 3.15 135 2 Houston, TX Large $175,380 12,670 0.96 93 3 Tallahassee, FL Midsize $118,010 2,190 2.85 93 4 Chicago, IL Large $159,900 26,860 1.3 109 5 Miami, FL Large $145,430 20,140 1.75 113 6 Birmingham, AL Large $127,170 2,220 0.98 84 7 Philadelphia, PA Large $152,100 18,280 1.44 111 8 Atlanta, GA Large $136,890 15,920 1.34 98 9 Pittsburgh, PA Large $132,330 5,340 1.05 91 10 Richmond, VA Large $147,500 3,330 1.16 104
11 New York, NY Large $172,020 80,900 1.92 146 12 Oklahoma City, OK Large $114,400 3,950 1.44 87 13 Milwaukee, WI Large $147,650 3,740 0.99 102 14 Charleston, WV Midsize $95,990 920 1.85 81 15 Montgomery, AL Midsize $119,120 970 1.33 89 16 New Orleans, LA Large $122,640 3,600 1.47 97 17 Denver, CO Large $156,000 9,650 1.47 126 18 Springfield, IL Midsize $117,660 490 1.06 87 19 Hartford, CT Large $147,370 3,350 1.29 117 20 Trenton, NJ Midsize $120,950 1,950 1.9 113
For Complete Ranking, Click Here
Methodology
AdvisorSmith’s study on the best cities for lawyers weighed three major factors in its ranking.
1. Cost of living index for each city
The cost of living was used to adjust the salaries earned in each city. Because some cities with very high compensation for lawyers, such as New York City, also suffer from very high costs of living, we normalized salaries using a cost of living index so that the lifestyle that a lawyer can expect in different cities could be compared more fairly. More affordable cities scored higher in our ranking of cities.
2. Average annual salaries for lawyers in the city
An important factor in deciding a place to practice law is the average annual compensation available to lawyers in a city. One variable we considered in our study is the pay that lawyers in each city can expect. Cities with higher pay were ranked more highly in this study.
Nationwide, the average salary for a lawyer in the United States was $144,230.
3. The density of jobs for lawyers in each city
Our study considered the location quotient for attorney employment, which indicates the number of jobs for lawyers in a city compared with the total number of jobs in the city. The higher the location quotient, the more likely it is that any given job in the city is a job for a lawyer. Cities with higher location quotients ranked more highly in our study.
According to the Bureau of Labor Statistics, there were 642,750 lawyers employed in the United States in 2018. The BLS also predicts that employment for attorneys will increase 8% in the 10-year period between 2016-2026.
The post Top Cities in United States for Lawyers to work appeared first on Legal Desire.
Top Cities in United States for Lawyers to work published first on https://immigrationlawyerto.tumblr.com/
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