Fiavre 1, Significant variables in general aviation physician fatalities.

1. Weather

2. Night/Dusk

8. Lack of Proficiency

4, Terrain

5. Faulty Technique

6. Fatigue

7. No Instrument Rating

8. Drugs

* Invisible wires, obstructions, sun blindness.

9, Alcohol

10. Pathology

11, Fuel Exhaustion
12. Overloaded

13. Low Flying

14. Poor Visibility*

15. Extreme Use of
Aircraft**

** Subjecting plane to forces beyond its design capabilities.





cross-country VFR in mountainous terrain.
Fatal crash.

Case D.—Physician-pilot and passengers part
of a fly-in group. Attempted to fly in adverse
weather over very hazardous mountain terrain.
Fatal crash into mountain. One of the pas-
sengers was a physician.

Case E.—Physician-pilot departed without cur-
rent weather information. No IFR experience.
Encountered severe storm. Fatal crash.

Case F.—Physician took off from airport at
night in rain while runway lights were inopera-
tive. Friends lighted airstrip with automobile
headlights. Plane crashed and burned.

Case G—Physician-pilot with passengers on
take-off overtook another plane and flew im-
mediately under the latter. Headed into weather.
Plane landed and pilot said he was lost. Air-
port manager later reported “they appeared to
be drinking”. Flew into thunder storm, fog,
and rain over mountainous terrain. Fatal crash
resulted. Toxicology revealed positive blood
alcohol.

Case H.—Physician-pilot heavily overloaded
plane with eight passengers. Took off in IFR
conditions. Questionable gyro-instrument relia-
bility. Instruments reported to be “not working”
by pilot just before crash. Struck high-tension
wires and burned.

Case I[—Physician-pilot in overloaded plane
encountered thunder storms, heavy precipitation,
and severe turbulence. Limited instrument ex-
perience. Was returning from hunting trip.
Fatal crash.

Case J—Physician-pilot with confirmed his-
tory of drug addiction. Fatal crash in swampy
wooded area. Toxicology revealed 3.54mgm%
barbiturate (phenobarbital) in the blood, 0.95
mgm% meprobamate in the blood, 5.28 mgm%
barbiturate (phenobarbital) in the urine, and
2.62 mgm% meprobamate in the urine. Syringe
found on pilot’s body. Numerous narcotics found
in airplane.

Case K.—Physician-pilot on cross-country
pleasure flight with wife and two children. IFR
flight plan filed. Cleared for ILS night ap-
proach at an international airport. Plane crashed
in inverted steep angle, exploded and burned.
Report of Navy pilot described weather as
cloudy, fog, and heavy rain and wind requir-
ing IFR flight. Pilot had history of vertigo on
previous flights.

Nore.—One physician-pilot was involved in a 1965
fatal glider accident and was not included in the
above powered aircraft series. He inadvertently
entered two spins while in the landing pattern, It
was found that the single place glider was placarded
for a maximum occupant weight of 191 pounds.
‘The physician weighed 240 pounds.

Also, in the late summer of 1965, a physician
and his family were fatally injured after becom-
ing lost at night on a flight outside of the United
States. This accident is not listed in the figures
above because the official investigation reports had
not been received at the time of preparation of
this paper.

IV. Discussion.

The results of this study indicate some com-
munality of relationship among the fifteen fac-
tors. This communality is related to risk-taking
attitudes and judgments. Of particular interest
was the tendency of many of these physicians
to fly-at night in inclement weather over danger-
ous terrain, despite limited or no instrument
flight experience. In almost every case, these
flights had a sole or primary recreational pur-
pose. Also, most of the accidents were witnessed.
In most of the weather accidents, the pilots had
received official briefings concerning adverse
weather, but decided to depart anyway. In four
cases, known mechanical deficiencies existed prior
to the flight.

The seriousness of these accidents is under-
scored by the fact that ten entire families were
wiped out in these two years of physician
accidents.

V. Summary and Recommendations.

Physician-pilot fatal accidents in general avia-
tion occurred in 1964-65 with a prevalence four
times that of the general aviation pilot popula-
tion.

Risk-taking attitudes and judgments appear to
be the key underlying thread uniting the major
variables studied.

For the most part, the flights were undertaken
for a purely recreational purpose. The premium
physicians place on their relatively restricted
opportunities for recreation is highlighted.

It is recommended that an intensive effort be
made to encourage the busy physician to exercise
extreme caution when making flight plans, espe-
cially in anticipation of pleasure flights. It has
been shown that physicians are susceptible to
specific hazards in this respect.


Fieury 2, General aviation physician fatalities prevailing circumstances during time of fatal crash.

