![]() |
If this is your first visit, be sure to check out the FAQ by clicking the link above. You may have to register before you can post: click the register link above to proceed. To start viewing messages, select the forum that you want to visit from the selection below. |
|
|
|
Thread Tools | Display Modes |
|
#1
|
|||
|
|||
![]()
On Tue, 22 Sep 2009 07:58:33 -0700, Ron Wanttaja
wrote: Stealth Pilot wrote: I could be jaundiced here but surely the drugs were prescribed. was the real failure a failure of the american medical system to diagnose and correctly treat his blocked anterior artery? Certainly, I'd say the drugs were prescribed. As far as failure to diagnose the problem, check the NTSB report again: "The pilot’s most recent application for airman medical certificate in May 2007 noted a “precautionary” coronary angiogram in 2006 which “showed no blockage.” ... Records obtained from the pilot’s cardiologist regarding the angiogram (performed September 25, 2006) noted a “totally occluded” small left anterior descending coronary artery with “good collaterals” and otherwise normal coronary arteries." So the diagnosis had been made. Phillips knew he had a problem; this angiogram was performed over a year before his death. We don't know if there had been any treatment other than drugs. I suspect not; his cardiologist would probably have noted it on his records and it would have been mentioned in the NTSB report. There could have been many reasons why Phillips didn't have surgery to alleviate the problem. Denial is common enough... "I feel fine...there isn't a problem!" Another factor is that surgery is hard to hide. Your friends know, your enemies find out, and there's always that fear that one of the latter will inform the FAA and get your medical canceled. All of us know friends who have gone through the tremendous hoops necessary to get their medicals back after heart surgery. btw if you have been taking medications for some time the body adapts. it is possible to have high levels of medications in the blood stream that have next to no cognitive effect on the individual. Certainly the body adapts, when exposed to large doses of drugs or alcohol over a long period. We've heard stories of drunk drivers with BACs above the line that would put most people unconscious. These people can outwardly seem normal. But this isn't just an issue of "Monkey Skills," as Phillips called them. This is an issue of reaction time and decision making, especially decision-making under stress with a less-than-nominal. cardiovascular system. The NTSB didn't just note high levels of a cocktail of drugs (vicodin, valium, paracodine, cardura, morphine derivatives, etc.)...the term used was "acute mixed drug intoxication". Ron Acute in the medical sense is quite different from our usual meaning. typically we laymen use acute to mean serious. In medical terms acute just means 'of short duration' we laymen also use chronic to mean serious whereas in medical terms chronic just means 'of long duration' so the term "acute mixed drug intoxication" just means a situation that hadnt occurred for a long period. it doesnt mean that he had a huge mixed drug intoxication problem, just one that had occurred at the time.(unless of course the report was written by laymen) we have little way of knowing what impairment that may have caused because as others have commented he took lots. rat poison is probably the warfarin that is used to break up blood clots. so yes the canopy was the direct cause, but long before that the heart problem. if we were honest the draconian aviation medical assessment for pilots also played a part in the accident. maybe if it wasnt so draconian, people would get the medical treatment they needed. in australia we see lots of pilots change to ultralights and self assessment during a clear period and go on to fly lots of hours that would be denied to them all without much problem. pilot medicals are after all a throwback to the days when governments kept civil pilots as a fighting reserve and wanted them to be fit to military standards. it is largely irrelevant now. if we were really interested in civil aviation safety we wouldnt bar pilots from flying, we'd more actively treat them. the other aspect that comes from this fatal accident is that the canopy design on that aircraft isnt fail safe. the slide back canopy on the Jodel aircraft (as an example) can pop open or even be deliberately opened in flight and the worst that happens is that it flies itself shut. The Thorp T18 has a similar style of fail safe canopy. I'll bet not many people would have the intelligence to change the canopy design on that design to something that was fail safe. so yes there are lots of lessons that can be learnt from bill's prang. the question is "will we actually learn them?" Stealth Pilot |
#2
|
|||
|
|||
