Gone West - Badwater Bill (Bill Phillips)

I never really considered Bill a friend, but he was always worth the time of day. If we had our differences it was always in private. He will be missed. One of the great characters in aviation. Very sad. I hope Boom Boom pulls through.

Bob Chilcoat
Chief Pilot, White Knuckle Airways
 
wanttaja said:
The NTSB Factual Report is out.

Ron Wanttaja
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Wow, he was "on" a lot of meds.

The report noted “other significant conditions” of atherosclerotic coronary artery disease, cardiomegaly, and acute mixed drug intoxication.

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.
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TangoWhiskey said:
Wow, he was "on" a lot of meds.
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Yup.. he was...

And while its pretty clear that he was practicing poly-pharmacy, it does not appear to be the obvious cause of the accident.

Vicodin.. AND dilaudid.. AND valium (it acts as a muscle relaxant too).. I'm presuming for his chronic back pain from the disc issue.

The heart vessel was likely non contributory too. While the LAD is called the "widowmaker" for a reason, it had apparently narrowed slowly enough over time that the heart built its own bypass vessels around the stenosis/occlusion (i.e. collateral circulation).

I'm surprised that the "precautionary" heart cath didn't raise a flag for review on his medical app. Those are done for a reason - chest pain, bad stress test, bad ekg.. not just out of the blue.
 
Doggtyred said:
Yup.. he was...

And while its pretty clear that he was practicing poly-pharmacy, it does not appear to be the obvious cause of the accident.
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Why do you suggest that? I'm thinkin' that he was so chemically enhanced that his perception of reality was seriously out of whack. He obviously thought he could fly it out of the situation when it is equally obvious that he wasn't capable of salvaging the situation.
 
Clark1961 said:
Why do you suggest that? I'm thinkin' that he was so chemically enhanced that his perception of reality was seriously out of whack. He obviously thought he could fly it out of the situation when it is equally obvious that he wasn't capable of salvaging the situation.
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Years of use equals years of tolerance.

What would knock you and me out, might be just enough to prevent withdrawal symptoms in a tolerant user with years of use. And it only render the pain barely manageable.
 
We also or at least I don't know that those were even at or above theraputic levels. To much info missing to speculate if it had an effect regardless he should not have been flying while on them. JMHO
 
Doggtyred said:
Years of use equals years of tolerance.

What would knock you and me out, might be just enough to prevent withdrawal symptoms in a tolerant user with years of use. And it only render the pain barely manageable.
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I disagree with that position. While tolerance is built up, it's not without a price. The cognitive processes and reactions will be impacted.
 
He was on three different narcotics; Tylenol with Codeine, Vicodin, Dilaudid, I assume in his blood (?) on the first two and urine on the third
The Vicodin level as reported is, high Toxic to low Lethal, range...
The Codeine is at the top of Theraputic and approaching Toxic...
The Valium and it's metabolites are at low levels..
The Tylenol is Theraputic level..
The Cardura is Theraputic level...
Since a serum level of Dilaudid was not reported I will not speculate other than to point out that the minimum detection level (for legal purposes) in a drug urine screen is 0.3 ug/ml and he had 0.54 ug/ml suggesting that his serum level was less than toxic...

Now, given only raw numbers, and not given specifically what body fluids each of these were obtained from, and not given the time post mortem, one can only speculate... The elevated Vicodin level is worrisome for impairment of motor skills and perception... The combination of the three narcotics makes that more likely, even where there is habituation...

denny-o (old, really old, EMR doc)
 
Dr. O said:
He was on three different narcotics; Tylenol with Codeine, Vicodin, Dilaudid, I assume in his blood (?) on the first two and urine on the third
The Vicodin level as reported is, high Toxic to low Lethal, range...
The Codeine is at the top of Theraputic and approaching Toxic...
The Valium and it's metabolites are at low levels..
The Tylenol is Theraputic level..
The Cardura is Theraputic level...
Since a serum level of Dilaudid was not reported I will not speculate other than to point out that the minimum detection level (for legal purposes) in a drug urine screen is 0.3 ug/ml and he had 0.54 ug/ml suggesting that his serum level was less than toxic...

Now, given only raw numbers, and not given specifically what body fluids each of these were obtained from, and not given the time post mortem, one can only speculate... The elevated Vicodin level is worrisome for impairment of motor skills and perception... The combination of the three narcotics makes that more likely, even where there is habituation...

denny-o (old, really old, EMR doc)
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Denny, I mentioned your analysis to some other folks, and got some push-back on your assessments. Is there a standard source for the toxicity/lethality levels of the various drugs?

Ron Wanttaja
 
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