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The National Transportation Safety Board has released its final report regarding a 2022 helicopter crash in Andalusia indicating that the pilot lost consciousness, possibly due to the effects of ethanol that were detected in his system during post-crash testing, an illness reported the previous day, or his history with obstructed sleep apnea.

The Eurocopter AS350B2 Ecureuil had departed Evergreen on July 29, 2022 and was traveling to Andalusia Health Hospital to pick up a patient to be transferred to another health facility. Once in Andalusia, witnesses at the scene reported seeing the helicopter flying overhead before impacting trees and powerlines before hitting the ground at Packer Field. The incident resulted in serious injuries to the pilot and one crew member with another crew member sustaining minor injuries.

According to the NTSB final report, as the helicopter began its descent to the Andalusia Health helipad when the pilot lost consciousness, as witnessed by the flight paramedic. The helicopter then departed controlled flight and impacted at Packer Field, about a mile from the hospital helipad. The report states that after post-accident examination of the helicopter there was no evidence of mechanical malfunctions or failures.

Following the accident, the pilot was admitted to the hospital and underwent evaluation for injury and syncope (loss of consciousness), but no definitive cause of the syncope was identified. The NTSB reported that toxicology testing detected ethanol in blood and urine specimens collected from the pilot approximately 1.5 hours after the crash. Testing also detected cocaine metabolites benzoylecgonine and cocaethylene in the pilot’s urine, but not in his blood. The NTSB stated that, based on the pilot’s blood ethanol level when tested, his ethanol level at the time of the accident was likely between .04 to .08 g/dL (grams per deciliter).

“Ethanol at this level would not sufficiently explain the pilot’s loss of consciousness but would be expected to have adverse effects on his performance capacity. Thus, it is likely that the pilot was impaired by effects of ethanol at the time of the accident,” according to the NTSB report.

The report further states that the benzoylecgonine detected in the pilot’s urine indicated that he had used cocaine, but the timing is unknown. “The cocaethylene in his urine indicated that both cocaine and ethanol were in his system at the same time, with more than a small amount of cocaine likely used. The time elapsed between the pilot’s last cocaine use and his blood specimen collection was sufficient for cocaine to be metabolized and for its metabolites to fall below detectable levels in his blood. However, the precise time of his last cocaine use could not be determined, and the possibility of residual adverse effects from his cocaine use could not be excluded.”

The NTSB also reported that the pilot had a history of obstructed sleep apnea and had called out sick the day before the accident, reporting a stomach illness.

The report states the reason for the pilot to lose consciousness is still unknown.

“At the time of the accident, the pilot likely was experiencing some impairing effects from alcohol use and may also have been experiencing impairing effects related to his use of cocaine. However, the event that precipitated the loss of helicopter control was the pilot’s acute incapacitation by a syncopal episode, the precise medical cause of which is unknown. Whether the pilot’s substance use, reported illness, or obstructed sleep apnea (or a combination thereof) contributed to his syncopal episode cannot be determined.”