Piper PA46 accident near Vineyard Haven, Massachusetts, July 15, 2023

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

According to the passenger, the 79-year-old pilot was performing a go-around when he experienced a medical emergency and “blacked out.” The passenger took control of the airplane and made an emergency gear-up landing, which resulted in substantial damage to the left wing. First responders found that the pilot was in cardiac arrest upon extricating him from the airplane. A review of the pilot’s medical history revealed his incapacitation was most likely due to a sudden in-flight cardiac event that led to the cardiac arrest. The event was likely related to the pilot’s significant underlying heart disease, which included coronary artery disease and damage from a previous heart attack. The Federal Aviation Administration (FAA) granted the pilot a series of Authorizations for Special Issuance of third-class medical certification based on annual medical testing and favorable status reports from the pilot's primary care and cardiology physicians. However, records from the pilot’s most recent aviation medical examination did not include any indication that the pilot reported his history of coronary artery disease, heart attack, or coronary artery bypass graft (CABG) to the Aviation Medical Examiner (AME). There also was no indication that the pilot presented his previously issued Authorization of Special Issuance letter to the AME, as required, and his most recent batch of medical reports submitted to the FAA provided no obvious indication that his incapacitation risk was substantially higher than the FAA had previously found acceptable when it issued his third-class medical certification by Special Issuance. The pilot reported using several medications. However, whether effects from the pilot’s medication contributed to his incapacitation could not be determined.

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.