Date: 201407
Local time of day: 1201-1800
Location: ZZZZ.ARTCC, FO
Flight conditions: VMC
Light: Daylight
Aircraft: B757 Undifferentiated or Other Model
Operator: Air Carrier
Operating under: Part 121
Flight plan: IFR
Mission: Passenger
Flight phase: Landing
Airspace: Class A ZZZZ
ATC / advisory: Center ZZZZ
Reporter organization: Air Carrier
Reporter function: Captain; Pilot Not Flying
Reporter qualification: Flight Crew Air Transport Pilot (ATP)
Human factors: Time Pressure; Troubleshooting; Workload
Anomaly: Deviation / Discrepancy - Procedural FAR; Deviation / Discrepancy - Procedural Published Material / Policy; Deviation / Discrepancy - Procedural Weight And Balance; Flight Deck / Cabin / Aircraft Event Illness / Injury
Detector: Person Maintenance
When detected: In-flight
Result: Flight Crew Became Reoriented; Flight Crew Took Evasive Action; General Maintenance Action
Contributing factors: Aircraft; Human Factors; Procedure
Primary problem: Ambiguous

Narrative: We were operating oceanic; when we received a cabin call. The Purser informed us that they had an old male found unconscious in the mid-cabin lavatory. The flight attendants administered oxygen and also performed CPR and monitored his condition with the AED. They also made a PA asking for medical personnel on board. The only responses were from a pharmacist and a veterinarian. We called to consult with Dispatch and commercial medical consultants. They suggested we try several medicines. These were administered to no avail. As the patient had a weak pulse and shallow respiration; it was decided to divert.We declared an emergency and received a clearance direct. Due to the dire condition of the patient; in consultation with Maintenance we decided to use emergency authority to make an overweight landing at approximately 200.8 K LBS rather than risk losing any more time. On the way to the divert airport; we performed the diversion checklist and reviewed the recovery checklist. We received landing performance data for Runway 20; and made an uneventful landing. We taxied to the ramp area and the ill patient (accompanied by his wife) departed with the local EMS.After arrival; we started to organize for departure. We had five basic areas to work on: 1. Passenger comfort and catering. 2. Maintenance for our overweight landing and cabin write-ups. 3. Dispatch to try and determine our next flight segment. 4. Fueling for the next leg of flight. 5. Duty Manager and Crew Desk to determine our duty time limit. We called Dispatch to coordinate a release to our next destination. We called Maintenance and read them each log book write-up and its coupon number. They replied that Contract Maintenance would 'take care of it' and they 'would coordinate with Dispatch.' Contract Maintenance came to the aircraft and began with the overweight landing inspection. After that was complete; he left with the logbook. When the Mechanic came back; he was trying to fill out the maintenance placards with MEL reference. We told him we had the MEL on our IPad and he referred to it as he filled out the placards that were taped to the front of the tin logbook. He also filled out the log coupons. Fueling was completed after consulting with Dispatch as to our planned stop short of our destination. He said we would be non-RSVM per procedure. The Duty Manager and the Crew Desk sent us a message with our crew duty time; which we were in time for with our extension that we OK'd over ACARS. We departed; and arrived at the next divert station about four hours later. At the termination of the pairing; we received notice from our Chief Pilot's office that Maintenance had filed a report regarding our second flight. Specifically; that four items had been improperly handled: 1. Lack of MEL Control Number and placard on logbook cover. We can only go on what we regard as being a reasonable corrective action. So when we see a logbook coupon signed after a corrective action and a placard on the logbook cover; we consider the item deferred. 2. Lack of amended release containing deferred items. When the First Officer initially called Maintenance with our write ups; he said he would coordinate with Dispatch on our further release. So when the flight plan and release were received reflecting a cruise altitude of FL260 for non-RSVM operation; we again assumed this was done with Maintenance consultation. 3. Discrepancy in overweight landing documentation with a First Officer file number. This was filled out as we descended into the first divert station by second First Officer; and in the confusion of the diversion; I did miss this item. After we received notice of the possible irregularities; the First Officer and I did have a phone conversation and discussed the FOM reference. 4. AED deferred under wrong MEL. I considered this item as also closed; as we referenced the log coupon and sticker.




Synopsis: A B757 diverted to a foreign airport with a critically ill elderly man; and after arriving at the domicile were notified of maintenance and procedural issues during the hurried departure.