![]() "Stealth Pilot" wrote in message ... ------------------much snipped--------------- Ron Acute in the medical sense is quite different from our usual meaning. typically we laymen use acute to mean serious. In medical terms acute just means 'of short duration' we laymen also use chronic to mean serious whereas in medical terms chronic just means 'of long duration' so the term "acute mixed drug intoxication" just means a situation that hadnt occurred for a long period. it doesnt mean that he had a huge mixed drug intoxication problem, just one that had occurred at the time.(unless of course the report was written by laymen) we have little way of knowing what impairment that may have caused because as others have commented he took lots. rat poison is probably the warfarin that is used to break up blood clots. so yes the canopy was the direct cause, but long before that the heart problem. if we were honest the draconian aviation medical assessment for pilots also played a part in the accident. maybe if it wasnt so draconian, people would get the medical treatment they needed. in australia we see lots of pilots change to ultralights and self assessment during a clear period and go on to fly lots of hours that would be denied to them all without much problem. pilot medicals are after all a throwback to the days when governments kept civil pilots as a fighting reserve and wanted them to be fit to military standards. it is largely irrelevant now. if we were really interested in civil aviation safety we wouldnt bar pilots from flying, we'd more actively treat them. the other aspect that comes from this fatal accident is that the canopy design on that aircraft isnt fail safe. the slide back canopy on the Jodel aircraft (as an example) can pop open or even be deliberately opened in flight and the worst that happens is that it flies itself shut. The Thorp T18 has a similar style of fail safe canopy. I'll bet not many people would have the intelligence to change the canopy design on that design to something that was fail safe. so yes there are lots of lessons that can be learnt from bill's prang. the question is "will we actually learn them?" Stealth Pilot I agree with you on both points, and really doubt that there is much real reason for medical certification unless passengers are being carried for hire--and even then a case could be argued that the requirement is currently more stringent than needed except in single pilot operation. As to the canopy, the only defense of the tilt forward designs that I have ever been able to understand is that they do make it much easier to enter and exit the aircraft under normal conditions, and much the same could be said of the side hinged designs. Personally, both have made me just a little nervous when I have sat in them on the ground at shows and I would prefer to stay with the many sliding canopy designs--with the addition of hand holds on the windshield hoop or on the underside of the glare shield and also a ridge across the floor, if one is not already present, in order to easily heave myself up to a standing position in the case of the tailwheel types. BTW, so far, all of the RV builders who I know personally have stayed with the sliding canopies. Peter |
#3
|
|||
|
|||
![]()
On Fri, 25 Sep 2009 05:30:52 +0000 (UTC), Clark
wrote: Stealth Pilot wrote in : [snip] Ron Acute in the medical sense is quite different from our usual meaning. typically we laymen use acute to mean serious. In medical terms acute just means 'of short duration' [snip] Nope. It means of severe and short duration so far. Don't minimize this one. Bill was obviously way over the line to be flying a plane. If we try to hide it behind fancy words then we are doing ourselves a disfavor. that's the problem. bill wasnt obviously anything. he could have had a pair of knickers over his face or have been blinded by something in his eyes. you leap to the drugs aspect as the cause. the stupid canopy design used on the aircraft was a greater factor in the accident than his blood chemistry. ymmv Stealth Pilot |
#4
|
|||
|
|||
![]() "Stealth Pilot" wrote in message ... that's the problem. bill wasnt obviously anything. he could have had a pair of knickers over his face or have been blinded by something in his eyes. you leap to the drugs aspect as the cause. the stupid canopy design used on the aircraft was a greater factor in the accident than his blood chemistry. ymmv Stealth Pilot Some clarifications; Acute in a clinicians realm is either a new sudden onset such as AMI (Acute Myocardial Infarction) or a sudden flare up of an old condition such as Acute Exacerbation of COPD. Chronic is an ongoing but currently stable problem. Chronic Obstructive Pulmonary Disease. Chronic conditions over the course of time cause deterioration and for many mortality. Example would be Pulmonary Fibrosis. In another post a "doctor" from POA said Bill's "Vicodin Level" was near lethal. There is no such thing as a Vicodin Level. Vicodin (Lortab, Norco etc) is a combination of acetaminophen (Tylenol) and hydrocodone. In the report Bill's acetaminophen level was barely at the low end of therapeutic and the hydrocodone and metabolites were sub therapeutic. This isn't meant as defense of anyone it is only a clarification from a clinicians perspective. tom c |
#5
|
|||
|
|||
![]()
tom c wrote:
