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Suit alleges Baxter’s heparin killed wife

Baxter International Inc. faces a growing number of lawsuits from families who blame the company’s blood-thinning drug heparin for deaths of loved ones. Heparin was used by millions of people to prevent blood clots during dialysis and other medical procedures.

The latest wrongful death suit was filed Wednesday in Cook County Circuit Court by the widower of an Iowa woman who died at home during kidney dialysis Nov. 30. Mark Scott of Davenport accuses Baxter of selling defective heparin that caused her death.His wife, Melissa Scott, 53, began experiencing nausea and vomiting after treatment began in August, said Tom Ellis, a spokesman of the Nolan Law Group in Chicago

Chicago, which brought the suit on behalf of Mark Scott. On Nov. 30, Ellis said, an allergic reaction to the heparin caused Scott to fall and as a result disconnect from the machine. Mark Scott found his wife on the floor after she called out to him during a treatment. The death certificate said death was caused by an air embolism in the heart, Ellis said. An autopsy was not performed.”Mark wants to know for sure what happened to his wife,” Ellis said. “His wife was well trained on the dialysis machine.”

A Baxter spokeswoman said the company had not yet seen the Scott suit and declined to comment on its specific allegations. But she said the company is aware of at least four other wrongful death suits in the

U.S.
U.S.

“No patient deaths have been confirmed by medical or epidemiological evaluation by Baxter or [the U.S. Food and Drug Administration] to have been caused by the allergic-type reactions associated with the current heparin recall,” said Baxter spokeswoman Erin Gardiner. “None of these suits includes any credible medical information to allow the company to medically evaluate these claims.”The Deerfield-based company also is defending at least five suits brought by patients who allege they were harmed by tainted heparin.

The FDA is investigating whether heparin is connected to as many as 19 deaths and more than 700 serious illnesses since

Jan. 1, 2007
. Baxter insists that four deaths so far may be connected to adverse reactions to heparin.Baxter recalled the drug in February after a spike in severe allergic reactions in patients. Further investigation revealed a significant amount of an unidentified foreign substance contaminated batches of heparin.

The suspect active ingredient originated at a

Changzhou, China, plant owned by Scientific Protein Laboratories, a Baxter supplier based in Waunakee, Wis. Last month the FDA disclosed that low-cost animal cartilage made its way into Baxter’s heparin but has not determined a specific link to allergic reactions.
Changzhou, China, plant owned by Scientific Protein Laboratories, a Baxter supplier based in Waunakee, Wis. Last month the FDA disclosed that low-cost animal cartilage made its way into Baxter’s heparin but has not determined a specific link to allergic reactions.

FDA finds unidentified substance in Baxter’s blood-thinning drug heparin

A significant amount of an un-identified foreign substance contaminated Baxter International Inc.’s blood-thinning drug heparin, the U.S. Food and Drug Administration said Wednesday, raising the possibility of intentional tampering in a supply chain that begins with pig farms in China
.The mysterious substance, which has a chemical makeup similar to heparin, comprises as much as 20 percent of the active ingredient in nine suspect lots produced by Baxter since September, the FDA said Wednesday. The suspect lots are connected to at least four deaths reported nationwide since Baxter noted a spike in adverse reactions to the drug in late December.

The FDA on Wednesday said heparin is connected to as many as 19 deaths and 785 serious illnesses since

Jan. 1, 2007
Jan. 1, 2007

. But the FDA timeline extends well beyond the period from September to November, when Baxter’s Cherry Hill, N.J., plant produced the heparin connected to the recent rash of serious allergic reactions. The suspect active ingredient in heparin originated at a Changzhou, China, plant owned by Scientific Protein Laboratories, a Baxter supplier based in Waunakee, Wis.
“We don’t know whether the introduction of the contaminant was accidental, as part of the biological process, or if it was deliberate,” said Dr. Janet Woodcock, acting director of the FDA’s center for drug evaluation and research.
At least one former top FDA official who helped lead the fight against counterfeit drugs indicated that some Chinese suppliers in the past have introduced foreign substances to boost production when supplies are tight. That’s what happened in the early 1990s with an antibiotic known as gentamicin sulphate, which produced adverse reactions and some deaths in the U.S.
“The obvious question is, ‘Are these plants back-dooring their supply in order to supplement their capacity?'” asked Benjamin England, who chaired the FDA’s Counterfeit Drug Working Group before leaving for a private law practice in

Washington, D.C.
, in 2003.Epidemic in

China
China

Heparin is produced from an enzyme in the mucous lining of pig intestines. The suspect lots of heparin were made beginning in September, just after the peak in an epidemic of an often-fatal disease known as “blue ear” that afflicted more than 250,000 pigs throughout

China
. More than half those pigs died or were exterminated.An FDA official at the press conference said it is possible supplies of the adulterated ingredient came from pig intestines. But FDA officials emphasized they have not pinpointed the source.

