Yes, lateral CofG, further exacerbated by the need to stand on the skid. The CofG was not just outside the envelope, it was across the room, through the door and down the hall. The OEM said that as long as the aircraft was in CofG prior to winching, then going outside whilst winching was ok...however...
There was a belief from some in the process that an allowance could be made for winching because they thought we flew for 20 mins to get to a casualty, winched out/in, then flew to a hospital ie. like an Alpine SAR unit. I was at a mtg when it was explained that a 1hr rearcrew sortie could easily involve 40 minutes of winching...cue a stunned silence followed by a lot of quiet.