.... Some clarifications; .... In another post a "doctor" from POA said Bill's "Vicodin Level" was near lethal.... tom c Hmmmm...you too may be a "doctor" or even a doctor, so let me ask: which elements of the drug cocktail reported in BWB's corpse would lead to the official description of a "toxic" quantity? I could mention that aspirin and codeine, and paracetamol (acetaminophen) and codeine are over-the counter pain killers in Europe, so presumably it is not that element that is drawing approbation... One supposes it is the rat-poison? Brian Whatcott |
#6
|
|||
|
|||
![]() "brian whatcott" wrote in message ... tom c wrote: ... Some clarifications; ... In another post a "doctor" from POA said Bill's "Vicodin Level" was near lethal.... tom c Hmmmm...you too may be a "doctor" or even a doctor, so let me ask: which elements of the drug cocktail reported in BWB's corpse would lead to the official description of a "toxic" quantity? I could mention that aspirin and codeine, and paracetamol (acetaminophen) and codeine are over-the counter pain killers in Europe, so presumably it is not that element that is drawing approbation... One supposes it is the rat-poison? Brian Whatcott The report itself never uses the term toxic. In Emergency treatment blood levels alone are used to gauge toxicity. Urine levels are used for detection alone. The urine level for hydromorphone (Dilaudid) was elevated to a level that would be toxic in blood tests but are not out of line in urine.. The report has no listing for warfarin (Coumadin), warfarin being the active ingredient in rat poisons. As for me not a doc. I'm a Registered Nurse with specialty certifications in Emergency Nursing, Prehospital Nursing and Flight Nursing (the crazy *******s who fly out to car wrecks and start treatment there). tom c |
#7
|
|||
|
|||
![]()
tom c wrote:
"brian whatcott" wrote in message ... tom c wrote: ... Some clarifications; ... In another post a "doctor" from POA said Bill's "Vicodin Level" was near lethal.... tom c Hmmmm...you too may be a "doctor" or even a doctor, so let me ask: which elements of the drug cocktail reported in BWB's corpse would lead to the official description of a "toxic" quantity? I could mention that aspirin and codeine, and paracetamol (acetaminophen) and codeine are over-the counter pain killers in Europe, so presumably it is not that element that is drawing approbation... One supposes it is the rat-poison? Brian Whatcott The report itself never uses the term toxic. Hmmm.... Let me quote from the finding of facts: The State of Utah, Office for the Medical Examiner, completed an autopsy on the pilot. The manner of death was classified as an accident due to blunt force injuries. The report noted “other significant conditions” of atherosclerotic coronary artery disease, cardiomegaly, and ***acute mixed drug intoxication.**** [my asterisks] The FAA Bioaeronautical Research Laboratory completed toxicology testing. The tests were negative for carbon monoxide, cyanide, and volatiles. The test was positive for the following tested drugs: 10.01 (ug/ml, ug/g) acetaminophen, 0.055 (ug/ml, ug/g) diazepam, 0.031 (ug/mL, ug/g) dihydrocodeine, doxazosin, 0.152 (ug/ml, ug/g) hydrocodone, and 0.094 (ug/ml, ug/g) nordiazepam, detected in blood; 0.46 (ug/mL, ug/g) dihydrocodeine, doxazosin, 1.755 (ug/ml, ug/g) hydrocodone, 0.54 (ug/mL, ug/g) hydromorphone, and nordiazepam, were detected in urine. "Drug intoxication" means the presence of toxic quantities of some drug cocktail. Brian Whatcott |
#8
|
|||
|
|||
![]()
"brian whatcott" wrote in message
... tom c wrote: ... Some clarifications; ... In another post a "doctor" from POA said Bill's "Vicodin Level" was near lethal.... tom c Hmmmm...you too may be a "doctor" or even a doctor, so let me ask: which elements of the drug cocktail reported in BWB's corpse would lead to the official description of a "toxic" quantity? I could mention that aspirin and codeine, and paracetamol (acetaminophen) and codeine are over-the counter pain killers in Europe, so presumably it is not that element that is drawing approbation... One supposes it is the rat-poison? Brian Whatcott Really, all of this is still just speculation whether there is some sound reason that the canopy might not have been fully latched and on how BWB's condition might have progressed during the flight if the takeoff and climb had been uneventfull. Taking the second issue first, it really does seem that Mrs Phillips would have been quite familiar with the aircraft and also had skills far above those of the typical AOPA Pinch Hitter level, if she is not a fully qualified pilot; so while we are speculating as to the causes, I am willing to speculate that pilot incapacitation was not the root cause of this accident. Which brings back to the issue of the canopy... Peter P.S.: Just as a slightly off topic aside: Even on a warm day at gross weight and with full flaps deployed, a Piper PA38-112 Tomahawk will take off and climb almost normally to the top of ground effect and a Cessna 150M will climb slightly on a missed approach under the same conditions. No one needed to be impared in any way to prove either of the above, or a few others, although the first situation was helped along by an instructor who was confident that the airplane could not get airborne. |
#9
|
|||
|
|||
![]()
