Overview
An airplane accident occurred when a pilot, an orthopedic surgeon by profession, crashed after flying over a local area for about an hour. The pilot had a significant medical history, including Hodgkin's disease, gastrointestinal damage, hypothyroidism, gall bladder disease, and coronary artery bypass surgery. He relied on intravenous feeding through a chest port. His FAA medical application listed only one medication, but he had filled prescriptions for several others.
Flight and Accident
The pilot departed from his home airport and flew locally. Witnesses observed the airplane circling over a cornfield. It initially climbed but then descended rapidly into the terrain. Witnesses reported hearing consistent engine noise throughout the event. Examination of the wreckage revealed no pre-impact mechanical malfunctions.
Medical History
Review of the pilot's medical and pharmacy records showed a history of Hodgkin's disease, substantial damage to his gastrointestinal tract, hypothyroidism, gall bladder disease, and coronary artery bypass surgery. He required most of his calories intravenously via a surgically placed chest port. Within the year before the accident, he had filled prescriptions for Synthroid, Zoloft, Deseryl, Prozac, Imodium, and Lasix. He wrote all his most recent prescriptions. However, on his most recent FAA third class medical certificate application, he listed only Synthroid as a current medication.
An aviation medical examiner noted the pilot's weight at 152 pounds and height at 71 inches. The examiner did not issue a medical certificate but deferred it to the FAA Aeromedical Certification Division, citing the Hodgkin's disease, coronary artery disease, bowel adhesions, and a central line used for occasional enteral feeding. The Manager of the FAA Aeromedical Certification Division authorized a special issuance of a third class medical certificate but did not mention the abdominal problems, the presence of a central line, or the need for parenteral feeding. The Manager did note a history of coronary artery disease.
Toxicology
Toxicological testing revealed sertraline and tramadol in the pilot's blood. The sertraline level was more than five times higher than expected from maximum recommended dosage. The tramadol level was almost twenty times the maximum expected from a typical single dose. Sertraline (Zoloft) is a prescription antidepressant, and tramadol is a prescription narcotic-like painkiller.
Conclusion
The accident investigation documented the pilot's extensive medical conditions, medication use, and discrepancies in his FAA medical application. No mechanical malfunctions were identified. The toxicology results showed elevated levels of two prescription drugs.