Injured Woman refused air lift by HEMS and dies

[MSP Aviation]

http://www.naplesnews.com/news/2007/mar/04/lawsuit_challenges_colliers_weight_rule_transporti/

:ugh:

[SASless]

Interesting case here.....who is at fault and accountable for the death of the victim?

What would you do in a case like this?


Lawsuit challenges Collier’s weight rule for transporting trauma patients
One calamity after another led to the death of Diana Lopez, a 37-year-old business owner in Naples who cared for her disabled parents and helped raise a niece and nephew.

She was the victim of a tire blowout one January afternoon last year on Interstate 75 and was thrown from her Ford Expedition after the vehicle flipped.

She wasn’t wearing her seat belt.

The next disaster came when the Collier County Emergency Medical Services Medflight helicopter declined to fly her to the trauma unit at Lee Memorial Hospital in Fort Myers because she exceeded the 300-pound weight limit per patient.

Instead, she was put in a ground ambulance for transport to Downtown Naples Hospital, which doesn’t have a trauma unit.

The third disaster struck three miles later when her ambulance broke down. A second ambulance had to be sent out to get her.

By the time she got to the hospital, nearly two hours after EMS initially got to the accident scene, Lopez was in heart failure and unresponsive. Emergency room doctors tried to revive her but it was too late.

The wrongful death lawsuit claims, among other things, that EMS was negligent in failing to assess the seriousness of Lopez’s injuries by deciding to transport her by ambulance instead of Medflight because of her weight. She met criteria as a trauma patient, having been thrown from her vehicle, and should have been transported by the fastest way possible to the nearest trauma unit, the lawsuit says.

Moreover, EMS was negligent by not maintaining ambulances in good operating order and failed to remove from service an ambulance with mechanical problems, according to the lawsuit.

“The ambulance had significant maintenance issues in the past, electrical problems, transmission problems, engine problems,” Hanlon said. “That is our review of the previous maintenance records.”

Lopez, who owned a trucking company to haul construction material, weighed 394 pounds at the time of her death. She had lost 94 pounds after gastric bypass surgery a few months earlier at a Miami hospital.

Her niece, Jane Trevino, was with her that day and so was Trevino’s 1-month-old son, who was in a car seat in the rear passenger seat. Trevino, now 21, and her son were not seriously injured.

The EMS rule of not transporting patients who weigh more than an estimated 300 pounds is arbitrary and not required by any regulatory agency, Hanlon said.

“I was shocked when I learned of the 300-pound limit. It doesn’t make sense,” she said. “I can’t find any state or national standard for that (rule).”
The EMS rule likewise says the maximum weight limit for each medic on board and the pilot is 200 pounds, yet Hanlon said the Medflight helicopter can handle a total of 1,300 pounds, which includes all equipment on board.

“With the amount of fuel and the patient’s weight, we would have exceeded the weight limit for that aircraft,” the Chief Pilot said.

Henderson said he doesn’t know how much fuel the Medflight was carrying when it responded to Lopez’s accident. The flight manifest with that information is no longer on file. By law, those documents must only be kept for 30 days, he said.

“I don’t know whether they had information of a large patient before they got at the scene,” he said.

Medflight pilots have had to make the same call before not to transport someone, usually when there are two injured patients and both are heavy, he said.

“Frequently it happens,” he said. “We can’t take both patients.”

[Shirtless]

394 lbs!!! Even if you could carry the weight I think it would be a case of baulking out first! Of the HEMS stretchers I've worked with and seen I doubt very much she would fit in the first place!!

What kind of helo is it?

[movin' up]

Damned if you do, damned if you dont.

You don't take her, she dies. Family sue you.

You take her, you are found to be overweight (no pun intended) after an accident. Family sue you.

Your employer finds you flying in breach of SOP's, they fire you.

Sad all round when life is ruled by the fear of litigation. :(

[B Sousa]

How much can you put on the hook..........

EMS Pilots have to make those decisions. He hauls and the crew dies.......No Way.
Pilot was doing the right thing.

"and was thrown from her Ford Expedition after the vehicle flipped.
She wasn’t wearing her seat belt."
OK, Do they even make seat belts for someone that size, and thrown.......Say again thrown from the vehicle. We are talkin serious physics here. She must have been haulin........well yes I guess she was..

But Im sure that the buzzards will storm on this like stink on poo poo.