Conventional quality and safety testing typically does not discover a foreign substance,

England
England

added, because the tests are not designed for that purpose.The FDA in its press conference Wednesday said conventional tests performed by Baxter and Scientific Protein did not show any variation because the contaminant is so similar to heparin.

“It acts like heparin in this test, so it looks like everything is fine in the test,” Woodcock said.

Only after further testing, using nuclear magnetic resonance spectroscopy, did the differences in chemical makeup become apparent, the FDA said.
Scientific Protein’s plant obtains heparin from bulk providers of raw material. From its plant in

Changzhou, Scientific Protein ships raw heparin to the company’s headquarters outside Madison, Wis., then on to Baxter’s Cherry Hill
Changzhou, Scientific Protein ships raw heparin to the company’s headquarters outside Madison, Wis., then on to Baxter’s Cherry Hill

plant for final processing, packaging and shipping.Pointing fingers

Baxter, in its own press conference, sought to point the investigative spotlight back to

China
China

. Baxter executives said the active pharmaceutical ingredient sourced from its China-based supplier is the focus of the company’s investigation.”Either the problem lies further back in the supply chain, somewhere before the material gets to the processing plant, or there’s something in the processing before it comes to Baxter,” said Peter Arduini, president of Baxter’s medication delivery business.

Arduini said the company’s

Cherry Hill
Cherry Hill

manufacturing plant, where multidose vials of heparin are finished and filled before shipment to hospitals and dialysis centers, recently passed an FDA inspection.Arduini said Baxter’s investigation centers further into the “supply stream” in

China
China

. There could be “process issues” associated with Scientific Protein’s Chinese manufacturing plant, he said.Baxter also took issue with the numbers provided by the FDA, which said heparin has played a role in 19 patient deaths since

Jan. 1, 2007
Jan. 1, 2007

. Baxter insists that four deaths so far may be connected to adverse reactions to the suspect heparin.For its part, Scientific Protein disagreed with the FDA’s interpretation of test results that seems to focus the investigation on a possible adulterated material being added during Scientific Protein’s production process.

“During the call with the media, FDA speculated that the source of the adverse events may be a contaminant,” Scientific Protein said in a statement. “It is important to note that this theory is speculation at this point, and [Scientific Protein] is participating actively in working with the FDA to pursue this theory as well as others so that we can understand the cause of the adverse events.”
Scientific Protein’s

Changzhou
Changzhou

plant, owned in a joint venture with a Chinese partner, is preparing a response to an FDA inspection report last week that criticized the plant’s record-keeping, reporting and processes. “It is important to emphasize that the root cause of the heparin adverse events has not been tied to any of the agency’s observations,” Scientific Protein said in a statement.FDA inspections

Dr. Andrew C. von Eschenbach, commissioner of the FDA, declined to say whether the FDA physically inspects the more than 700 Chinese facilities that ship pharmaceutical ingredients and drug products to the

U.S. The FDA has deployed a “risk-based” system that seeks to focus inspection on plants that might potentially cause the most harm to U.S.
U.S. The FDA has deployed a “risk-based” system that seeks to focus inspection on plants that might potentially cause the most harm to U.S.

consumers.Von Eschenbach said the agency is beginning to reallocate resources to better address the problems presented by the huge growth in foreign-made drugs. “We recognize that the number of sites that we must pay attention to that are beyond our borders are going to require us to address this systematically,” he said.

