HISTORY OF FLIGHTOn January 14, 2022, about 1001 central standard time, a Bell 407, N167RL, was destroyed when it was involved in an accident near Houma, Louisiana. The commercial pilot and a passenger sustained fatal injuries. The helicopter was operated as a Title 14 Code of Federal Regulations Part 135 on-demand passenger flight. The helicopter was equipped with an Appareo Vision 1000, which captured cockpit imagery of the accident flight. The recorded video indicated that the flight was proceeding normally until about 10:00:50, when the pilot’s head began to fall back in a motion not consistent with scanning for traffic or with directed attention. The helicopter was traveling at a speed of about 123 knots and an altitude about 1,220 ft mean sea level. The pilot’s movements after this time appeared to be undirected and solely in response to the g-forces resulting from aircraft motion. The pilot’s head began to move toward the right and upward until the end of the recording. The pilot’s motion remained consistent with an undirected response to aircraft motion. The view outside the windscreen was consistent with a nose-down, inverted attitude just before the end of the recording. A witness near the accident site stated that he saw the helicopter descend into terrain in a nose-down attitude and did not see any parts separate from the helicopter while it was airborne. WRECKAGE AND IMPACT INFORMATIONA postaccident examination of the helicopter revealed there was no mechanical failure or malfunction that would have precluded normal operation. MEDICAL AND PATHOLOGICAL INFORMATIONThe 30-year-old male pilot held a second-class Federal Aviation Administration (FAA) medical certificate with a limitation for corrective lenses. At the time of the most recent exam, he reported no medications or medical conditions. No significant medical concerns were identified. Department of Veterans Affairs disability records showed that the pilot had a history of migraines and tinnitus, but had no diagnosis of traumatic brain injury. According to the autopsy, the pilot’s cause of death was massive total body trauma and the manner of death was accident. The examination was limited by extensive trauma. The cardiovascular system showed no evidence of natural disease. Toxicology testing performed by the FAA Forensic Sciences Laboratory detected ethanol in the pilot’s liver, lung, kidney, and muscle tissue at 0.056 grams per hectogram (gm/hg), 0.012 gm/hg, 0.055 gm/hg, and 0.039 gm/hg, respectively (grams per hectogram in tissue samples are directly comparable to grams per deciliter in blood samples). N-butanol was detected in liver, kidney, and muscle tissues, but was not detected in lung tissue. N-propanol was detected in kidney and muscle tissues but was not detected in his liver and lung tissues. The non-impairing over-the-counter antihistamine, fexofenadine, and its metabolite, azacyclonol, were detected in the pilot’s liver and muscle tissue.