[blade root]

This reminds me of a job request many moons ago...

Get a phone call asking if we can fit a pallet on the rear of the aircraft (bk 117). I respond " yes, why?", "well we have a lady weighing 250 kg needing hospital transfer. The only way we can lift her is with a forklift."

Not sure what happened as the job got cancelled.

[B Sousa]

Second thread on the same subject............

[spinwing]

Mmmmm....

Even if they had been able to carry her ..... if she had arrested in flight there PROBABLY would have been no way to to get her back ....

Obese patients are one of those things all paramedics and air crew hate! :{

And its not the air crews fault the patients are that size is it???

You'd need a fork lift to load 'em and prob a 412 to fly 'em!

:=

[MSP Aviation]

Collier County flies EC-135s. (Not sure what T-/P- series)

[TwinHueyMan]

Crew made a decision, I fully support it. Pushing the limits was/is a common acceptance amongst HEMS operations, "to save the life", but in far too many cases it has a crew theirs. If they had enough concern to put a restriction on this situation in advance, then they obviously conciously thought about it and decided it was a risk.

If the crew is persecuted for this, next thing you know, a crew somewhere will (based on the repurcussions from this mission) try to drive on anyways, and get themselves killed.

Our policy is -- if the crew makes a decision based on safety, it's supported 100% unless grossly negligent. If there was a better way, it's discussed and worked with so that future scenerios can be handled better. Sure, it sucks when we picked up a guy who died after a delay involving a safety issue, but if we go john wayne every time someone is "critical", we'd be playing russian roulette.

The lady should have worn her seatbelt if she really wanted the best chance of living through an accident.

-Mike

[jackjack08]

Spinwing

Comment;
Even if they had been able to carry her ..... if she had arrested in flight there PROBABLY would have been no way to to get her back .... Rubbish!!!

1. Could you have defibrillated the patient in-flight ?
2. If the patient went into a shockable rhythm, then why not consider landing. resus guidelines now say 2 mins CPR then shock
http://www.resus.org.uk/pages/als.pdf
3. Could easily maintain airway with laryngeal mask.
4. Drug therapy

Obese patients are one of those things all paramedics and air crew hate!
1. I think your comment 'HATE' above is too strong. individuals of the larger size may be difficult to manually handle but they deserve the same life saving clinical interventions as the next person ! I certainly don't hate people who are overweight and i can say that you do not speak on behalf of All Paramedics

[Gomer Pylot]

Our stretchers have a weight limit of 350 lb. That's a limitation, in the flight manual. The belts on the stretcher also have to be able to be fastened around the patient. If either of these factors come into account, we cannot legally fly the patient, no matter what the medical condition.

Medical condition does not concern me at all, and I don't even want to know it. If the helicopter wasn't there, the patient's condition would be the same. Someone else's carelessness or bad luck does not compel me to do anything I wouldn't do under other circumstances, nor to ignore regulations. I hope the jury finds for the defense in this case. Someone is just trying to make a lot of money for themselves.

[B Sousa]

"that you do not speak on behalf of All Paramedics"
Thankfully its the Pilot that made the decision. As your only a passenger it does not seem that you may have made the correct one.

[TwinHueyMan]

Well said gomer.

[Revolutionary]

Someone on another board made a good point about this case. In almost every country the population is increasing in weight and girth. Something to do with Twinkies maybe. Whatever the reason (and however much healthy, slim people may personally be offended by fatties), EMS services have to adapt to the changing shape of their customers. Of course there are always going to be patients who fall so far outside of the norm that they can't be accommodated. But as a rule, if the average customer gets bigger then as an industry we need to provide a bigger vehicle. Like, maybe, an EC145 or uh, an AW139. A guy can dream can't he:ok:

[SARBlade]

I once transported a 580 lb woman from a hospital pad on Vancouver Island to an awaiting ambulance at Vancouver International. Had to take the normal stretcher units out and strap 3/4 inch plywood to the floor so that we could roll the entire hospital bed and her into the chopper. When we landed at the airport, we didn't have the EMS staff as the ambulance hadn't arrived but was on way, fortunately the airport firefighters were on a training exercise and wanted to see the chopper. They assisted in getting her off. The ambulance showed up but couldn't take the bed, nor was their stretcher able to take the wait, so another ambulance had to come. EMS coordination at their best. :(

