Accident Sequence
The aircraft was in radio and radar contact with air traffic control (ATC) at 7,000 feet mean sea level when the pilot declared a medical emergency for his diabetic passenger, who was experiencing tremors. The pilot reported that he was "wrestling with the other guy." ATC cleared the pilot for a straight-in visual approach to the diversion airport, but the pilot did not acknowledge the clearance. The airplane subsequently struck trees. Both occupants sustained fatal injuries.
Aircraft and Operational Information
The airplane was a Grumman American AA-5BA. Examination of the wreckage revealed no evidence of preimpact failures or malfunctions with the airframe or engine.
Toxicology and Medical Information
The passenger used an insulin pump to manage diabetes. Postmortem toxicology testing was positive for quinine, a substance found in tonic water, used to treat malaria, and available in over-the-counter nutritional supplements marketed to reduce the frequency of nocturnal leg cramps. Quinine can cause hypoglycemia, even in non-diabetics, leading to behavioral changes, confusion, fatigue, seizures, and loss of consciousness. The pilot's postmortem toxicology testing was positive for butalbital, venlafaxine, and ibuprofen. The pilot had not noted any medical conditions or the use of any medications on his most recent FAA application for an airman medical certificate.
Investigation Findings
The investigation noted that the pilot may have been sufficiently distracted or impaired by his existing medical conditions, leading to inadequate handling of an impending or evolving incapacitating event in his passenger; it was considered less likely that impairment was caused by the medications used to treat those conditions.