Daniel Wylie wears tight stockings on both legs all the time now. He takes an 81mg tablet of aspirin every day. On flights, he drinks water like a parched camel and paces up and down the aisle and tries to stretch out as best he can.
All that came about, he said, after he developed a blood clot on an American Airlines flight from Paris to San Francisco with a stop at a New York-area airport three summers ago.
After arriving home in Windsor, California, he walked into a local hospital with a bluish right leg. A doctor, he said, told him he was lucky that the clot had not broken off and traveled to his lungs, which could have resulted in a fatal pulmonary embolism. Wylie was put on a series of blood thinners for six months.
He is now suing American, a unit of the AMR Corp, and Boeing in District Court, charging failure to take proper preventive measures that would help passengers avoid blood clots.
"I was very frustrated about the fact that not in any of my travels have I ever received a warning about deep vein thrombosis, or what's commonly referred to now as economy-class syndrome," Wylie said at his home north of Phoenix.
Wylie's suit is coupled with one from Debra Miller, of Watsonville, California, who accuses Air France, Continental Airlines and Boeing of the same failure.
Her complaint said she developed a life-threatening clot on a two-stage flight to San Francisco after running in the Paris Marathon in April 2001.
These could be the first suits of their kind to go to trial in this country, after District Court Judge Vaughn R. Walker ruled against the defendants' motion to dismiss the case in July.
Representatives of Boeing and the airlines declined to comment on the matter because of the pending litigation.
The lawsuit focuses attention on the question of what kind of role air travel may play in causing blood clots, and what actions, if any, airlines should take in warning passengers and recommending preventive measures.
Debate on these matters has intensified in recent years as more than 200 lawsuits have been filed against foreign and domestic airlines, and because better aircraft technology is making long-haul flights more common.
The British Medical Journal published a study last month that found the risk of getting a blood clot or pulmonary embolism was highest within two weeks of a long-haul flight.
The researchers, who looked at records of more than 5,400 patients admitted to hospitals from 1981 to 1999 in the state of Western Australia, also concluded that the annual risk of a clot developing increases by 12 percent if one long-haul flight is taken per year.
"Airlines and health authorities should continue to advise passengers on how to minimize risk," the researchers wrote.
Despite a growing number of recommendations like that to airlines, a plaintiff has yet to win a case in any of the lawsuits.
In this country, the most prominent lawsuits have been filed in California and Texas. Besides the case involving Wylie and Miller, only two other suits, both in Texas, have been allowed to go to trial, but they are on hold while an appeals court looks at issues of liability, said Michael Danko, the lawyer representing Wylie and Miller.
In a case that helped to bring the problem to worldwide attention, a 28-year-old British woman died of deep vein thrombosis in October 2000, minutes after stepping off a nonstop Qantas Airways flight to London from Sydney, where she had been watching the Olympics.
Her parents joined relatives of other blood-clot victims in a lawsuit against 18 airlines. That suit was dismissed by an appeals court in London in July, but lawyers for the families said they are trying to get the House of Lords to overturn that decision.
The Air Transport Association, the industry's main trade group in this country, said it is starting to look more into deep vein thrombosis, but does not mandate or suggest to airlines that they take cautionary or preventive steps.
"In our view, there are no direct relationships between air travel and deep vein thrombosis," said Dave Berg, general counsel for the trade group.
Deep vein thrombosis occurs when a blood clot forms, usually in a person's legs. Most clots dissolve, but if one breaks off, it can be lethal.
Even if not fatal, clots can be debilitating, some people say. Miller had to have open-heart surgery after the clot moved to her heart, and she is now permanently on blood thinners, Danko said.
Certain people have a higher chance of getting deep vein thrombosis -- those who are older or overweight, for example, or those who have recently had surgery.
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