The FDA plans to increase the number of inspectors, base inspectors in key foreign cities, and build stronger working relationships with foreign regulators, Von Eschenbach added.

test

$6.25 Million Dollar Settlement Paid By Insurers For 57 Year Old

On July 13, 2010 Cook County Judge Donald J. Suriano approved a settlement in the amount of $6,250,000.00 for the benefit of Luis and Kathy Vasquez.  Luis Vasquez was a roofer for Knickerbocker Roofing and Paving Co. and suffered severe injuries on March 8, 2004 when he fell through a roof on the premises owned and operated by Metra known as the 51st Street Coach House. Mr. Vasquez fell straight through a concrete roofing tile some twenty feet to the concrete floor below. The general contractor for the entire project including the re-roof project was Defendant Walsh Construction Company. The roofing contractor, a sub contractor to Walsh, was Knickerbocker Roofing and Paving Company. CTE, Inc., a/k/a Consoer Townsend Environdyne and Cotter Consulting were also contractors.  Plaintiffs allege the Defendants were jointly responsible for inspection of the panels and that Defendant Walsh was responsible for safety on the job.

The $6.25M was paid by all Defendants to settle all claims.  Settlement includes waiver of the $560,000.00 workers’ compensation lien. 

Luis and Kathy Vasquez are represented by Donald J. Nolan, Thomas P. Routh and Paul R. Borth, of Nolan Law Group in Chicago, Illinois.

Defendant Walsh Construction Company is represented by Thomas Boylan and Bradford Burton of Cassiday Schade, LLP in Chicago, Illinois.

Defendant Metra is represented by Michael McColl of Foran Glennon Palandech Ponzi & Rudloff, PC in Chicago, Illinois. 

Defendant CTE, Inc. is represented by C. Steven Tomashefsky and Jean Gallo of Stein, Ray & Harris, LLP in Chicago, Illinois.  

Defendant Cotter Consulting is represented by Bruce Lyon and Angie Grove of LaBarge, Campbell & Lyon in Chicago, Illinois. 

Defendant Knickerbocker is represented by John Prusik of Prusik Selby Daley & Kezelis in Chicago, Illinois. 

CASE NUMBER:        04 L 011387 Vasquez v. Walsh Construction Co., of Illinois et al.        

JUDGE:                       The Honorable Donald J. Suriano        

Settlement Amount:       $ 6,250,000.00

Nolan Law Group is a Chicago based personal injury law firm concentrating in aviation accidents, construction accidents, brain injury litigation, medical malpractice, premises liability, product liability, and trucking accidents.

Questions should be directed to Thomas P. Routh of Nolan Law Group at 312.630.4000

$500 Million Jury Verdict Leveled Against Teva Pharmaceutical Industries and Baxter International in Propofol Lawsuit

A District Court jury in Clark County Nevada ordered Teva Pharmaceutical Industries and Baxter to pay a combined $500 million in punitive damages to a plaintiff  who contracted Hepatitis C during an endoscopy procedure after vials of the drug Propofol were allegedly reused on him. The verdict comes on top of the $5.1 million in compensatory damages awarded to the plaintiff and his wife.

Attorneys for the plaintiffs originally offered to settle the case for $1.7 million but the offer was rejected by the defendants.

The bulk of the verdict was against Teva Pharmaceutical who was ordered to pay $356 million in punitive damages, while Baxter International was ordered to pay only $144 million (Teva manufactures Propofol and Baxter distributes Propofol).  

The lawsuit claimed that the plaintiff contracted Hepatitis C as a direct result of product misuse related to unsafe clinical practices from reuse of 50 mL vials of propofol.

Propofol is a short-acting, intravenously administered hypnotic agent often used during the induction and maintenance of general anesthesia. It is also commonly used as sedation for mechanically ventilated adults, and for procedural sedation during colonoscopy and endoscopy.

According to attorneysfor the plaintiff, the 50 mL Propofol vials manufactured and distributed by Teva and Baxter were packaged with inadequate warnings against re-using or “double-dipping’ for more then one patient.  Nurses were alleged to have administited multiple doses of the drug one patient, then used the remaining amounts of the 50 mL vial on other patients. The plaintiffs said  that Teva and Baxter knowingly manufactured and distributed 50 ML vials of propofol to these endoscopy centers, fully aware that only 10 ML vials were needed. The plaintiffs also maintained that this encouraged multi-dosing.

At least nine and possibly as many as 114 other patients were infected with the Hepatitis C during a 2008 outbreak. Additionally fifty thousand other patients were notified that they might be infected.

Teva Pharmaceutical Industries Ltd. is a global pharmaceutical company specializing in the development, production and marketing of generic and proprietary branded pharmaceuticals and active pharmaceutical ingredients. Teva is among the top 15 pharmaceutical companies and among the largest generic pharmaceutical companies in the world.  The Company enjoys a firmly established international presence, operating through a carefully tailored network of worldwide subsidiaries. Headquartered in Israel, above 80% of Teva’s sales, which totaled US$13.9 billion in 2009, are in North America and Europe. Teva has over 35,000 employees worldwide and production facilities in Israel, North America, Europe and Latin America.

