Medical conditions likely "incapacitated" an elderly man and caused him to crash his airplane into a Richmond high-rise two years ago, according to the Transportation Safety Board.

On Tuesday, the board released its final report into the investigation of an Oct. 19, 2007 crash that claimed the life of 82-year-old Peter Garrison and injured two others.

"The pilot had pre-existing health risk factors, making it possible that he suffered an acute medical event resulting in incapacitation and loss of control of the aircraft," said the report.

The report also noted an incorrect setting of the aircraft's flight controls as a contributing factor to the crash.

"With the pitch trim at an inappropriate setting, the aircraft accelerated in a descent below the height of the building and collided with it."

The aircraft's pitch trim—the default position of the flight controls—was set for nose down, which could explain why the aircraft was descending over Richmond instead of gaining altitude had the pilot blacked out.

Garrison's small twin-engine Piper Seneca crashed into the ninth floor of the Rosario Gardens high-rise minutes after taking off from the south runway of Vancouver International Airport at 4 p.m.

Garrison, who was headed for Pitt Meadows, died in the crash, and two occupants of the condo were injured, one seriously.

Fully loaded with fuel, the aircraft didn't cause a fire when it hit the 15-storey building, but the crash caused extensive water damage that kept residents out of their condos for months.

Transportation Safety Board inspector Bill Yearwood said the pilot made no attempt to avoid the building, nor did he communicate with the airport's control tower.

"A conscious pilot would have likely made some effort to correct the descent, to maneuver away from the building, or to communicate with air traffic services," he said.

An autopsy found no evidence Garrison suffered a heart attack or stroke, but he did have medical conditions that could have caused him to be incapacitated, said Yearwood.

Garrison was an experienced pilot, with 60 years of flying under his belt, but he also had a heart attack 10 years before the crash, and had diabetes for four years and hypertension for 20 years.

"The medical conditions that he had, at least two of the conditions he had, could cause a person to fall into reduced state of consciousness," said Yearwood.

Garrison had a valid medical certificate, as all recreational pilots over 40 are required to have a medical exam every two years. But the report notes there is no regulatory requirement to evaluate cognitive and motor skills. The report also notes there is no way to ensure private pilots reveal previous medical symptoms or chronic conditions.

Yearwood said there's "a general acceptance of a lower standard for private operations," as older commercial pilots must get a medical exam every six months.

Although it does raise safety issues associated with elderly pilots, the report makes no recommendations. That will be left to Transport Canada.

Garrison had three previous accidents in the same aircraft—in 1979, 1998 and 2006—each resulting in "substantial damage," according to the report.