NY Times article on the NTSB report
Here is the NY Times article on the NTSB report:
January 26, 2006
Report Faults Rules and Judgment in Crashes of Air Ambulances
By MATTHEW L. WALD
WASHINGTON, Jan. 25 — Air ambulance crashes killed 54 people, most of them pilots, paramedics and nurses, in a three-year period ending in early 2005, according to a special study by the National Transportation Safety Board.
The report, which was approved by the board on Wednesday, concluded that pilots were not good at analyzing risks and that the rules are too lax for flights that are not carrying a patient or a donated organ.
Helicopters and planes used as ambulances fly under airline-type rules when carrying a patient or organs. But if they are on their way to a pickup, they fly under rules that apply to private planes, which do not limit how many hours a pilot can work and allow flights in worse weather. Three-quarters of the accidents occurred under those rules.
"It seems like a ridiculous paper loophole that needs to be closed," said one member of the board, Debbie Hersman. "You've got one, two or three medical personnel on board, and they have organs in their bodies. They're just as important cargo as an organ for transplant."
Investigators also supported a formal program of "flight risk evaluation," in which the pilot and possibly a second expert would dispassionately score each mission, based on weather conditions, time of day and other factors. Of the 55 accidents, 13 might not have occurred if such evaluations had been done, they said.
While the number of crashes is up, including nine more crashes killing eight people since the end of the study, the rate of accidents is uncertain because of difficulties in determining the number of flights. According to the Federal Aviation Administration, there are about 650 emergency medical service helicopters; an industry group estimates there are more than 750.
According to investigators, there were no accidents among "public use" aircraft, including those flown by police and fire departments. Government agencies tend to have dispatchers trained to obtain weather data and discuss conditions with the pilot, investigators said, adding that professional dispatching might have eliminated 11 of the 55 crashes.
For example, a helicopter sent for a passenger in Newberry, S.C., in July 2004 ran into trees and crashed shortly after picking up the patient. The pilot, who was dispatched by a 911 operator, did not know that before he accepted the job that three other helicopter companies had turned it down because of weather conditions. Everyone on board died.
Kitty Higgins, named to the safety board this month, referred to the problem as "helicopter shopping."
The safety board investigators said accidents could also be reduced by use of night-vision equipment and terrain warning systems.
A spokeswoman for the Federal Aviation Administration, Alison Duquette, said that the technology was not well suited to helicopters because they sounded false alarms frequently at low altitudes, which is where helicopters often fly.
A spokesman for the industry, Thomas P. Judge, a paramedic in Maine and the previous president of the Association of Air Medical Services, said that risk management programs would be helpful, but that applying airline rules to all flights would not. For example, Mr. Judge said, the airline rules require that before departure, the pilot receive a weather report on the destination from a source approved by the F.A.A. But the destination might turn out to be an isolated area for which no weather report was available.