A PILOT who died in a helicopter crash at Maitland Vale had significant heart health issues and had failed to declare surgeries and medications, a regulator's report has found.
The Australian Transport Safety Bureau on Tuesday released its report into the October 6 2022 crash, in which a voyage from Casino to Warnervale ended in tragedy over the Hunter.
The report notes the pilot was approaching Dungog when they told a family member by phone all was going to plan. Less than ten minutes later they began deviating from their course, and by 4.11pm the chopper was flying as low as 120 feet above ground level over Vacy and leaving its flight lanes.
Minutes later, witnesses saw the helicopter descending towards the Hunter river before it "rolled markedly, descended rapidly and collided with the river bank".
"Some of those witnesses, as well as others who only heard the helicopter and the impact, reported the helicopter sounded normal ... while others reported it sounded rough or the engine was 'screaming'," the report states.
The pilot, who was the helicopter's lone occupant died in the crash.
The ATSB found the pilot was diagnosed with minor coronary artery disease less than a year beforehand and "was at a low to intermediate risk of a cardiac event".
"However, the pilot's post-mortem showed they had severe coronary atherosclerosis within all three major coronary arteries with at least 80 per cent blockage observed within each artery," the report states.
"While it was not possible to forensically determine if the pilot experienced a heart attack prior to the accident, it remained a significant risk factor for the pilot."
The pilot had returned from overseas recently and had a head cold, but a family member had reported he had eight hours' sleep the night before flying and was in good spirits.
The report also notes the pilot did not declare "a significant surgery" during their most recent aviation medical examination and was taking "numerous prescribed, non-prescribed and recreational drugs" that were undeclared.
"There was insufficient evidence to enable an assessment of whether the drugs and medications alone contributed to the accident," the report states.
"However the forensic pharmacologist advised that some of these drugs were at levels where some impairment of the high-level psychomotor skills required for flying would be expected."
The report notes the pilot received a 27-second call from an unknown person roughly a minute before the crash, but "despite numerous attempts, the ATSB was unable to establish contact with this caller".
The report concludes the tragedy was likely the result of the pilot experiencing "an incapacitating event".
"While it was not possible to forensically determine if the pilot experienced a heart attack, it remained a significant risk factor," ATSB director transport safety Kerri Hughes said.
"Pilots are responsible for declaring their full medical history and medication use at the time of an aviation medical examination, so CASA and your designated aviation medical examiner can assess suitability for flying.
"This accident reinforces to pilots the importance of remaining aware of any health and lifestyle changes, and how these may affect your fitness to fly.
"Alternative medication may be available to medications that are incompatible with flying," Ms Hughes said.