ERA24FA069

The helicopter’s gradual descent and impact with terrain for reasons that could not be determined.

The helicopter accident occurred during an electronic news gathering (ENG) flight in night visual meteorological conditions. Weather and visibility at the time were good, and though the helicopter had been operating at or near the freezing level, no clouds or precipitation existed along its flightpath. Other air traffic did not appear to be a factor. The pilot and non-pilot videographer departed about 41 minutes before the accident on their third flight of the day. The non-pilot videographer was seated in the back of the helicopter, without access to the flight controls. They arrived at the scene of the assignment about 20 minutes after departing, collected video for about 10 minutes, and then began heading back to base. Up to this point, there were no anomalies with the flight. About 3 minutes before the accident, the helicopter drifted right of its established flight track and passed through its outbound course. Within 1 minute, the helicopter began to descend from an altitude of about 1000 ft mean sea level (msl). The gradual descent continued for about 2 minutes, with the ground speed gradually increasing. The helicopter then impacted terrain and a postimpact fire ensued. Examination of the wreckage did not reveal any evidence of a preimpact failure or malfunction of the helicopter, engine, or its systems that would have precluded normal operation. Examination of the wreckage also did not reveal any evidence of a bird strike. The flight profile, though, was consistent with the pilot becoming incapacitated or falling asleep. The pilot had a history of prediabetes, and toxicological evidence indicated he had used the blood-sugar-controlling medication metformin. His negative urine and vitreous glucose results indicated that he was unlikely to have been experiencing markedly elevated blood sugar at the time of the crash. The glucose results neither excluded nor supported a hypothesis of low blood sugar related to diabetes/prediabetes medication use; however, metformin use is not likely to result in symptomatic low blood sugar. Thus, there is no specific evidence that the pilot’s blood sugar was a factor in the accident. The pilot also had a history of high blood pressure treated with multiple medications. His toxicology results indicated that he had used the blood pressure medications telmisartan, hydrochlorothiazide (HCTZ), and carvedilol. Detected chlorthalidone likely was an impurity in the HCTZ rather than a fourth medication. Although the pilot’s blood pressure medications would not typically be impairing, his high blood pressure conveyed some increased risk of him experiencing an impairing or incapacitating cardiovascular event. However, there is no way to determine whether such an event occurred from the limited autopsy evidence. The combination of tadalafil and alfuzosin use, along with the multiple blood pressure medications, may also have conveyed some increased fainting risk, but this would have depended on multiple unknown variables, as tadalafil and alfuzosin are not typically impairing. Therefore, the only medication detected on postmortem toxicology that had typical impairing effects was chlorpheniramine. Although the measured level of chlorpheniramine in cavity blood could not be reliably related to specific effects, it indicated a possibility that the pilot may have been experiencing some associated sedation or psychomotor slowing. This may have made the pilot more susceptible to falling asleep. Chlorpheniramine effects also may have generally impaired his task performance, although it is less obvious how such impairment would explain the accident circumstances involving an extended period of uneventful flight followed by 3 minutes of unusual flight. Whether the pilot was using chlorpheniramine for a distracting or otherwise impairing condition is unknown. Overall, the pilot had medical conditions and had used medications that were associated with increased risk of impairment or incapacitation. However, there was insufficient medical evidence for the investigation to establish whether the pilot was incapacitated, or, if he was, the specific reason for his incapacitation.

