Doctor: Pilot's license shouldn't have been renewed

By Kirsten B. Mitchell - NYT Regional Newspapers - April 09, 2008

WASHINGTON — The pilot of a freighter that struck the San Francisco-Oakland Bay Bridge in November received a sleep apnoea diagnosis that should have triggered a Coast Guard review that could have resulted in the loss of his license.

Pilot John Cota of Petaluma also reported 10 months before the accident taking a cocktail of prescription drugs to treat depression, pain and other conditions. The drugs can cloud judgment and slow reaction time, according to testimony Wednesday before the National Transportation Safety Board.

“I wouldn’t want anyone taking those medicines and making decisions” or “judgment calls in situations that are urgent,” said Dr. Robert Bourgeois, a Louisiana physician who has examined thousands of mariners for licensing and other purposes.

It has not been disclosed what drugs were in Cota’s system at the time of the Nov.7 oil spill.

Records disclosed in Washington D.C. Wednesday also show that Cota was convicted of a DUI in 1999, entered and attended Alcoholics Anonymous. He also at one time had taken a drug for pancreatitis, a condition linked to alcoholism.

The accident, which occurred in heavy fog, caused more than 50,000 gallons of fuel oil to pour from the ship’s hull. It was the largest spill in the San Francisco Bay in two decades.

Wednesday’s hearing, the second of two days of testimony in the NTSB investigation, painted a scene in which neither pilots’ groups nor the Coast Guard have clear guidelines for prescription drug use by mariners.

Sometime in the two years before Cota’s January 2007 medical report he was diagnosed with sleep apnoea, a condition that causes people to stop breathing repeatedly while sleeping.

The diagnosis should have been a red flag for further review by Coast Guard’s National Maritime Center, which licenses merchant mariners, according to NTSB investigators.

“If this physical had gone to the National Maritime Center, it would have been stopped,” said Bourgeois. He has not examined Cota and has seen only a summary of Cota’s medical report, but testified that the license should not have been renewed in January 2007.

Sleep apnoea is not an automatic reason for yanking a mariner’s license, but the medical records of anyone with the condition should be closely examined and should include an up-to-date sleep study and whether treatment is effective, Bourgeois said.

“You can still have daytime ... sleepiness,” he added. “That’s not something you want to see in a mariner.”

NTSB investigators and witnesses discussed information in Cota’s medical report, but, citing privacy concerns, declined to release a copy or discuss it beyond the public hearing.

Capt. Arthur French of the National Maritime Center testified that he would not have renewed Cota’s license and that an official at the Coast Guard’s Regional Exam Center in San Francisco who reviewed Cota’s report misinterpreted rules regarding when a medical waiver can be applied to a license.

Cota’s license was renewed in 1999 under a medical waiver. Under such a license, Coast Guard rules require changes in condition, but not medication, to trigger closer review, a policy that Capt. French said was not followed and that he labeled “unclear.”

The Coast Guard reviews about 2,000 medical reports a year. After an overhaul of the medical oversight system is complete in September, the Coast Guard expects to review 60,000 such reports annually, Capt. French said.

The new system will not include rules governing prescription drug use by mariners.

Cota surrendered his license after the Cosco Busan accident.

Cota reported in January 2007 taking six prescription drugs used to treat sleep apnoea, depression, migraine headaches, acid-reflux, anxiety and pain, according to testimony.

It is unclear what medications Cota was taking at the time the Cosco Busan hit the bridge. In a wide-ranging interview with NTSB investigators nine days after the accident, Cota said he was taking Provigil for sleep apnoea and Synthroid to regulate thyroid function. The NTSB released a transcript of the interview Tuesday. Wednesday’s hearing did not touch on the thyroid medication.

Referring specifically to four drugs, AcipHex, lorezepam, Provigil and Darvon to treat acid reflux, anxiety, sleep disorders and pain, respectively, Dr. Bourgeois testified that pilots should not take such medications.

The Cosco Busan collision was the second incident involving Cota in less than two years, according to the Board of Pilot Commissioners for the Bays of San Francisco, San Pablo and Suisun. Cota received a warning letter of reprimand for pilot error and “lack of situational awareness” in July 2006, five months after the bulk freighter Pioneer ran aground in the San Francisco Bay, according to one of more than 150 exhibits and documents the NTSB released Tuesday.

Cota did not testify and has pleaded not guilty in U.S. District Court in San Francisco to violating federal pollution and migratory bird laws.