As a result of a number of accidents in which the pilots omitted information or lied about substance and/or alcohol dependence during medical evaluations, and the NTSB later determined that the dependency “was relevant to the cause of the accident,” the Safety Board has recommended three policy changes in regard to the evaluation of pilots with dependency issues.

In a June 25 letter to FAA Administrator Marion Blakey, the NTSB recommends that the FAA require pilots to submit full arrest and court records to the FAA, including details such as blood alcohol levels and behavior at the time of the offense; ensure that arrest and court records and complete medical records from the Aerospace Medical Certification Division are provided to medical examiners; and require all pilots diagnosed with substance/alcohol dependency to be evaluated regularly in accordance with special-issuance medical certificates.

“The substance-dependency issue has not been adequately addressed by current regulations,” said an NTSB spokesman. “Each of these recommendations is meant to remedy what we feel is a gap in the system.”

In the letter to the FAA, the NTSB stated that the FAA “was or should have been aware” that the pilots in these cases had a history of substance dependence. And even though the FAA requires pilots to report substance dependence, arrests, administrative actions and convictions, the Safety Board believes the agency has failed to “routinely obtain arrest reports or court records for drug- and alcohol-related offenses” or verify information pilots supplied to medical examiners.

The NTSB cited one case in which a pilot reported a DUI conviction to the FAA, but the FAA did not obtain the arrest reports. After the pilot was killed in an alcohol-related aircraft accident last year, the NTSB obtained the prior DUI report and discovered that the pilot had a blood alcohol level of 0.28 an hour after his arrest and had been “actively controlling his vehicle, was completely conscious and was conversing with the arresting officer.”

“The fact that the pilot was able to operate a vehicle at a level even greater than 0.28 percent (his blood alcohol level would have dropped from the time of the traffic stop to the time of the blood alcohol testing) is evidence of tolerance; this pilot would have met the FAA’s definition of substance dependence,” the NTSB wrote. “As a result, this pilot would not have been issued a medical certificate, had the FAA considered the DUI arrest record as part of the medical certification application process.”

The NTSB concluded that the accident was a result of the pilot’s “impairment from alcohol consumption” and “the Federal Aviation Administration’s failure to identify existing evidence of substance (alcohol) dependence in the pilot due to an inadequate and incomplete process of screening medical applications.”

Patient Records Missing Pertinent Information
The NTSB has also found that even though medical examiners are required to “defer the issuance of a medical certificate for pilots with a history of substance dependence or abuse,” there have been cases where medical examiners have not been given complete medical records or medical history before issuing medical certificates.

In one instance, an airline-transport pilot admitted prior marijuana use to a medical examiner, and the examiner concluded that the pilot could obtain a second-class medical certificate. In 2001, the pilot and his first officer were killed in a DC-3 accident in Alaska, due in part, according to the NTSB, to the pilot’s
“impairment from cocaine.” During the investigation, the Safety Board discovered that the pilot had served four years in jail on a cocaine-related drug charge, and his official FAA medical record, which the examiner had not seen, stated that the pilot had a cocaine habit.

In a similar case three years later, the pilot of a Beech C-45H had denied substance dependence to a medical examiner, but upon investigating the fatal accident in which he was killed, the NTSB discovered a note in his medical record from an outpatient treatment center discharge summary that stated the pilot was “alcohol/cocaine abusive” and had “secondary issues” that included “denial and minimization of alcohol abuse.”

According to the FAA, the agency has “not seen any data to support the idea that pilots making false statements on medical certificate applications is rampant,” but the agency will “take a serious look at the recommendations and determine a response within 90 days.” An FAA spokesman added that the agency is “concerned about any falsification of information. But at the same time, we believe the vast majority of pilots are honest.”

The NTSB spokesman said the recommendations “are all about information, getting that information consistently to the FAA” and ensuring that medical examiners “have access to that information.” “We want the evaluator to have all of those records available because they contain information that may be valuable to determine to what degree the substance dependence is an issue with that individual, and what the likelihood of relapse is,” he added. “And that all affects potential safety-of-flight issues.”