By BlueShift | 2026-01-15

Four members of the International Space Station (ISS) crew splashed down in the Pacific Ocean on January 15 after the first medical evacuation in the orbital lab's history.

The astronauts' safe return to Earth demonstrated the successful execution of carefully considered emergency protocols, while also highlighting the need for their further development and refinement.

The capsule carrying US astronauts Mike Fincke and Zena Cardman, Russian cosmonaut Oleg Platonov and Japanese astronaut Kimiya Yui landed off the US coast near San Diego at 12:41 a.m., a video feed from NASA showed.

The crew had spent five months in space, when a health issue prompted their mission to be cut short.

Without revealing details, NASA administrator Jared Isaacman said the unnamed crew member experienced "a serious medical condition" that "could have happened on Earth completely outside of the microgravity environment."

The affected crew member "is doing fine," he said, noting that all crew members are in good spirits and were undergoing standard post-arrival medical checks.

The Crew-11 quartet arrived at the ISS in early August and had been scheduled to stay onboard the space station until they were rotated out in mid-February, AFP reported.

NASA's chief health and medical officer James Polk said "lingering risk" and a "lingering question as to what that diagnosis is" led to the decision to bring back the crew earlier than originally scheduled.

"This was a deliberate decision to allow the right medical evaluations to happen on the ground, where the full range of diagnostic capability exists," Fincke, the SpaceX Crew-11 pilot, previously shared in a social media post.

"It's the right call, even if it's a bit bittersweet."

Handling unexpected situations

Pre- and post-flight medical operations form the foundation of crew member health and mission success, according to NASA.

"Prior to launch, crew surgeons focus on optimizing crew health, mitigating known medical risk, and prepare the crew for the physiological demands of spaceflight," the agency says.

"These pre-flight medical operations include comprehensive medical assessments, planning of countermeasures, and readiness evaluation."

"Following landing, medical teams focus on monitoring the crew’s re-adaptation to gravity, evaluate the extent of deconditioning, and manage any mission-related changes."

But sometimes, unexpected situations can arise in flight.

In-flight emergencies fall into four categories, according to NASA: rapid depressurization, fire, toxic spill, and medical emergency.

The four astronauts had been trained to handle such situations, said senior NASA official Amit Kshatriya, praising how they have dealt with the situation.

Yet space rescue is still in its infancy as a discipline, with NASA celebrating 30 years of aerospace medicine in 2023, and there is still much to be learned.

A high risk endeavor

At this time, human spaceflight is significantly higher risk than any other type of flight, according to a study published on the NASA Technical Reports Server.

The risk of loss of life in human spaceflight is one in a hundred flights, compared with one in a million in a commercial airplane, per the Johnson Space Center Safety and Mission Assurance.

"Given that it is likely that human spaceflight will remain the riskiest of human flight endeavors for the foreseeable future, it is likely that much more work will need to be done in this field," the study said.

In light of the Crew-11 incident, "NASA needs to address some urgent and sometimes uncomfortable questions," retired NASA astronaut Clayton Anderson wrote in a January 13 op-ed in the Washington Post.

"For example, should a doctor always be on the crew? Should a spaceship heading to Mars have high-tech medical capabilities and facilities -- not just a 'med kit'?"

NASA has always said its top priorities are crew safety, vehicle safety and mission success, which should reassure the public, Anderson said.

But he noted that "the Crew-11 episode shows we will only succeed with better medical safeguards for deep-space goals," especially in light of longer missions, where returning astronauts to Earth is simply not possible.

"Space exploration is dangerous," he said. "It’s difficult and expensive. NASA’s cautious ISS evacuation decision should spark urgency, so we don’t get caught flying blind."