On September 12, 2021, about 0930 eastern daylight time, an American Champion Aircraft 8KCAB, N390PE, was substantially damaged when it was involved in an accident near Rhine, Georgia. The commercial pilot was fatally injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. A witness, who was a friend of the pilot, reported that the pilot told him that he felt dizzy, nauseous, and vomited while practicing aerobatics earlier in the day before the accident flight. The pilot landed at a private airstrip and subsequently departed to fly to a nearby field, where the witness was located, to look for birds. While the witness was in the field, the pilot "buzzed" him and flew around for a second pass. During the second pass, the pilot descended the airplane below the tree line and started an aileron roll. However, about halfway through the roll, the pilot abruptly stopped the maneuver, and the airplane flew straight into the trees at full engine power. The airplane came to rest oriented on a magnetic heading of 220°, and all major components of the airplane were located at the accident site. The fuselage, from the firewall to the empennage, exhibited accordion crush and impact damage. The instrument panel and cockpit were destroyed due to the impact. Both wings had separated from the fuselage, while the horizontal stabilizers and vertical stabilizer remained attached to the empennage displaying damage consistent with the impact. Flight control continuity was established from the flight control surfaces to the cockpit controls. The propeller was splintered and broken. Fresh cuts, which were consistent with propeller slash marks, were found on several trees at the accident site. The examination of flight controls and engine revealed no mechanical malfunctions or failures that would have precluded normal operation. The Georgia Bureau of Investigation Division of Forensic Sciences performed the pilot’s autopsy at the request of the Dodge County Coroner. According to the autopsy report, the cause of death was multiple blunt impact injuries, and the manner of death was accident. The Federal Aviation Administration Forensic Sciences Laboratory performed toxicological testing of specimens from the pilot, identifying only tadalafil, in cavity blood and liver. Tadalafil, sometimes marketed as Cialis, is a prescription medication commonly used to treat erectile dysfunction. It may also be used to treat symptoms of a large prostate, or to reduce high blood pressure in the lungs. According to reviewed primary care records, the pilot visited his primary care provider 5 days before the accident, on September 7, 2021, for sore throat and fever. No complaints of cough, nausea, vomiting, dizziness, or other symptoms apart from sore throat and fever were noted.