Peter Dohm wrote:
Really, all of this is still just speculation whether there is some sound reason that the canopy might not have been fully latched and on how BWB's condition might have progressed during the flight if the takeoff and climb had been uneventfull. ...I am willing to speculate that pilot incapacitation was not the root cause of this accident. Which brings back to the issue of the canopy... I don't think pilot incapacitation is the root cause of the accident, either. However, pilot *impairment* may well have been a contributing cause. Let's play NTSB here, and step through the known facts. 1. Was the canopy open at time of impact? A. No damage to the canopy latches, and significant sideways impact damage to the canopy hinges. Canopy was probably open at the time of impact. 2. Had the canopy been properly latched at the time of takeoff? Nothing overt, here. No detected damage to the latching mechanism. No previous problems noted with the latch on the accident airplane. Aircraft equipped with a pressurized seal that may have held the canopy in place until the airspeed rose to the point where lift forces on the canopy may have overcome the friction of the seal. 3. Would an unlatched canopy cause the airplane to be uncontrollable? A. The kit manufacturer says no. Several owners of that aircraft type have reported open canopies in flight with varying effects of control of the aircraft. There were two other accidents involving open Lancair canopies within six months of Phillips'. In the first case, witnesses reported that the pilot had trouble closing the canopy before takeoff. The canopy opened after takeoff, and witnesses report seeing the canopy bob up and down like the pilot was trying to close it. Engine power was lost, but as there was no reaction, it's possible the pilot killed the throttle to try to reduce the airflow over the canopy to assist in closing it. The airplane pitched nose down and descended in a left-hand turn. No mechanical cause was found for the reduction in power. In the second case, the pilot apparently failed to latch the canopy. He reports the canopy oscillated on its own, and that pitch control of the aircraft became very difficult. The pilot brought the plane around, but wasn't able to maintain the approach path and landed short. In short, everyone who experienced an open canopy and lived reported that the airplane was at least somewhat controllable. There is only one other instance of a fatality after a Lancair open canopy, and that case exhibited a simple stall with no outward signs of control trouble. (More discussion at: http://98.192.103.179/forums/viewtopic.php?f=19&t=296 4. Was the pilot qualified to fly the aircraft? A. Yes. ATP with 4,500 hours, including 150 in type. 5. Were there factors that may have affected the pilot's ability to control the aircraft? Evidence of use of sedatives, painkillers, and muscle relaxants. Side effects of Vicodin can include dizziness, lightheadedness, drowsiness, euphoria, changes in mood, and mental fogginess. I suspect the NTSB probable cause will be similar to that of the April 2008 fatality: "The pilot's failure to maintain aircraft control. Contributing to the accident was the pilot's distraction with the canopy during takeoff." They'll probably add a comment about pilot impairment, as well. I don't think the heart trouble or the lying on the medical will even gain a mention, in the Probable Cause. However, since Phillips gained his medical by fraud, the insurance company has grounds to deny any claim. Ron Wanttaja |
#10
|
|||
|
|||
![]() "Ron Wanttaja" wrote in message ... Let's play NTSB here, and step through the known facts. 1. Was the canopy open at time of impact? A. No damage to the canopy latches, and significant sideways impact damage to the canopy hinges. Canopy was probably open at the time of impact. Also in the report supporting this conclusion a The witnesses to the crash who "... saw objects fall, ...off of or out of the airplane." AND: "Law enforcement personnel that initially responded to the accident site went to the area specified by the witnesses as the location where the objects departed the airplane. At this location, personal effects including clothing were identified." Unless Bill and his wife were busily stuffing these items out the canopy vent door just to confuse us, there seems little doubt that the canopy was open at the time of the impact. We can speculate about everything else, but this part of the accident sequence seems pretty sure to me. Vaughn |
|
Thread Tools | |
Display Modes | |
|
|
![]() |
||||
Thread | Thread Starter | Forum | Replies | Last Post |
Badwater Bill - Janice Phillips contact | BobR | Home Built | 1 | October 24th 08 02:46 PM |
NTSB report - ILS and ATC. How does it all come together? | Montblack | Piloting | 1 | June 19th 06 11:26 PM |
NTSB report - ILS and ATC. How does it all come together? | Montblack | Instrument Flight Rules | 1 | June 19th 06 11:26 PM |
Preliminary NTSB report on Walton accident | ChuckSlusarczyk | Home Built | 11 | July 12th 05 04:23 PM |
Prelim NTSB report, Pilatus accident in PA | vincent p. norris | Piloting | 15 | April 11th 05 02:52 PM |