Lucky we had the only chopper able to do this mission!
http://www.aeroflight.co.uk/types/international/agwest/EH101/Cormorant_01.jpg

[B Sousa]

Revolutionary has a point. At least in the states. Folks are getting larger as in huge. AND its always someone elses fault. I can say that after dumping 20 pounds after the last flight physical. Its called pay attention. What really brings it home is watching the guy on the tube do a 30 day Mcdonalds only diet. He dam near died. Many are in a hurry, cant cook, off to work to survive and need the quick shot of food. Others have nothing to do, watch the tube and eat. Both are now leading this generation to become huge.
Back on track a bit. As they get bigger you will notice that the B206 Jet Ranger and long Ranger, even the A-star are not prepared to haul the load. Also consider that the Medical equipment on board has got the look and weight of the latest ER room. Pilots NOW can only weigh so much as they are the lowest common denominator ( albeit I have seen some pretty big heffers in the back, called Nurses)
Aircraft now have to be larger and most are going to twins, for more than one reason.
There are going to be exceptions as to who can fly as an evacuee, this case is one of them.
Since it is a case of life and death, it falls on the Pilot to determine go/no go.(not the Passengers, Nurse-Paramedic) That goes with the territory and in this case, sadly, he did the right thing.

[Revolutionary]

SARBlade, I wasn't dreaming that big:ok:

[Brian Abraham]

Have the utmost respect for the job the EMS guys/gals do and the calls they are obliged to make at times. The accident rate suggests they may be trying too hard with the equipment they have to hand. I found a book given to me by the author Dan Green "In The Footsteps Of Angels" made me somewhat glad that it was a carreer path I never had to contemplate. I lie in bed at night and listen to our local IFR 412 EMS bird go over on God aweful nights and offer a quiet prayer and glad its him and not me.

I did have one memorable EMS call out in the middle of one night for a suspected heart attack on an oil rig. Picked up the patient with two medics on board. Returning home and passing over the top of another rig they called and said they had an accident on the rig where a guy had been hit in the head by a crane hook and in bad shape. The patient we had was concious and I asked the medics was it possible to get him off the stretcher and sit him up as it was obvious the other was a stretcher case. No was the answer so had to return to home. I asked one of the medics to return offshore with me while the other transported the heart case to hospital in the ambulance but they have to operate the ambulance with a crew of two so that was a no go. We cooled our heels for a good two hours while a doctor was rounded up to come offshore with us. Turned out the original guy had merely tripped going down some steps and the medic on board the rig went to assume the worse mode (litigation possibilities again?). The head injuries to the second guy resulted in him surviving with severe physical and mental disabilities (and somewhat ironically he was the son of a local doctor).

I salute all you EMS guys/gals. Just be careful out there.

[B Sousa]

Had that in the Military. The old addage we never refuse a mission. Got called out in the zero moon to pick up a guy whos leg was a compound fracture. Guided in by Illum. from a tank. We went and picked him up. Risked the crew for what turned out to be a Sprained Ankle. No problem with that but got a piece of the troopers CO's ass for that one later.
Pilots make the aircraft decisions and Medics make the medic decisions, hopefully they work out for the best, but sometimes things happen.....

[itoldyouso]

Well said by all, but a thought!

You walk into a factory and see safety signs everywhere about how to do things safely and not get hurt. One of those signs is someone bending over and showing you how to LIFT things safely. This sign also has a maximum WEIGHT limit.

Now, back to the subject.
There are weight limitations on the stetcher, the rails, the tiedowns, the seat belts, the aircraft MTOW etc etc. BUT one of the most important limitations to remember is the safe lifting capacity of the crew (a human) to lift that patient sometimes about waist height and into the helicopter.

Then you have to go to work and fly them back to the hosiptal!

food for thought!

:D

[Gomer Pylot]

Usually there are plenty of people to help load the patient. I don't load patients, ever. If I hurt myself, the patient is out of luck. We normally load hot at a scene, both to save time and to make sure there isn't a problem during the start, so it's usually a moot point anyway. Loading a 400lb (or very nearly) person into a helicopter on a stretcher is going to be a goatroping* no matter how many people you have helping, though.

*In Texas, goatroping is a polite term for what is known in other circles as a clusterf**k.