Baxter International is valued at more than $26 billion and netted $2.2 billion in 2009.

Teva and the drug Propofol were also the subject of a recent recall. On Dec 10, 2009 the FDA warned Teva Pharmaceutical of “significant” manufacturing violations in their California manufacturing facility that makes Propofol. Inspectors found that Teva had not screened every lot of their raw materials for bacterial endotoxins. 

The FDA had previously issued an alert in June of 2007 regarding reports of clusters of patients who have experienced chills, fever, and body aches shortly after receiving propofol for sedation or general anesthesia.

Teva voluntarily recalled two lots of Propofol Injectable Emulsion 10 mg/mL 100 mL vials on 7/17/2009 due to presence of elevated endotoxins. Customers were instructed to cease using the product and return it to their distributor. A shortage of Propofol followed the 2009 recall.

Baxter Botches Another Safety Recall

On March 2 2010, FDA designated Baxter International’s January Feild Corrective Action of HomeChoice and HomeChoice PRO automated peritoneal dialysis cyclers a Class I recall. A Class I recall is the U.S. Food & Drug Administration (FDA) most serious type of recall action, and are usually only issued when a device poses a risk of serious injury or patient death.

Baxter and the FDA are conducting the recall of the HomeChoice and HomeChoice PRO devices due to reports of serious injuries and at least one death associated with increased Intraperitoneal Volume (IIPV), also known as overfill of the abdominal cavity.

The recall notice says that Baxter will not be removing the HomeChoice and HomeChoice PRO from the market, however clinicians should weigh the risks and benefits to continued use of these devices. The notice goes on to say that clinicians should also review the prescription settings for patients who continue to use these devices.

Untreated Crohn’s Disease Blamed for Child’s Death: Jury awards Plaintiffs estate 1.7 Million in damages

A Cook County jury returned a verdict in excess of $1.7 million in favor of the Estate of a 10-year-old girl who died in the early morning hours of November 13, 2002, just five days after seeing a local pediatrician at Advocate Health Centers, Inc., with complaints of periodic rectal bleeding for about one year, abdominal pain, vomiting, fatigue, and a bloody watery bowel movement that day.

The 10-year-old girl had been complaining of loose stools, vomiting, streaks of blood with nearly every bowel movement for the last year, and periodic abdominal pain. On November 8, 2002, after having a bloody, watery bowel movement, her mother called the pediatrician and rushed her to their office at the Advocate Health Center in Hyde Park to discuss what she believed were serious symptoms with the doctor. The pediatrician noted all of these symptoms in his chart in addition to noting that the child had an unexpected weight loss of thirteen pounds over the last few months. The pediatrician ordered blood studies and a stool culture and sent the child home with instructions to drink clear liquids.

A few days later, the lab tests were reviewed by the pediatrician and he diagnosed the child with mononucleosis. He confirmed this diagnosis in his chart as well as in a telephone message left for the child’s mother. In the meantime, however, in the early morning hours of November 13, 2002, the child collapsed. She was rushed to Trinity Hospital and transferred to Hope Children’s Hospital where notations were made that she had a gastrointestinal bleed and had blood coming from her rectum. Efforts to resuscitate her failed and she died in the hospital soon thereafter. The Cook County Medical Examiner reported the cause of death to be a massive gastrointestinal hemorrhage due to an inflammatory bowel disease known specifically as Crohn’s Disease.

At trial, the attorney for the Estate, Paul R. Borth of Nolan Law Group, presented evidence that, at the time of her single office visit with the local pediatrician, the child presented with the classic signs and symptoms of inflammatory bowel disease and the pediatrician should have referred the child to a pediatric gastroenterologist or admitted her to the hospital for diagnosis and treatment. Stephanie L. Stalter of Nolan Law Group also represented the Estate at trial.

“The pediatrician knew he could not diagnose or treat inflammatory bowel disease, so he should have sent the child to a specialist who could. This child could have survived if she had been referred to a pediatric gastroenterologist for prompt evaluation and treatment,” Mr. Borth stated.

