Piper PA-46-500TP, San Antonio, Texas, Jan. 18, 2008–The NTSB determined that the pilot’s failure to execute an instrument approach was the cause of the crash, which destroyed the Meridian and killed the owner-pilot, the sole person on board. Contributing to the accident was the pilot’s impairment due to use of over-the-counter medication. The single-engine turboprop was on an instrument approach to San Antonio International Airport in IMC when the instrument-rated pilot made three unsuccessful attempts to intercept the ILS localizer for Runway 30L. The private pilot reported he was having trouble performing a coupled approach and that he was trying to “get control” of the airplane before the flight disappeared from radar. An eyewitness who was a former Navy flight instructor saw the airplane make several passes before it rolled right wing down to an approximately 60-degree angle. The Meridian assumed an “extreme nose-low attitude” and then disappeared behind trees. According to the witness, “The [airplane] exhibited a classic approach turn stall maneuver” and did not have enough altitude to recover. The Piper struck a farm field and then a barn before being consumed by fire. An autopsy revealed use of the prescription antidepressant Sertraline and a larger-than-normal dose of the powerful antihistamine Doxylamine, which is known to cause impairment. The pilot’s most recent medical certificate application made no mention of the use of either drug.