[tottigol]

You can only fit so many people around a stretcher, any extra ones that think they maiy be participating are only adding to the confusion and the number of heads the pilot has to count in and out.
The APLS (Airborne Patient Loading System) in our 430s are rated for a maximum of 350 lbs, even so you have to consider the patient's girth.
I believe the crew made a safe call in declining the flight, the EC-135 being a smaller airframe, if anything else, the first responders and the requesting agency ought to have communicated the patient weight well in advance.
I remember flying many (but one at a time) cooks to the Offshore Oil & Gas facilities that were "displaying" over 400 lbs and needed a dedicated belt extension.
I always thought of who was going to be the poor bastard having to haul 'em out of a confined quarter and onto the flight deck if they keeled over due to a heart attack or something similar.

[Gomer Pylot]

The way it's usually done offshore is with a crane and a personnel basket. A few platforms don't have a crane close enough to the heliport, but they're few and far between. Almost every medevac I've ever done from offshore used a crane to get the patient onto the heliport. Getting them outside in the first place can be a trick, though.

[spinwing]

Jack Jack 08 ....

Terribly sorry if I upset your delicate sensibilities ol' chap .... appologise profusely ... of course didn't realise that you do speak an behalf of ALL |PARAMEDICS

I of course, defer to your superior knowledge of these things ...and realise that since I've only been flying Medivacs since '76 I still have many paramedics yet to meet. They will no doubt be the ones who will enjoy working on obese critical patients in the confined areas at the back of a smallish helicopter!

Cheers :eek: :E

[tottigol]

Allright, this thread is getting off the beaten path, that usually happen when people that are not qualified to seat in the cockpit want to play pilot and use a decision making mechanism that exudes aviation.
The decision was made SOLELY based on patient weight/aircraft performance and limitations.
I would have done the same and honestly I don't give a rat's ass what the patient's conditions were at the time, as a matter of fact aren't those very same conditions supposed to be not communicated to the pilot so as not to influence his/her judgement?.
Rationalizing the way Jack08 did is the reason why this industry is going down the drain.

[Mac the Knife]

Grossly obese patients with significant injuries usually die of subsequent complications anyway (this woman was 178kg, the weight of 2 big adults).

[MSP Aviation]

It's all a balance. Bigger choppers mean fewer practical LZs and qualified pilots. It's a tough question, and I think the only answer is to hold people accountable. One must understand that if one is obese, certain opportunities may not be possible, some of which may be necessary.

[Brian Abraham]

aren't those very same conditions supposed to be not communicated to the pilot so as not to influence his/her judgement?.

Spot on totty :ok:

[unstable load]

I agree with totti,

BUT, who is the one who will ultimately be at the sharp end of the upcoming lawsuit? There are a few likely candidates...
1) The pilot who refused the transfer
2) The guy who designed the kit and wrote the flight manual supplement
and "neglected" to take into account the possibility that the ever
expanding American physique may overcome his design,
OR
3) The FAA for issuing the STC and for approving the flight manual that
prevented the pilot from doing the transfer..............:ugh:

The lawyers are going to get rich from this one!:{ All because some fat chick did not wear her seatbelt. What is the law regarding seatbelts in that state, anyway?

[B Sousa]

The Answer is......Deep Pockets... Attorneys wont bother with the Mobile Home owning Pilot.
Watch. Aircraft Manufacturer, Hospital, City or County for not providing. Anyone who was in the state on that day... IT will make you laugh when you see the court documents...........AND the funny thing is that those who are sueing could probably give one sh1t about the person who died, its just another way to get some go away money for free.

[MSP Aviation]

Just a bit of an update, Collier County Medflight operates an EC-135 T1.

From the Florida State Code:

"(4) It is unlawful for any person:

(a) To operate a motor vehicle in this state unless each passenger of the vehicle under the age of 18 years is restrained by a safety belt or by a child restraint device pursuant to s. 316.613, if applicable; or (b) To operate a motor vehicle in this state unless the person is restrained by a safety belt."