STORY _

PRIMARY CONTRIB
64 | 65 Total 64 | 65 Total
VARIABLE
Weather 9 8 17 0 I I
Night/Dusk 6 0 6 12 3
Lack of Proficiency 0 2 2 4 I 5
Terrain 0 0 0 4 0 4
Faulty Technique l 0 | 2 | 3
Fatigue | 10) | ! 2 3
No Instrument Rating 0 0 0 4 4 8
Drugs 0 | ! 0 0 0
Alcohol 0 i | | I 2
Incapacitation 0 0 0 0 2 2
Fuel Exhaustion 0 | ! 0 0 0
Overloaded 0 0 0 0 2 2
Low Flying 0 I | 0 2 2
Poor Visibility (Invisible o 0 0 0 ! |
wires, obstructions, sun
blindness)
Extreme Use of Aircraft 0 0 0 0 2 2

(Subjecting plane to forces
beyond its design capabili-
ties)



AM 66-25

PHYSICIAN FLIGHT ACCIDENTS

S. R. Mohler, M.D.

S. F. Freud, Ph.D.

J. E. Veregge, B.S.
E. L. Umberger, B.A.

Approved Released by
frome LAree (Usege€ wo
J. L. Harris P. V. Smeen, M.D.
Cuter, AzromepicaL Epvcation Feprrat Arr Surceon
Drvision

September 1966

FEDERAL AVIATION AGENCY
Office of Aviation Medicine





Qualified requestors may obtain Aviation Medical Reports from Defense Documentation
Center. The general public may purchase from Clearinghouse for Federal Scientific and
‘Technical Information, U.S. Dept. of Commerce, Springfield, Va, 22151


PHYSICIAN FLIGHT ACCIDENTS

Srantey R. Mouter, M.D., Suevpon Frevp, Ph.D.
Jack Verecer, B.S., and Exzasern Umpercer, B.A.*

I. Problem.

During the period 1964-1965, more than thirty
physicians sustained fatal injuries while piloting
light aircraft. This represents a contribution to
general aviation pilot fatalities which is about
four times the physician pilot representation in
the general aviation pilot population.

FMD F 15 500 1 1

MD GAP 3000 400,000 200 800
FMD = Physician Flight Fatalities (ave./year)
MD =Number of physicians flying aircraft
F  =General Aviation Pilot Fatalities

(ave./year)
GAP=Number of General Aviation Pilots

II. Method.

The purpose of this study is to delineate the
major factors which underlie physician-pilot
accidents. Detailed analysis was made of the
CAB Pilot Operator Aircraft Report (CAB
Form 543), the FAA General Aviation Accident
Report (FAA Form 2401), and the FAA AME
Aircraft Accident Report (FAA Form 3550).
In addition, medical background information
was extracted from the Airman Medical Record
(FAA Form 2173). From these records sixty
categories were extracted as potentially significant
to the chain of circumstances underlying each ac-
cident. Brief summaries of each accident were
prepared based upon witness and investigator re-
ports. After careful review of the sixty cate-
gories, fifteen were selected as the most common.

* Dr. Mohler is Chief of the Aeromedical Applications
Division, Office of Aviation Medicine, Federal Aviation
Agency, Washington, D.C. Dr. Freud is Research Psy-
chologist, Aeromedical Applications Division. Mr.
Veregge and Miss Umberger are statisticians in the Aero-
medical Applications Division. The authors extend ap-
preciation to Miss Genlese Stedman for assistance in
data tabulations, Prepared for the April 17-21, 1966,
meeting of the Aerospace Medical Association, Las
Vegas, Nevada,

The fifteen variables are shown in Figure 1.
Detailed analysis was then made of each fatal
crash. Each fatality was then matched against
one or more of the variables. In addition to the
primary relationship betwen variable and fatal
crash, contributory variable matches were also
made. Thus, the variables were matched both
on the basis of a primary and a secondary
(contributory) relationship. In some cases, no
primary relationship was found and in other
cases both a primary and a contributory rela-
tionship was determined.

TIL Results,

Results of this analysis can be. seen in Fig-
ure 2. They reflect a combined total of physi-
cian-fatalities for the years 1964 and 1965.

In addition to the numerical data obtained by
this study, a significant body of information was
accumulated consisting of witness and investi-
gator reports describing the conditions prior to
and during each fatal flight. It is interesting to
note that ten of the thirty physicians involved
in this study had instrument ratings. Five of
these ten were killed in accidents not involving
weather.

Examples in brief summary follow:

Case A.—Physician-pilot was performing low
acrobatics at a fly-in, He was not a highly ex-
perienced acrobatic pilot and had been very
active during the day. Colleagues reported that
he had appeared fatigued. Fatal crash occurred.

Case B.—Physician was inexperienced in IFR
operations. Attempted flight through mountain-
ous terrain at night during thunder showers in
an unlighted area. Purpose of trip was to
transport a friend to a fishing trip. Pilot lost
control. Fatal crash.

Case C.—Physician inexperienced in IFR.
Flying in overloaded aircraft. Departed in fog
with forecast of severe fog en route. Attempted