On September 9, 2022, at 1132 eastern daylight time, N8925Y, a twin-engine Piper PA 39 airplane was substantially damaged when it was involved in an accident at the Essex County Airport (CDW), Caldwell, New Jersey. The pilot and the passenger were not injured. The airplane was being operated as a Title 14 Code of Federal Regulations Part 91 personal flight. According to the passenger, she and the pilot were flying to Maine to visit friends. They arrived at CDW around 1000. Once she and the pilot boarded the airplane, the pilot said he forgot where they were going and had to ask the name of the airport. After informing the pilot of their destination, the pilot taxied to the runway and began to accelerate for takeoff. The pilot aborted the takeoff because he thought the passenger’s door was open. The door was secured, and the pilot taxied back to the runway. Just before taking off again, the pilot asked for the second time where they were going. The passenger said she again had to tell the pilot their destination. The pilot initiated the takeoff roll but aborted because he felt something was wrong with the airplane. The passenger said the pilot shut off both engines and “locked up” the brakes, but the airplane went off the runway into the grass. The airplane swerved right and came to rest upright. The left main landing gear collapsed, and the left wing was substantially damaged. The pilot stated that he did not recall any details of the accident. He could only remember pulling the airplane out of the hangar before the flight, then later being in the hospital. The 84-year-old male pilot’s most recent aviation medical examination before the accident was on October 4, 2021. At that time, he reported a medical history including chronic lymphocytic leukemia (CLL) in remission. His reported medications did not include any medications that are generally considered impairing. The Aviation Medical Examiner issued the pilot a third-class medical certificate, in accordance with an FAA Authorization for Special Issuance for CLL. The medical certificate was limited by a requirement to wear corrective lenses and carried a time limitation, which had not expired as of the crash date. In July 2022, the pilot submitted additional reports to the FAA indicating that his CLL remained in remission. Following the accident, when first responders arrived at the accident scene, they noted that the pilot seemed confused and had memory problems. The pilot was hospitalized for neurological evaluation and consultation. Magnetic resonance imaging of the pilot’s brain performed the day after the accident demonstrated an acute-to-subacute lacunar stroke in the right medial temporal lobe. The pilot was discharged from the hospital the day after the accident with a diagnosis of transient global amnesia. The 84-year-old pilot said that he did not recall any details of the accident. He could only remember pulling the airplane out of the hangar before the flight, then later being in the hospital.