The pilot was the lead pilot for the helicopter operator and had been employed by them for about 19 years. During the accident flight, he was seated in the front right seat of the helicopter. The videographer was the lead photographer for the helicopter operator and had also been employed by them for about 19 years. During the accident flight, he was seated in the rear left seat and did not have access to the flight controls. His primary duty onboard was to operate the ENG equipment. The Burlington County Medical Examiner’s Office performed an autopsy of the pilot. According to the autopsy report, the cause of death was multiple injuries, and the manner of death was accident. Due to the extent of the pilot’s injuries, his autopsy was severely limited for evaluation of natural disease. Structural evaluation of his heart and lungs was not possible, and structural evaluation of his brain was markedly limited. The 68-year-old male pilot’s last aviation medical examination was July 18, 2023. At that time, he was 73 inches tall and weighed 208 lbs. His reported medical history included prediabetes and high blood pressure. His high blood pressure was noted to be qualified under Conditions Aviation Medical Examiners Can Issue (CACI) criteria. He reported using the medications metformin (a prescription oral medication commonly used for blood sugar control in diabetes and prediabetes), valsartan (a prescription medication that can be used to treat high blood pressure and heart failure), nifedipine (a prescription medication that can be used to treat high blood pressure, angina, and certain other conditions), carvedilol (a prescription beta blocker medication that can be used to treat high blood pressure and heart failure), simvastatin (a prescription medication commonly used to control cholesterol and reduce cardiovascular risk), and alfuzosin (a prescription alpha blocker medication commonly used to treat symptoms of an enlarged prostate). He was issued a second-class medical certificate limited by a requirement to use corrective lenses to meet vision standards at all required distances. According to the FAA medical certification file, the pilot had a diagnosis of new onset diabetes not on medication in 2000 and had a 2015 FAA Letter of Eligibility for second-class medical certification with prediabetes and high blood pressure. NMS Labs (at the request of the Medical Examiner’s Office) and the FAA Forensic Sciences Laboratory performed toxicological testing of postmortem specimens from the pilot. NMS Labs identified a presumptive positive result for caffeine in chest cavity blood. This unverified positive screening test was performed without a confirmation test. Of the medications the pilot reported using at his last aviation medical examination, the FAA detected metformin and alfuzosin in cavity blood and urine; carvedilol was detected in cavity blood and was not detected in urine. Additionally, the FAA detected chlorpheniramine at 18 ng/mL in cavity blood and at 15 ng/mL in urine. Telmisartan, HCTZ, tadalafil, and salicylic acid were detected in cavity blood and urine. Chlorothiazide was detected in urine; cavity blood testing for chlorothiazide was inconclusive. Trimethoprim was detected in urine and was not detected in cavity blood. Glucose was not detected in urine or vitreous (a normal result). Metformin use has low potential to result in symptomatic low blood sugar and is not typically impairing. A pilot on metformin may be granted FAA medical certification depending on the status of the pilot’s underlying condition and response to treatment. Chlorpheniramine is a sedating antihistamine medication that is available over the counter (OTC) in a variety of cold and allergy products, and that sometimes also may be used for motion sickness or as a sleep aid. Chlorpheniramine use can result in psychomotor slowing and drowsiness. It often carries warnings that drowsiness may occur, and that users should use caution when driving a motor vehicle or operating heavy machinery. The FAA lists chlorpheniramine as “No Go” OTC medication and a “Do Not Fly” medication, and states that pilots should not fly within 5 days of using chlorpheniramine, to allow time for it to be cleared from circulation. In living individuals, the typical elimination half-life of chlorpheniramine is about 12-43 hours and the therapeutic range of chlorpheniramine in plasma is about 3-20 ng/mL, with chlorpheniramine levels in blood being about 1.2-1.3 times those in plasma. Chlorpheniramine may undergo postmortem redistribution, affecting measured drug levels. Furthermore, comparing drug levels in postmortem cavity blood to reference ranges in living individuals generally is unreliable. Telmisartan is a prescription angiotensin receptor blocker (ARB) medication commonly used to treat high blood pressure; it may also be used in the treatment of heart failure. HCTZ is a prescription thiazide diuretic medication used very commonly to treat high blood pressure. Using a thiazide diuretic together with an ARB also is common, and combination medication containing both HCTZ and telmisartan is available. Chlorothiazide may be present as an impurity in HCTZ, and also may occasionally be prescribed as a thiazide diuretic medication, primarily to treat edema. Tadalafil is a prescription medication commonly used to treat erectile dysfunction, as a sexual enhancement aid, and to treat symptoms of an enlarged prostate. It also is sometimes used to treat other conditions, including pulmonary hypertension. Tadalafil is not typically impairing, although the FAA states that pilots who use it on an as-needed basis should wait 24 hours after use before flying, and that otherwise-qualified pilots who use it daily should undergo a 7-day ground trial before flying, to monitor for side effects. Additionally, tadalafil typically carries a warning that use in combination with alpha blocker medication (like alfuzosin) may result in symptomatic low blood pressure or fainting in some individuals. The FAA states that if a pilot uses tadalafil with an alpha blocker, the pilot should not fly until verification that no low blood pressure episodes or other side effects occur. Salicylic acid is the primary active metabolite of aspirin, a widely available over-the-counter medication that can be used to control pain and fever and to reduce cardiovascular risk. Salicylic acid also is a metabolite of some other drugs and is used as a topical skin exfoliant in a variety of retail products. Salicylic acid is not typically impairing. Trimethoprim is a prescription antibiotic medication. Trimethoprim is not typically impairing. Telmisartan, HCTZ (and chlorothiazide), carvedilol, and alfuzosin are not generally considered impairing. The combination of telmisartan, HCTZ, and carvedilol can be acceptable under CACI criteria for high blood pressure if all criteria are met. The FAA states that daily use of telmisartan, HCTZ, carvedilol, or alfuzosin requires pilots to first pass a 7-day ground trial when beginning the medication, to monitor for side effects. On December 19, 2023, about 2004 eastern standard time, an American Eurocopter AS350B2 helicopter, N606HD, was destroyed when it was involved in an accident near Hammonton, New Jersey. The pilot and videographer were fatally injured. The helicopter was operated as a Title 14 Code of Federal Regulations Part 91 ENG flight. According to the helicopter operator’s chief pilot, about 1923, the helicopter departed Northeast Philadelphia Airport (PNE), Philadelphia, Pennsylvania, after being dispatched by the news station assignment desk to a scene 44 nautical miles to the south/southeast, in the Smithville, New Jersey area. This was the third flight of the day for the helicopter and crew, and a fixed-base operator at PNE had refueled the helicopter before the accident flight. The helicopter arrived on scene about 20 minutes later and began orbiting while co