[rotorfan]

What if the responding heli was legal up to a 450-pound patient and the deceased made it to the ER, was patched up, and lived to eat another jelly donut or three? Surely, the day would come when the crew was dispatched to fetch a 460-pounder and the scenario starts all over (cue the sharks, er, lawyers). Is not EVERY machine a compromise? If the pilot isn't the most qualified to judge whether the flight is practical, prudent, or even possible, then who the hell is? Convene the Board of Directors to have an emergency vote on the revenue to be had or lost? Get the musings of the company attorney? Call the A/C manufacturer's test pilot to see if they can cheat just a LITTLE, and JUST this one time?
Common sense would say to leave the decision with the pilot, and that's the end of it. Silly me, we're talking about the American legal system, where common sense ain't so common.
This simple private pilot tips my hat to you EMS guys and gals. I'd love a flying job making a difference in people's lives, but I'm not cut out to do what you can. Y'all be careful out there. Scary to think that the biggest dangers might not be the wires and weather. :uhoh:

[scooter boy]

"There are weight limitations on the stetcher, the rails, the tiedowns, the seat belts, the aircraft MTOW etc etc. BUT one of the most important limitations to remember is the safe lifting capacity of the crew (a human) to lift that patient sometimes about waist height and into the helicopter."

Quite so..

Mac the Knife - I totally agree - she would probably have never made it out of hospital even if she had survived the immediate injury.

This was a morbidy obese patient (almost 400lb) ejected from her vehicle - the survival odds were looking incredibly slim (no pun intended) even if the accident happened in the Emergency room parking lot!

Sadly, we now have to try to blame somebody who was there to help this woman (and most importantly was not even responsible for causing the accident) for this woman's death. Lets hope the case gets thrown out as it surely deserves to.

Crazy world we live in...

[Devil 49]

The posts advocating 2-pilot, twin engine, multi-patient, IFR capable aircraft as *the answer* ignore so many realities, it's difficult to address them, so heres a start-
My program is VFR only with generous minimums, and absolutely NO recrimination for weather turndowns. We're able to dispatch 95% of the time requested, my guess. For the cost of fielding 1 IFR dream machine, we're able to profitable field 3-4 VFR aircraft. So, to provide service in the the 5% of the time that IFR capability is required, one would lose the capability to service 3-4 times as many calls, an obvious loss to public benefit.
Do I see the advantage of the dream machine as touted? Certainly, but it could only come with some sort of agency support, and the only nightmare that's worse than hospital control of EMS aircraft is government control. Much as I hate insurance companies, they're positively rational in comparison.
The reality underlying this thread is that the US legal system is an even bigger whore than our politicians. It doesn't matter why this patient wasn't flown. Some attorney knows that there's money to made, whether or not the responding aircraft was capable of transport.
Incidental observation, I'm not aware that any of my program's 8 aircraft could have flown a 394 lber- 350 lbs is the record, to my knowledge.
"Gravity- It's not just a good idea, it's the LAW!"

[unstable load]

"Sadly, we now have to try to blame somebody who was there to help this woman (and most importantly was not even responsible for causing the accident) for this woman's death. "

WHY?? The silly woman BROKE THE LAW!! She never wore her seatbelt.
BLAME HER!!

If she had strapped herself in she may well have been in a survivable crash, but no, her family are probably too embarrased that they had an individual in their family who had total disregard for the most basic of common sense laws, and are now suing everyone they can so they can feel better for having this idiot in their midst.:{

The services should bill her estate for the flight and the repairs to the ambulance. It probably would not have broken down if it was not hauling her fat @ss in the first place! :}
OK, rant over!

"Lets hope the case gets thrown out as it surely deserves to."

AMEN!! I concur wholeheartedly with that sentiment.

[Revolutionary]

"The posts advocating 2-pilot, twin engine, multi-patient, IFR capable aircraft as *the answer* ignore so many realities"

Devil 49, reality does continue beyond your own program, you know. There are other states and other countries where the healthcare system is not jury rigged to reward the lowest bidder. What do you have against some government control? When it comes to EMS helicopters at least, some countries do seem to have a much more sensible system in place. Like Canada. Or most European countries.

Where I work, helicopter EMS is a complete free-for-all. There are over a dozen helicopters serving an area that can easily be served by three or four aircraft. As a result, they are all the cheapest single engine model that can do the job. What's worse, each aircraft is both over utilized and under utilized at the same time. Over utilized because the system (the entire state EMS system, that is) encourages companies to fly anything and everything from a broken ankle on up. Under utilized because as soon as an aircraft does more than 30 flights per month, the competition will roll in and park a helicopter next door to try and steal some call volume.

