NYC01FA172 · Beech A23-24

The pilot, an orthopedic surgeon, departed his home airport and flew over the local area for about 1 hour. The airplane was observed circling over a cornfield, and initially climbed, but then descended rapidly into the terrain. Witnesses stated that the engine noise could be heard, and was consistent throughout the accident. Examination of the wreckage did not reveal any pre-impact mechanical malfunctions. Review of the pilot's medical and pharmacy records revealed a history of Hodgkin's disease, substantial damage to his gastrointestinal tract, hypothyroidism, gall bladder disease, and coronary artery bypass surgery. In addition, the pilot required most of his calories to be delivered intravenously through a surgically placed port in his chest. Within 1 year prior to the accident, the pilot had filled prescriptions for Synthroid, Zoloft, Deseryl, Prozac, Imodium, and Lasix. The pilot wrote all of his most recent prescriptions. However, on his most recent application for an FAA third class medical certificate, the pilot listed only Synthroid as a currently used medication. An aviation medical examiner noted the pilot's weight at 152 pounds, and his height at 71 inches. The examiner did not issue a medical certificate, and deferred it to the FAA Aeromedical Certification Division, citing the Hodgkin's disease, coronary artery disease, bowel adhesions, and "a central line which he still uses 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. Toxicological testing performed on the pilot revealed sertraline and tramadol present in the blood. The level of sertraline present in the blood was more than five times higher than would be expected from maximum recommended dosage. The level of tramadol in the blood was almost twenty times the maximum level expected from a typical single dose of the drug. Sertraline (Zoloft) is a prescription antidepressant, and tramadol is a prescription narcotic-like painkiller.

Verbatim NTSB analysis and probable cause from the NTSB dataset