(CNN) — A flying instructor died inflight after suffering a cardiac arrest, but his co-pilot thought he was fooling around and only realized after landing on the runway with the man slumped on his shoulder.
According to a newly published safety report on the incident, the pilot thought the instructor was pretending to be asleep as the pair flew a circuit above near Blackpool Airport in Lancashire, England, on June 29, 2022.
The qualified pilot had asked the instructor to accompany him aboard the four-person Piper PA-28 for safety reasons during windy conditions, according to the UK's Air Accidents Investigation Branch report.
Prior to takeoff, the pair chatted normally while the pilot taxied the craft out to the runway, the pilot told the AAIB. He said that the instructor's last words were, "Looks good, there is nothing behind you."
Shortly after takeoff, the instructor's head rolled back. As the two pilots knew each other well, the co-pilot thought his companion was "just pretending to take a nap" while he completed the circuit, the report said. When the plane turned around, the instructor slumped over so that his head rested on the co-pilot's shoulder, but again the pilot still thought a joke was being played on him.
After landing safely with the instructor still resting on his shoulder and not responding, the pilot realized something was wrong and alerted airport emergency services who were unable to revive the instructor.
The instructor, who had close to 9,000 hours of flying experience, was said to be in good spirits before his final flight.
"People who had spoken to him on the morning of the incident said he was his normal cheerful self and there were no indications that he was feeling unwell," the AAIB report said. "The three people who had flown with him for the trial lesson just prior to the incident flight said he seemed well and nothing abnormal had occurred."
The medical department of the UK Civil Aviation Authority reviewed the incident and the instructor's medical history and concluded that, "From the evidence provided, it is likely the individual suffered a cardiac arrest as the aircraft took off." He was known to suffer from high blood pressure, but it was within regulatory limits.
The AAIB's report concludes that, while on this occasion the instructor's co-pilot was qualified and was able to land the plane safely, the outcome could have been very different.
"No tests or assessment can give a 100% reliable detection of cardiac issues" and "a balance needs to be struck between minimizing the risk to flight safety and providing fair and reasonable medical assessment of individuals," says the AAIB. "The rarity of accidents cause by cardiac events in flight suggests this balance is currently about right."
About 70% to 90% of people who go into cardiac arrest in the US die before they get to a hospital because the people around them don't always know how to help. CNN's Dr. Tara Narula demonstrates some simple steps you can take right away if you suspect that someone has gone into cardiac arrest.