CEN20FA038

The pilot was flying to an airport about 60 miles north of the departure airport. About 18 miles short of the destination airport, the pilot informed air traffic control (ATC) that he was returning to his departure airport and performed a 180° turn to the south. The pilot did not report any problems or concerns to ATC during the flight and he was cleared to land on runway 18 at the departure airport. Witnesses observed the airplane enter a right descending turn and impact a field about 2 miles north of the airport. No anomalies were noted with the airframe or engine during postaccident examination that would have resulted in a loss of aircraft control. According to the autopsy of the pilot, the cause of death was multiple blunt force injuries; however, the autopsy was limited due to the injuries the pilot received. The pilot’s medical records demonstrated the pilot had severe coronary disease than was not fully identified by the limited autopsy. The disease had progressed over the previous 20 years and placed the pilot at risk of sudden symptoms such as shortness of breath, chest pain, disturbances in heart rhythm causing palpitations and fainting. Heart rhythm problems leave no evidence at autopsy and even large heart attacks do not leave autopsy evidence if death occurs within about 3 hours. The absence of findings during the autopsy were not indicative that an acute cardiac event did not occur. Based on available evidence from the pilot’s medical records, it was possible that the pilot had experienced a sudden incapacitation due to an acute cardiac event, which led to a loss of control of the airplane. However, this could not be definitively determined based on a lack of additional corroborating operational evidence. Based on available evidence from the pilot’s medical records, the most likely explanation for the accident is sudden incapacitation of the pilot due to an acute cardiac event, which led to a loss of control of the airplane.

On December 21, 2019, at 1514 central standard time, a Piper PA-28-140 airplane, N601FL, was destroyed when it was involved in an accident near Evansville, Indiana. The pilot was fatally injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. According to air traffic control and radar data, the pilot departed Evansville Regional Airport (EVV), Evansville, Indiana, and requested visual flight rules flight following to Crawford County Airport (RSV), Robinson, Illinois, a straight-line distance of about 60 nautical miles (nm). About 1449, when the airplane was about 18 nm from RSV, the pilot was issued a frequency change. The pilot requested to return to EVV, and he was instructed to resume his own navigation. The airplane turned 180° and began flying south (see Figure 1.) The pilot continued toward EVV, where he was subsequently cleared to land on runway 18. According to EVV air traffic control, the pilot did not report any difficulties with the airplane or indicate why he was returning to land. Witnesses observed the airplane enter a descending right turn to the west and impact a field about 2 miles north of the approach end of runway 18. Figure 1 – Flight Overview The 56-year-old pilot had a history of severe, early coronary artery disease and a heart attack that required 3-vessel coronary artery bypass grafting in 1999. In 2003, the pilot had recurrent chest pain and had a stent placed in the distal right coronary artery and an angioplasty of the second obtuse marginal (stenting was not able to be performed). Six months later, in 2004, symptoms again recurred; another catheterization demonstrated restenosis at the same location but this time a stent was able to be placed in the area. In 2014, the pilot underwent a diagnostic cardiac catherization following an abnormal stress test. That study identified that the arterial graft to the left anterior descending (LAD) coronary artery was no longer functional but that the vessel was being fed from its native origin with only about 30% stenosis. The remaining grafts and stents were patent, but the proximal (dominant) right coronary artery was completely occluded and without flow. In addition, the pilot reported having obstructive sleep apnea treated with a positive airway pressure (PAP) device, facial dystonia treated with routine botulinum toxin (Botox) injections, and esophagitis. He had also reported previous ear/nose/throat and orthopedic procedures. At his last exam, he also reported using Repatha to treat his high cholesterol, clopidogrel, a platelet inhibitor, to help prevent future heart attacks, candesartan to control his blood pressure, and dexlansoprazole for his esophagitis. The FAA reviewed his required annual stress test and other medical information. Electronic documentation of his PAP use indicated use for more than 99% of nights for an average of 6.5 hours. No significant abnormalities were identified on the remainder of the exam, and athis last exam he was issued a special issuance third class medical certificate marked, “Not Valid for Any Class After 9/30/2018; Must Wear Corrective Lenses.” The pilot completed the requirements for BasicMed in June 2018. According to the autopsy requested by the Vanderburgh County Coroner’s Office, the cause of death was multiple blunt force injuries, and the manner of death was accident. The brain was not available for examination and there was injury to the heart attributable to the accident, which limited the examination. The right coronary artery contained a stent and appeared 95% stenotic; the graft to that artery was not described. Calcific atherosclerotic plaque occluded 98% of the proximal third of the left anterior descending coronary artery; the graft to the LAD was not described. The graft to the marginal branch was patent. The myocardium looked generally unremarkable, but no microscopic evaluation was performed. The heart had biventricular dilation and weighed 450 gm; the right ventricle was 0.3 cm thick, and the left ventricle was 1.5 cm thick. The pathologist commented that the pilot’s severe coronary artery disease did “not appear contributory to the cause of death.” Toxicology testing did not identify any tested-for substances in available liver tissue. The airplane impacted terrain in a right bank of about 90°, as determined by the green beacon lens at the initial impact point and the location of impact marks made by the main landing gear and fuselage. The left aileron and balance cables remained attached to the bellcrank arms and were continuous to the fuselage. The right aileron and balance cables remained attached to the bellcrank arms and were continuous to the wing root. Flight control cable continuity for the stabilator and rudder was confirmed from the cockpit to the attach points at the empennage. The left and right wing fuel tanks were breached, and no fuel was observed in either tank. The smell of aviation fuel was present at the accident site. No anomalies were noted during the examination of the airframe that would have contributed to a loss of control. The propeller was separated from the crankshaft propeller flange and located in the debris field. One blade exhibited leading edge polishing and aft bending. The other blade exhibited forward bending about mid span. The six propeller retention bolts were sheared at the propeller flange and several bolts exhibited torsional bending. The engine was examined, and rotational continuity was verified through manual rotation of the engine crankshaft from the accessory drive to the propeller flange. Thumb compression and valve train continuity was verified at each cylinder. No anomalies that would have contributed to a loss of engine power were noted.