Health Hazards

The initial sport-pilot ruling contains enough medical restrictions to dash the hopes of medically disqualified pilots who were expecting to get back into flying. In addition to the simple driver's license requirement, sport pilots have to certify to the FAA that they have no disqualifying medical conditions. Furthermore, past denial of an FAA medical certificate would be disqualifying. Advocates of the driver's license standards called for the FAA to reconsider it. They pointed out, among other things, that an existing pilot who has disclosed a disqualifying condition to the FAA couldn't exercise sport-pilot privileges, while someone new to aviation with the same condition could get a sport-pilot license by concealing it.

These peculiarities have re-ignited the long-standing debate over the value of the FAA's medical-certification process. It's estimated that the Aerospace Medical Certification Division at the FAA's Civil Aerospace Medical Institute in Oklahoma City receives about 2,000 medical applications each workday for pilots and controllers, and each month, they must deal with 190,000 pages of material. A transition to electronic document handling coupled with the medical examiners' ability to submit applications via the Internet has streamlined the workflow. A new contract, estimated to be worth up to $12 million, recently was awarded to a software supplier for further modernization.

While the FAA's concept is that public safety is dependent on the medical fitness of those individuals who participate in aviation, NTSB accident files have yet to provide ample direct evidence of chronic, medically related safety problems within the pilot community. The argument, of course, is that the FAA's medical certification process has already screened out the problem pilots. Yet another argument is that the prospect of having to undergo an FAA medical exam encourages some pilots to see a personal physician well before the exam date, so nothing startling will be discovered by the FAA's examiner. A counterargument is that the FAA needs to put at least the same effort into addressing threats to safety, which are continuously documented by the NTSB, such as running out of gas, flying into adverse weather and ignoring checklists.

In the overwhelming majority of investigations in which an accident pilot was found to have an undiscovered---or undisclosed---medical condition, the NTSB determined that something else was the probable cause of the accident. Each year, however, there are a handful of cases that bolster the FAA's position and policies regarding the importance of medical certification.

Beechcraft K35
On October 9, 2002, about 10:57 a.m., a Beech K35 operating as a Part-91 personal flight crashed at Pine Mountain, in the vicinity of Jellico, Tenn., after the pilot became incapacitated. Marginal VMC prevailed in the vicinity of the accident site, and an IFR flight plan was filed. The airplane was destroyed. The private pilot was fatally injured. The flight originated from Houghton Lake, Mich., at 8:02 a.m.

A review of radio communications between the pilot and Indianapolis Center revealed that the pilot had requested and received updated weather for Atlanta and Knoxville, Tenn. Indianapolis Center started coordinating a handoff of the flight with Atlanta Center at 10:48:36. Indianapolis Center instructed the pilot to contact Atlanta Center at 10:56:03. The pilot didn't respond to the request. Indianapolis Center instructed the pilot to contact Atlanta Center again at 10:56:13 and to verify that he was level at 9,000 feet. There was no response from the pilot, and Indianapolis Center observed the last radar return to be at 10:56:10. The Mode-C readout showed that the airplane was at 7,700 feet.

The Campbell County 911 operator located in La Follette, Tenn., received two phone calls from separate local residents saying that they had heard an airplane fly over their location, which was followed by what sounded like a "plane going down." A deputy sheriff was dispatched, and pieces of the airplane's wreckage were located at 12:35 in the vicinity of Pine Mountain.

A review of FAA records revealed that the pilot was issued a private-pilot certificate on November 10, 1976, with ratings for airplane single-engine land, multi-engine land and instrument airplane. A review of the pilot's logbook revealed that his last recorded flight, which included a biennial flight review, was conducted on March 1, 2002. A handwritten paper log sheet found in the logbook revealed that the pilot had flown 16 additional flights between March 8, 2002, and July 7, 2002.

When investigators reviewed FAA medical records, they found that the pilot previously held a third-class medical certificate. The pilot underwent coronary artery bypass surgery on January 17, 2002. There was no record that the pilot informed the FAA of a change in his medical condition while his previous medical certificate was current. The pilot applied for another medical certificate on August 6, 2002. On the application for that medical certificate, the pilot reported that he had accumulated 6,700 total hours with no hours flown in the last six months and noted "yes" for item 18.g, "heart or vascular trouble." The aviation medical examiner who conducted the physical examination noted the pilot's history of coronary artery bypass surgery and acknowledged it with a "no certificate issued---deferred for further evaluation" written on the application.

Components from the left and right wing, the left and right stabilizer and the aft portion of the fuselage of the Beech K35 were sent to the NTSB Materials Laboratory in Washington, D.C., for analysis. All of the fractures that were examined were typical of overstress separations. There was no evidence of fatigue cracking or other type of a preexisting defect. An autopsy disclosed that the pilot was suffering from atherosclerotic cardiovascular disease.

The NTSB determined that the probable cause of this accident was the pilot's incapacitation in flight due to a heart attack, resulting in an in-flight loss of control and collision with terrain. The pilot's disregard of his medical grounding condition by continuing as pilot in command was a factor.

Mooney M20C
On January 3, 2004, a Mooney M20C was destroyed when it crashed into terrain shortly after takeoff from the Tradewind Airport near Amarillo, Texas. The private pilot was the only person on board and was fatally injured. No flight plan was filed for the cross-country flight. The destination was Lamesa Municipal Airport, near Lamesa, Texas. VMC prevailed for the personal flight conducted under Part 91.

A review of air-traffic-control voice communications revealed that the pilot made initial contact with Amarillo Approach Control at 2:41 p.m., and requested VFR flight following. Approximately four minutes later, he reported that he was having chest pains and wanted to return to the ground. There were no further communications with the pilot.

At 2:49, a pilot who was flying in the local area reported to ATC that the Mooney airplane had crashed about a mile southwest of the Tradewind Airport. A witness who was located at an airport about 10 miles south of the accident site initially observed the airplane as it headed south at about 1,200 to 1,500 feet AGL. He then watched the airplane enter a descending, 180-degree right turn. The airplane continued to descend until it disappeared from his view. The witness added that the engine was loud and operated at full power during the turn. The landing gear was in the retracted position, and there were no "apparent difficulties" with the airplane. Additionally, several other witnesses observed the airplane descending in a steep bank prior to impacting the ground.

The pilot held a private-pilot certificate for airplane single-engine land. His most recent FAA third-class medical certificate was issued on April 3, 2002. The examination of the pilot's logbook revealed that he had accumulated a total of 1,142.2 hours, of which 799 hours were in the Mooney. The examination of the airplane and engine revealed no mechanical difficulties. A review of the pilot's personal medical records revealed that the pilot had experienced heart-disease symptoms, such as high blood sugar, high triglycerides and low HDL cholesterol, in the months preceding the accident. The NTSB determined that the probable cause was the pilot's incapacitation due to chest pains, resulting in a loss of control.

Peter Katz is editor and publisher of NTSB Reporter, an independent monthly update on aircraft accident investigations and other news concerning the National Transportation Safety Board. To subscribe, write to: NTSB Reporter, Subscription Dept., P.O. Box 831, White Plains, NY 10602-0831.