FAA Office of Aerospace Medicine
Civil Aerospace Medical Institute

Report No: DOT/FAA/AM-18/08

Title and Subtitle: Incidental Medical Findings in Autopsied U.S. Civil Aviation Pilots Involved in Fatal Accidents

Report Date: September 2018

Authors: Ricaurte EM

Abstract:
Introduction: This study examined incidental medical findings (IMFs) reported in the autopsies of pilots who died in U.S. aircraft accidents from April 2013 through March 2016, using the FAA CAMI Aerospace Accident Injury Analysis Data System (AA-IADS). Incidental medical findings are previously undiagnosed medical conditions that were incidentally discovered during the autopsy, which may or may not have been related to the cause of death or of the accident. Created in 2013, the AA-IADS database collects pilots' IMFs. By analyzing this data, it is possible to evaluate the prevalence and evolution of certain chronic medical conditions that may have an impact on aviation safety.

Methods: Data was extracted from the AA-IADS for all records available in the system where a pilot was involved in a fatal accident from April 2013 through March 2016, including all types of civilian operations. Records of pilots with the International Classification of Diseases, Version 10 (ICD-10) codes describing incidental medical findings, as well as medical conditions extracted from the CAMI Aerospace Medical Certification Division (AMCD) Document Imaging and Workflow System (DIWS), and toxicological information from the CAMI Forensic Toxicology database were collected in a dataset and prepared for statistical analysis. Finally, the NTSB database was searched to identify fatal accidents in which either a medical cause or a drug was cited as a probable cause or a contributory factor in the accident to determine if those pilots had any IMF reported in the autopsy.

Results: Out of the 601 selected pilots, 42% were found with IMFs reported in the autopsy. Incidental cardiac findings were reported in 84.5%. Cardiovascular abnormalities were the most common incidental finding in the autopsies (85%), followed by Gastrointestinal (11%), Fatty Liver (8%) and Benign Enlarged Prostate (6%). The NTSB determined that a medical issue was either the probable cause (PC) or a contributory factor (CF) in the IMFs of 31 pilots (12.2%).

Conclusions: This study suggests that autopsy findings can support data-driven decision making in the aeromedical evaluation of medical conditions.

Key Words: Incidental medical findings (IMFs), post-mortem analysis, Coronary Heart Disease, Pre-Existing medical conditions, Autopsy findings, Toxicological findings, fatal aircraft accidents, aviation safety, ICD-10 codes, probable cause (PC) or contributory factor (CF)

No. of Pages: 18