Painkillers, Anti-Depressants, Anti-Seizure Meds Found During Autopsy

When Robert Monaco's Beechcraft B200 went down in Leominster (MA) last year, he had traces of morphine, desipramine, imipramine and carbamazepine in his system. The crash killed five people, leaving just one survivor.

The NTSB factual report states:

Hospital and pharmacy records maintained on the pilot were obtained and reviewed by the NTSB Medical Officer. According to hospital records, the pilot was examined on January 29, 2002. The entry stated that the pilot presented with symptoms of, "head to toe body aches...explosive headaches...episodes of not knowing where he is...Medical History...Seizure...Migraine..." The entry further stated that current medications included Tegretol [carbemazepine] and aspirin. A spinal tap was performed on the pilot, and he was diagnosed with viral meningitis.

On January 23, 2003, a plastic surgery entry stated that the pilot was examined for multiple abscesses on his right upper extremity. The doctor recommended incision and drainage, dressing changes, and admission for intravenous vancomycin. The pilot refused treatment, informing the doctor that he needed to work the following day. The doctor emphasized the risks of refusing treatment, which included "systemic infection, endocarditis, sepsis, necrotizing infection risking viability of right arm and requiring wide debridement." The doctor's note indicated that he "advised patient of risks of flying (piloting an airplane) if bacteremia develops."

The survivor, Tora Fischer, said the aircraft made several sharp left turns, banking to the point of almost being inverted, according to the NTSB report. The aircraft plowed into a building in Leominster, sparking a massive fire and killing five of the six people on board. Dead were Monaco, 49, developer M. Anthony Fisher, 52, and his wife Anne, who were flying their daughter Tora to a private school. Also killed were Michael Campanelli, 36, and Thomas Fox, 50, both of New York, and the co-pilot, Eric Jacobson, 30, of Peabody.

The NTSB factual report also indicates Monaco might have entered an "accelerated maneuver stall."

A review of FAA-H-8083-3, Airplane Flying Handbook, revealed:

"...At the same gross weight, airplane configuration, and power setting, a given airplane will consistently stall at the same indicated airspeed if no acceleration is involved. The airplane will, however, stall at a higher indicated airspeed when excessive maneuvering loads are imposed by steep turns, pull-ups, or other abrupt changes in its flight path. Stalls entered from such flight situations are called "accelerated maneuver stalls..."

"...Failure to take immediate steps toward recovery when an accelerated stall occurs may result in a complete loss of flight control...

"...At any given airspeed, the load factor increases as angle of attack increases, and the wing stalls because the angle of attack has been increased to a certain angle...The speed at which a wing will stall is proportional to the square root of the load factor."

According to the load factor chart in FAA Advisory Circular 61-23C, Pilot's Handbook of Aeronautical Knowledge, a bank angle of 45 degrees will produce a load factor of 1.4, a bank angle of 60 degrees will produce a load factor of 2, and a bank angle of 80 degrees will produce a load factor of 6 (or 3 times the stalling speed).

FMI: www.ntsb.gov/ntsb/brief2.asp?ev_id=20030415X00505&ntsbno=IAD03FA043&akey=1