Frankly, I would welcome a little government control if it means I can have some kind of service area that is all mine. If I had that then I bet my employer could field a more capable helicopter and still turn a profit.

[scooter boy]

"She never wore her seatbelt"

Unstable Load,
I doubt she would have been able to get a regular seatbelt around her body at 400lb. It is possible to buy extenders that add a foot or two but her sheer bulk may well have been the reason why she wasn't buckled up.

Personally I would apportion the blame equally between McDonalds/Burger King/KFC for providing fast food of incredibly high calorific value (i:e fatty food) at unbelieveably low price to a vulnerable American public and the accident victim for being a (presumably) crap and wholly unrestrained driver with an insatiable penchant for "going large".:E

Kong my whopper!
SB

[helmet fire]

I think the issue here is actually two fold - and most of us seem to be fixated on aircraft performance. The other issue is the certification limitations of the stretcher installation both in terms of patient to stretcher weights and stretcher (plus patient) to floor weights.

I believe there would be a case to answer if the patient was below certification weights, did not exceed aircraft performance criteria, and the weather and landing site was suitable. I think it is therefore very unlikely to be a solid case given the pilot is an EMS professional and would have determined appropriate limitations in declining the job well before it got down to the patients own fault for being fat/not wearing a seat belt/being vulnerable to fast food/etc/etc/etc.

[Genghis the Engineer]

Of course, one only sees the newsreel precis of this.

But, can you imagine the outcry if a captain exceeded W&CG limits on the helicopter, or structural limits on a litter, and as a result either the aircraft was lost, or the casualty came adrift in the air!

G

[unstable load]

Genghis,

Absolutely right. If the pilot was wrong or stuffed it up and crashed then by all means indulge in the american national pasttime and sue.

I feel strongly that it all boils down to the driver being criminally irresponsible in not wearing her seatbelt, and if it did not fit her, then being WILFULLY disobedient of the laws in place at the time.
If I was the judge on this one I would toss it out with costs to the family for wasting court time and putting a necessary service (the EMS) in a negative spotlight to appease their egos and to assuage their embarrasment.:=

[MSP Aviation]

When one mentions aircraft performance, one must also wonder "would the SOPs of an aircraft large enough to carry her allow said aircraft to use that LZ?" Everything's a tradeoff...

[Pilot DAR]

I shall lend my voice of support to those who correctly consider the implications of flying an oversize person who cannot be restrained/supported/carried within the limits of the approved design.

I do not know the capacity of the stretcher installation of the helicopter in discussion. I would not be surprised, though, to be told that the maximum capacity is less than the mass of the intended patient describe here. Every design has intended limitations. These are the best compromise between the need for capability, and the cost of excess capability, which would go largely unused. The customer specifies the requirements of the job, the designer makes it work safely, and the regulator finds compliance with the prevailing requirements and issues an approval of the design.

This process assures that pilots can safely do the job without having to worry about suddenly becoming test pilots. Funny though, that even with a design requirement of 170 pounds per occupant for nearly all (North American anyway) certified aircraft, and the resulting reality that design compliance with the restraint requirements may not have been shown for heavier occupants, society seems willing to ask the pilot to overload the aircraft by filling the seats with heavier occupants. We would not think to ask the pilot to carry a greater number of occupants than the aircraft is approved to carry, so why is there an outcry when a pilot declines to carry more pounds of occupant than was approved?

There was a Canadian Cessna Caravan crash, in which the excess mass of all of the occupants of the aircraft was cited as a major contributing factor to unintended overloading, and the resulting total fatal crash.

A baggage net at the back of the cabin has a maximum capacity to assure that it will restrain the contents under crash loads. The pilot is not allowed to exceed that limitation, which was imposed by the designer or approving authority. Society would criticize a pilot who overloaded there. Why then would society ask the pilot to exceed the capacity of occupant restraints? It's probably the pilot who will be squashed if the overweight occupant comes loose in the crash!

If overweight people want to fly (in any aircraft), they should be prepared to pay the cost to travel safely, that is what they expect, isn't it? That could be as cheap as buying an extra seat on an airliner, or paying the additional cost to approve air ambulance helicopters with greater capacity, just in case they need it one day! Air carriers charge for overweight baggage don't they? Why is a person's excess mass exempt from this reasonable approach?

If, following the second crash of the day, you asked the overweight patient to cover the cost the damaged helicopter, because the pilot tried, but couldn't manage to fly her, would she be willing to pay?