The defense denied liability at trial and argued that referral to a gastrointestinal specialist or admittance to the hospital was unwarranted and that the blood tests and stool culture ordered by the pediatrician were the appropriate first steps in forming a plan for this child’s care. Defense experts, including a world renowned pediatric gastroenterologist from the University of Chicago who has been practicing in the field for over thirty years, and a professor of gastrointestinal pathology from the University of Chicago, opined that they had never seen a death from a gastrointestinal hemorrhage due to Crohn’s Disease, none had been reported in medical literature, and the autopsy results and independent review of pathology slides failed to demonstrate any signs of inflammatory bowel disease or Crohn’s Disease.

The defense and its experts argued instead that the child died from an acute bacterial stomach infection which came on sometime after the child’s November 8 visit with the pediatrician but before her demise on November 13. The defense called the Chief of the Division of Infectious Disease at Children’s Memorial Hospital who testified that this infection killed her within 24-36 hours and there was no indication that inflammatory bowel disease had anything to do with the child’s untimely demise. James W. Kopriva and Trisha K. Tesmer from Cassiday Schade, LLP, represented the local pediatrician and Advocate Health Centers, Inc.

The plaintiff contended that the child’s symptoms were the classic symptoms of inflammatory bowel disease, as admitted by the defense experts. “This case was won by obtaining concessions from the defendants’ experts,” said Mr. Borth. “No one could deny that this child presented to the pediatrician with these classic signs and symptoms of inflammatory bowel disease at that November 8 visit. The question for the jury was whether that single visit to the pediatrician was enough to prompt a referral to a gastrointestinal specialist and whether some intervening infection was the cause of this catastrophe.”
On February 26, 2010, the jury awarded $1,706.125.48 to the Estate of the child for loss of society, and medical and funeral expenses. The jury reportedly found the local pediatrician negligent for failure to refer the child to a pediatric gastroenterologist on November 8, 2002.

The Honorable James P. Flannery, Jr., presided over the trial. No. 06 L 7302.

Two Dead In Royal Air Freight Plane Crash Near Chicago Executive Airport

WHEELING, Illinois – A Learjet on final approach to the Chicago Executive Airport in northwest suburban Wheeling crashed into the Des Plaines River Tuesday January 5th killing both the pilot and co-pilot.

The small cargo plane was registered to Michigan-based Royal Air Cargo and was empty at the time of the accident. The flight left Waterford, Michigan around 1: 00 p.m. and had been hired to pick up a load in Wheeling, Illinois later that afternoon.

Emergency personnel arrived on the scene shortly after the accident and had to travel on-foot to reach the wreckage, which was submerged in about four feet of water. Authorities from several neighboring communities — Wheeling, Mount Prospect and others — sent crews to the scene of the crash. Members of the National Transportation Safety Board arrived around 4 p.m. and said the investigation would begin Wednesday morning.

Royal Air is a family run business which owns and operates both passenger aircraft and cargo planes. They have approximately two dozen aircraft and are no stranger to regulatory scrutiny, accidents and operational violations. In 1999, a Royal Air aircraft was involved in a crash in Pittsfield, Mass., which has some similarities to Tuesday’s accident. On March 25, 1999, a Royal Air plane plummeted almost 12,000 feet in less than a minute before hitting the ground. In both accidents there were sudden losses of communication just before the planes crashed. Pilot Brian Templeton, of Waterford, Mich., was killed in the 1999 accident.

A lawsuit related to the 1999 accident accident was filed by Nolan Law Group on behalf of the family of pilot Brian Templeton. According to the lawsuit, Royal Air Freight.was negligent in performing maintenance on the aircraft, autopilot and de-icing system and in supplying information to support an alternate means of compliance for an MU-2 Airworthiness Directive. Other Defendants include Mitsubishi Heavy Industries, Honeywell and Mid-Continent Instruments.

Royal Air was also sued by federal authorities in 1999 for cutting corners on engine maintenance and inspections. Violations listed in the lawsuit included failure to conduct scheduled inspections of engines, propellers and wing flaps and failure to produce maintenance records. The company ultimately agreed to pay $250,000 in fines for maintenance and record-keeping violations as part of an agreement with the U.S. attorney for the Eastern District of Michigan. Less than a year later, the FAA proposed $60,000 in additional fines against Royal Air for allegedly failing to investigate the backgrounds of 13 newly hired pilots.

