Amateur-built SNS-7 accident near Palmer, Alaska, August 18, 2004

The NTSB's narrative final · quoted from the NTSB record

The solo private pilot was departing in a recently built experimental/homebuilt airplane. A witness reported that just after the airplane became airborne, it climbed to about 200 to 300 feet above the runway. As it approached the departure end, it initially turned about 90-degrees to right of the runway centerline, immediately followed by a tight 360-degree turn to the left, circling the departure end of the runway. As the airplane continued the tight 360-degree left turn, the wings rolled and continued to roll until the airplane was inverted. The nose of the airplane abruptly pitched down, and the airplane descended into a large stand of trees at the departure end of the runway, followed by a large plume of black smoke. The wood and fabric-covered airplane was destroyed by a combination of impact forces and a postimpact fire. A postaccident investigation revealed that the accident pilot had been diagnosed with Type II diabetes about 12 years prior, and was using self-administered insulin injections to control his diabetes. A review of the pilot's FAA Airman Medical Records Center located in Oklahoma City, dating back to July 1, 1980, revealed no disclosure of his use of medications or any diagnosis of diabetes. The aviation medical examiner that issued the pilot his most recent third-class medical certificate was not the pilot's personal physician that was treating him for diabetes. The pilot's primary care physician prescribed Humalog 75/25 insulin for treatment of diabetes. Humalog 75/25 insulin has a very rapid onset of glucose-lowering action, and the manufacturer recommends that the dose be given within 15 minutes before eating a meal to avoid hypoglycemia (low blood glucose), a condition which can lead to behavioral changes, confusion, fatigue, seizures, and loss of consciousness. The pathologist that conducted the postmortem examination noted that the pilot's stomach was empty. Postmortem toxicology tests revealed the presence of glucose in the pilot's urine, suggesting that his blood glucose was likely over 180 mg/dL at some time between his awakening and the time of the accident (normal levels are typically between 80 and 120 mg/dL).

The complete narrative as the NTSB published it. The NTSB's docket holds the report as a PDF and any photographs, statements and other documents from the investigation.