Our society offers an amazing array of products and services. If a person's physical charteristics make it not possible for them to fit within the limitations of certain of those products and services, is it the responsibility of society in general to make the additional accomodations? Our society has spent many fortunes designing, testing and installing safety systems. If a person chooses not to use a simple system (seat belt), is it the responsibility of society to pay the cost to clean up the mess? Was this overweight person operating the vehicle within it's design limitations? Road vehicles have maximum capacity too! (or did she exceed the lateral C of G limits, and hence the rollover?)

The pilot's made the right decision - do it that way every time crew! That's what those of us who approved the design you are flying intended!

Safe flying....

Pilot DAR

[TorqueOfTheDevil]

But as a rule, if the average customer gets bigger then as an industry we need to provide a bigger vehicle.


The financial implications of this are enormous - not just new, larger helicopters, but larger helipads, hospital buildings reinforced for stronger rooftop pads etc - just so some people can continue to eat too many pies?


I doubt she would have been able to get a regular seatbelt around her body at 400lb. It is possible to buy extenders that add a foot or two but her sheer bulk may well have been the reason why she wasn't buckled up.



So it's okay for her to drive without a seatbelt because she's too fat to do one up? Would it therefore be okay for someone to exceed the speed limit because their car's speedo was broken?


Was this overweight person operating the vehicle within it's design limitations? Road vehicles have maximum capacity too! (or did she exceed the lateral C of G limits, and hence the rollover?)



Yes, and did the tyre blow out because it was overloaded or hadn't had its pressure and condition routinely checked?


Personally I would apportion the blame equally between McDonalds/Burger King/KFC for providing fast food of incredibly high calorific value (i:e fatty food) at unbelieveably low price to a vulnerable American public


Vulnerable to what? Greed? If people choose to eat fatty junk food instead of healthy food, you can hardly blame the fast food providers - should the government of a free country close down successful restaurants because a large part of the population is too weak to wean itself off a junk food habit? A bag of lettuce/tomatoes/carrots etc hardly costs a lot, and could make a filling and healthy salad.


Many are in a hurry, cant cook, off to work to survive and need the quick shot of food.

You can eat a piece of fruit in the time it takes to eat a chocolate bar. You can cook some pasta and vegetables in the time you usually waste waiting in the drive-thru queue at McDonald's or wherever.


Others have nothing to do, watch the tube and eat


So the rest of us have to pay higher taxes to provide facilities for those who don't work and pay a penny of tax to gorge themselves?

If people choose to overeat junk food, that's their choice, but they need to understand that being grossly obese will mean that they can't take part in certain activities, whether it's a funfair ride, a cinema seat...or being transported rapidly to hospital in a helicopter which is more than adequate for normal-sized people.

Trying to punish the EMS crew for their safe and sensible decision is disgusting.

[unstable load]

Hear, Hear!!:D :D :D

[Blue Rotor Ronin]

The Devil speaks the dogs dangleys:D :ok:

[Revolutionary]

TorqueOfTheDevil, I detect a hint of resentment towards fat people in your post, which can be summarized as: "if you're such a self-control lacking slob that you can barely fit your fat arse inside your crummy, poorly maintained car anymore, then veer off the road because the view outside the windshield is blocked by all the candy wrappers lying on your dash, you deserve to be left by the roadside." Or to paraphrase Marie Antoinette: "Let them eat fruit."

I know it hurts to be a healthy, trim person and to feel that your tax dollars are helping to underwrite other peoples' unchecked gluttony and laziness. Personally I hate it when my tax dollars are used to repair some highway in Nebraska that I'll never use, but oh well. When it comes to health care, you might as well get used to the idea that you, a healthy, carrot-munching tri-athlete, are contributing more to the system than you might ever take out, and that others lean on the system more than they ever put in.

Emergency rooms of hospitals are filled with fat, lazy, stoned, alcoholic and/or stupid people who got themselves shot or stabbed, who overdosed, got drunk and fell down, didn't wear their seatbelts and got ejected or otherwise contributed to their own sorry state. You hardly ever see any carrot-munching tri-athletes in there. But even a person who is wholly responsible for his own injury, such as a 'triple six' or attempted suicide, is still deserving of medical care wouldn't you agree?

