Challenges Faced. by the FAA Autopsy Program Team. Federal Aviation Administration. Presented to: Aerospace Medical Association. Date: May 14, 2013

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1 Challenges Faced by the FAA Autopsy Program Team Presented to: Aerospace Medical Association By: C. Hileman, RHIA, N. Webster, M.D., C. DeJohn, D.O. Date:

2 Disclosure Information 84th Annual AsMA Scientific Meeting Christy Hileman, RHIA I have no financial relationships to disclose. I will not discuss off-label use and/or investigational use in my presentation.

3 The Team Autopsy Program Team Objectives Help coordinate accident autopsy and toxicology for U.S. registered fatal aviation accidents Collect, file, and distribute autopsy reports Composed of two full-time employees Registered Health Information Administrator (RHIA) American Health Information Management Association (AHIMA) 3

4 Autopsy Program The s Autopsy Program was centralized to the Civil Aerospace Medical Institute (CAMI) in Oklahoma City, Oklahoma and began operations October 1, Coordinates, acquires and stores information for all U.S. registered fatal aviation accidents. Supports the FAA Office of Accident Investigation, Office of Aerospace Medicine, and the National Transportation Safety Board (NTSB). 4

5 Fatal Aircraft Accidents.What happened? 5

6 The autopsy team responds to all civilian fatal aircraft accidents in the U.S.A. Occasionally, we will get involved when a registered U.S. civilian aircraft crashes in another country. 6

7 Outside the U.S.A. 7

8 Introduction U.S. civil aviation accidents ,500 accidents with 469 fatalities ,550 accidents with 485 fatalities General aviation accidents account for the greatest number of civilian accidents accidents with 454 fatalities accidents with 444 fatalities Source: National Transportation Safety Board Aviation Statistical Reports 8

9 Introduction The autopsy team faces challenges in obtaining autopsy records. One of the biggest challenges is the various regional investigative systems. In 23 states: 46% have a medical examiner system In 27 states: 54% have a coroner system 9

10 Methods Data obtained and analyzed from: The Medical ANalysis TRAcking (MANTRA) Registry Geographic Pilot Demographics Regional Analysis The Autopsy Team Reviewed 1,067 Autopsy Reports from 1,016 Fatal Accidents Years

11 Results 11

12 The Example In 2011, we assisted with a light sport aircraft fatal aviation accident. Airman had 2,500 hours of flight time with 20 hours in last 6 months. Accident occurred in a coroner system state. Local coroner was also the County District Attorney. 12

13 The Situation Local coroner did not want to order an autopsy because a crime was not committed. The FAA does not have the authority to order an autopsy. The autopsy team worked with National Transportation Safety Board (NTSB) and local pathologist group to obtain autopsy. 13

14 The Truth is out there 14

15 Medical Certificate Medical Issues Issued 8 years prior Coronary artery disease - status post four stents Diabetes Hypertension Medications Clopidogrel bisulfate Aspirin Ramipril Metoprolol Hydrocodone Metformin Simvastatin 15

16 The Results Clinical History Hypertension Diabetes Hyperlipidemia Coronary artery disease Myocardial infarction Status post stents placement Status post Hodgkin s lymphoma recurrence 16

17 Autopsy Findings Heart 410 grams Severe atherosclerosis Stents identified in left anterior descending, right coronary, and mid-posterior descending coronary artery Cardiomegaly Acute plaque rupture and occlusive thrombus immediately proximal to the left anterior descending stent 17

18 Probable Cause - NTSB Outcome The accident occurred during climb after take off. The pilot s most recent FAA third-class medical certificate was 8 years prior to accident. Before the accident, airman applied for third-class medical and he was deferred. 18

19 Autopsy The Truth The autopsy revealed that the pilot suffered a fatal heart attack during the take-off attempt. Pathologist indicated on autopsy Based on his clinical history and autopsy findings, he had an acute infarction leading to fatal arrhythmia which likely led to the plane crash. 19

20 Our Solution The Autopsy Team created a brochure for investigators, coroners, and medical examiners describing our goals. 20

21 Questions 21

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