American Airlines Flight 331 Likely a Preventable Accident

The December 22 American Airlines Flight 331 accident that injured more than 90 passengers has left numerous questions unanswered. However, even before the National Transportation Safety Board determines a probable cause for this accident, two things are clear from the initial reports: we are fortunate that, in light of the circumstances, the injuries sustained were not catastrophic; and, more troubling, this scenario was likely entirely preventable.

2009 has proven an interesting year for airline pilots and the flying public. In January, we witnessed the heroism of Captain Sullenberger averting disaster and gracefully landing US Airways Flight 1545 in the Hudson River. Cockpit voice recordings reveal a calm and measured reaction to a bird strike, as well as a calculated decision to land the plane in the Hudson. His professionalism, training, experience and judgment prepared him to successfully and artfully land a plane under trying circumstances.

A mere month later, Continental Air Flight 3407, operated by Colgan Air, crashed into a house during approach near Buffalo, NY, killing all 49 passengers and crew as well as one person the ground. Unlike Captain Sully, the pilots operating this regional flight were sleep deprived, sick, distracted and flying in inclement weather. They lacked sufficient training and resources, and were thus unqualified to be flying a plane under those circumstances.

In October, two Northwest pilots missed their destination by over 150 miles and failed to respond to air traffic controller attempts to reach them. The pilots claimed they “lost situational awareness” because they were distracted, reviewing a new company policy on a laptop. Speculation surrounding this incident has focused heavily on the theory that the pilots were in fact sleeping, again highlighting the issue of pilot fatigue.

Which brings me to the events of Tuesday night in Jamaica. The facts as they unfold have many similarities – both from an operational standpoint, as well as the aircraft type and runway environment – to Southwest Flight 1248 overran its runway in December 2005. In the Southwest accident investigation, the NTSB looked at factors such as decision to land, calculation of landing distance on a contaminated runway, company braking procedures, as well as pilot training.

Reports indicate that Tuesday’s flight in Jamaica had sufficient fuel to return to Miami, yet decided to land on the contaminated runway rather than turn around. The pilots were near timing out for their flight hours for the day, which raises the possibility of pilot fatigue impacting their decision-making process and their operation of the aircraft. Was the decision to land made based on the safety of the passengers or – considering the pressure of holiday travel, passenger frustration, pilot fatigue and cost – did the pilots decide that the safety risk was worth it?

The numerous accidents and incidents of 2009 raise serious questions about what is going on in the cockpit. The over arching question is a serious one: during these economic times, is aviation industry creating a culture of undervaluing risk to save money?

Make no mistake, there are numerous technical issues that may have contributed to the scenario that unfolded on Tuesday night, as well as the lack of preventative measures that could have mitigated damages. Moreover, the risk of human error is everpresent, and for that reason we must advocate also for additional safety measure that minimize the impact of such errors. Nonetheless, the events and mistakes outlined above are not discrete individual incidents; rather, they are evidence of a deteriorating safety culture. We are entrusting the safety of passengers to tired, overworked, and often under paid pilots who have insufficient training and distractions in the cockpit. Congress must act to ensure that the business interests of airlines do not outweigh the safety of our passengers. In 2009, Captain Sullenberger’s “Miracle on the Hudson” was an exception in a year fraught with serious safety hazards. But the reality is, he was not lucky – he was prepared. In 2010, let’s make his example the rule.

Kingston weather poor at time of American 737 overrun

While details on the American Airlines Boeing 737-800 overrun at Kingston remain sketchy, meteorological data shows poor weather conditions during arrival.

American’s timetable shows flight AA331’s scheduled arrival time is 21:10, but the carrier says the aircraft landed at 21:22CST, equating to 22:22 local.

Meteorological information from Norman Manley International Airport indicated heavy rain and possible thunderstorm activity at this time.

The airport has a single runway, designated 12/30, which has a length of 2,716m (8,910ft) but its virtually-offshore location – on a thin strip of land south of Jamaica – leaves little overrun margin at either end.

There is no confirmation of which runway the aircraft was using. While there is an instrument landing system for runway 12, the weather data indicates that this would have required landing with a tail wind.

NOTAM information, dated today, shows that the airport has restated the runway distances available to aircraft, and introduced a displaced threshold on runway 30.

American states that two of the 148 passengers were admitted to hospital for observation, but all others have been released. The jet, arriving from Miami, was also carrying a crew of six.

Damage to the 737 is substantial. Its fuselage has fractured aft of the wing, its right-hand CFM International CFM56 engine has separated and the left wing-tip has snapped.

By David Kaminski-Morrow