Of course people should be more like you and me and crack open a nice bag of lettuce to munch on instead of a packet of crisps. But there's what you and I think people should do and then there's reality. Maybe we're all on a Darwinian path to becoming 300 pound behemoths who will someday sprout two assholes just to get rid of all the garbage we eat. Who knows? The operating word here is 'reality' not 'should'. So yes, if the reality is that the average customer is getting bigger then we as an industry need to consider providing a bigger vehicle.

And don't think 'financial implications'. Think 'economic opportunities' and a chance to get a bigger helicopter.:ok:

[Devil 49]

Revolutionary, you've hit it exactly:
"Think 'economic opportunities' and a chance to get a bigger helicopter."

There's a subscription based business model currently doing very well in the US, so you don't have to re-invent that wheel. All the EMS pilots I know would love to fly bigger, more capable IFR equipment, another hurdle you will have leaped.
Revolutionize the industry!

[Revolutionary]

Devil 49, that's the spirit! A little positive thinking... Although I'm not sure that the 'subscription' model is worth emulating. They can only make it work by flying hand-me-down ex-GOM LongRangers! Seriously, Travis County is a good example of a HEMS service supported by public funds that is working very well (and using nice aircraft I might add). Other countries often bid out exclusive service areas to private contractors, enabling them to field better equipemnt. Don't just accept that you're in an Astar because that's the only way to make it work. Try to be more 'Like Che', as they tell little kids in Cuba, and join the revolution, my friend!

[Blue Rotor Ronin]

Hang on a minute here, I'm a bit of a chubster. And being built like a brick sh!@thouse can honestly say its a constant struggle. However when she or any other human is confronted by scales which read 300lbs there must be a glimmer of dense reality that causes said person to think " 300lbs! Really; bugger! That's a lot for a homo sapien, maybe I should do something other than stuff my face with junk food and go for a walk after my salad."
Accountability was something i was lucky enough to learn from a mother that told me to 'face the consequences of your actions' something that a few of her compatriots could maybe try getting there heads around instead of attempting to sue every poor sod they can whilst ignoring that long silenced whisper of common sense that resides within a good proportion of any society.:E

[B Sousa]

"is still deserving of medical care wouldn't you agree?"
Now theres a point to ponder. When the average or above Average Joe has as his topic of conversation how much he has to fork out of his own pocket for his own health care, he may start to get a bit greedy for those who contribute nada out of their own carefree lifestyle.
Prices go up and income does not means that at some point Average Joe is going to say Whoa, you want health care fine, but Im not going to pay for it.
Its coming to that point.
My Guarantees by the contract I lived by gave me free medical upon retirement on one job and partially pay health care on the other. The partial pay Governemnt job has now said......well no we are not going to give you anything. (27 years on that lie) and the free stuff ( not free any longer) may soon go up from a minimum to 300% next year. My retirement may go up 2% go figure what kind of a fix I am in. And that was with GOOD planning for retirement.
So I have little sympathy for those who think that the Governemnt tit is a deep well. I am that deep well, and I say get her fat a55 a tow truck and be lucky if she has Auto Insurance.
Best way for Health care here in the states is to be illegal, on welfare or stinking rich.

[Pandalet]

Somewhat relevent happenings down under:

http://news.bbc.co.uk/1/hi/world/asia-pacific/6494117.stm

[topendtorque]

Best way for Health care here in the states is to be illegal, on welfare or stinking rich.

Hmmm, and yes the email joke traffic down here is often clogged with jokes about health care freeeloaders, of the immigrant variety?

But that is not why I posted.

I only just hit this thread and it has taken an interesting twist, one of intense interest for those who are a tad overweight, and or especially of high cholestral count.

It's topical in this household at the moment, and for those of who who do NOT wish to LOSE their flight status because of Statin drug use, OR WORSE, may I refer you to a book currently before me.

'Lipitor the thief of memory'
by Duane Graveline, M.D.

The author is an ex, astronaut, aerospace medical researcher, research scientist, flight surgeon and family doctor. And I suggest, also loaded with an uncommon amount of common sense.

A Very scary read.

I'll add one anicdote, for the last fifty years since heart attacks, obesity and diabetes became known, the low fat diet and lately statins have been used to combat these ills.

To the general effect that all three ailments are now in epidemic proportion. Statin production is a multi billion juggernaut!

good post Pandalet.