What happened
On October 22, 2018, at approximately 1710 Hawaiian standard time, a Robinson R44 helicopter, registration N4132H, was involved in an accident near Kaneohe, Hawaii. The aircraft was operating as a Part 91 air tour flight when the pilot experienced a loss of consciousness approximately 20 minutes into the flight.
The pilot reported regaining consciousness briefly and attempting to turn inland for a precautionary landing, but subsequently lost consciousness a second time. Passengers reported seeing the pilot slump over, and the front seat passenger attempted to grab the controls to slow the descent. The helicopter impacted a sandbar in approximately 2 feet of water, coming to rest on its left side. The accident resulted in 3 serious injuries and no fatalities.
The investigation
Post-accident examination of the aircraft revealed the main rotor mast was bent forward, the tailboom was bent to one side, and both skids sustained impact damage.
Medical records for the pilot showed that while he held a current second-class FAA medical certificate, he had a history of mitral valve replacement surgery in 2012. Although he had been under a special issuance requirement for periodic cardiovascular evaluations, his cardiologist had previously reported the valve was in good condition with no restrictions. During the hospital stay following the accident, the pilot experienced episodes of complete heart block, which necessitated the surgical placement of a permanent pacemaker.