Air Ambulance Crashes Hit Record: Why?

[Heliport]

From the Washington Post (and other newspapers worldwide) Air Ambulance Crashes Hit Record
Associated Press

Pilot errors, industry carelessness and poor government oversight have combined to drive the number of air ambulance crashes to record levels, USA Today reported.

Sixty people have died in 84 crashes since 2000 _ more than double the number of crashes during the previous five years, the newspaper said in Monday editions.

Its study found that more than 10 percent of the U.S. air ambulance helicopter fleet crashed during that time, a proportion that would have translated to 90 jetliner crashes if applied to commercial airlines.

About two-thirds of the fatal crashes occurred in poor visibility.

After reviewing hundreds of pages of documents and interviewing dozens of pilots, aviation experts, federal officials and executives with the companies that operate the flights, USA Today concluded that air ambulance companies and the Federal Aviation Administration have failed to imposed safety requirements that might have saved lives.

It also cited a 2002 study in The Journal of Trauma that found helicopters were used "excessively" for patients who weren't severely injured.

But the newspaper also noted that industry leaders cite other studies to show that thousands of lives are saved each year by speedy flights to hospitals. It pointed out, as well, that pilots operate in challenging situations, such as having to land on hospital roofs and being summoned on live-and-death missions to rural accident scenes despite darkness or bad weather.

"I don't know anybody in this industry who isn't dedicated to safety and dedicated to what we do," Ron Fergie, president of the National EMS Pilots Association, told USA Today.

"Most of the accidents will say 'pilot error.' It's not so simple, really," said Eileen Frazer, executive director of the Commission on Accreditation of Medical Transport Systems, which conducts safety audits of air ambulance firms. "There are all sorts of extenuating circumstances."

"We take this very seriously," Jim Ballough, who oversees the FAA's safety efforts, was quoted as saying. "The public will see change."

[alouette]

It's always easy to point fingers and state an accident is the result due to pilots error. Remembering the classes I took in college - Safety in Commercial Aviation and Human Factors - there are always a number of factors leading to accidents. But the numbers since 2000 are quite shocking if I may say so:uhoh:

[Decks]

Other point to bear in mind is that there now something like 700 EMS helos in the US. A massive number compared to other countries.

[HOGE]

How many of those accidents were down to commercial pressure?

[[email protected]]

SASless has been highlighting this trend for quite a while on this forum and it seems to confirm that using non IFR rated crews and ill equipped aircraft for these duties is a false economy. Having a sick or injured person in the back is the worst sort of commercial pressure - how can you say no even if it is the right decision?

[Geoffersincornwall]

Methinks a Zotov Error Map would be very revealing. This Flight Safety 'tool' tracks back every related decision by everyone whose slightest touch has influenced the events that lead to an accident.

Although not quite up to date Davis Beaty's "The Naked Pilot" also shines a wicked spotlight on those tempted to utter those not-so-magic-words "PILOT ERROR".

Some dispassionate analysis of the root causes of so many accidents in the US EMS world might reveal the truth but I don't think we would be far wrong to conclude that the old adage "If you want cheap then you'll get cheap - and evertything that goes with it seems to apply here.

Safety costs, quality costs and nothing, believe me nothing puts that reality into sharper focus than when you suffer a fatal accident in your own organisation. Suddenly people come up with the cash that should have been there in the first place. Suddenly everyone, including the bean-counters want to help.

Why oh why do we have to wait - can't these people read! Or are they founder members of the "It'll never happen to us" club!!

[SASless]

The causes are well known....

Night flying in unlit areas without NVG's....

Night flying without adequate surface light reference to control the aircraft.

Lack of weather reporting along the route.

Taking off at minimum weather conditions for VFR flight....to encounter deterioating weather conditions.

Striking unlit obstacles at night during scene operations.

CFIT in IMC flight.

Equipment/mechanical failures.

Chopper Shopping by Emergency Dispatch Centers.

I would suggest "commerical pressue" is less an issue than "personal....self inflicted pressure" being a culprit.

One recent case involving Omniflight Helicopters in a fatal crash in South Dakota.....involving a Japanese Pilot seems the most interesting one to study. That is being done in civil court as we speak I think.

EMS pay is embarassing.....the use of " no-notice-hurry up and get airborne SPIFR flights " are like rolling dice in my view....as are hurry up and launch night flights either VFR or IFR when marginal weather exists.

FAA Part 135 has a requirement for adequate surface lighting to control the aircraft for night VFR flight....but in the industry....ignoring that is commonplace. As a result....there are lots of IIMC occurrences....some of which result in crashes and fatalities.

One man's opinions here......

[bondu]

SASLess wrote...

One man's opinions here...

Yes, but accurate ones! Well said once again!

bondu :(

[Shawn Coyle]

I'd like to add at least one issue to the 'reasons why'.
Not enough enroute weather reporting - weather reporting is for fixed wing, it seems. Many facilities don't report weather after normal working hours, the facilities are widely spread out and don't consider the problem areas like mountain passes.
Some major cities have no ATC after midnight. And a lot of the time you're operating at such low altitudes that you can't talk to anybody.
Also, no good helicopter appropriate instrument procedures to get us into hospitals and the like.
And not enough performance! At least one recent helicopter crash appears to be caused by operating way outside the capabilties of the machine, and I know we have to keep reduced fuel loads because of the hot and high performance (or lack thereof).
There, I've got that off my chest.

[SASless]

Gets a bit dark and lonesome out there does it Shawn?

Just like a lot of other places the boys and girls fly EMS...Nebraska, South Dakota, West Texas, New Mexico, Oregon, Washington, Montana, Idaho....ah the list does go on.

[Oogle]

Maybe our US cousins can enlighten me??!!

Do your EMS crews get a bollicking if a job is turned down? The administrators would obviously say "no, never" - but what is it really like?

In Australia at least, there is NO pressure put to bear on any pilot who rejects a job (not in the organisations I have flown with anyway). That is not to say that Australia is immune from any accidents by any means.

It is sad to think that the almighty dollar drives the US EMS orgainsations. We all tell the younger/less experienced pilots to err on the side of safety and if in doubt - don't go. Are we more experienced pilots somehow immune from the harsh realities of weather, CFIT, wires, etc? Certainly not! Some may think they are more bullet-proof than others.

EMS helicopters are not unlike the charter guys who may be under pressure to accept a flight - whatever that flight may be.

Point in case - the recent unfortunate accident that happened in the Victorian high country recently killing a well known identity, his wife and the pilot.

[NickLappos]

The causes are so simple, they can't be seen by those of us within the system. Its as if we can't undestand why those who scoop up broken glass get cuts (Scooper Error) or those who toss eggs get them broken (tosser error).

"About two-thirds of the fatal crashes occurred in poor visibility." Says it all.

We have the most versitile craft, able to stop in space, move laterally, vertically at the command of its pilot, but we give that pilot nothing to guide him when he is on his mission. In reduced visibility, we tell him to turn back, abandon his mission, and that is the cure.

Visionics, navigation and maping technologies are all now proven that can (and have) solved this. We can give the pilot the tools to complete the task. We can give the glass scooper a shovel, the egg tosser a soft glove, but we give the pilot lectures on how to say no, and blame him when he doesn't.

Sad world, sadder because the visionics in a Caddilac, and the nav system in a FedEx truck are more sophisticated than that we allow an EMS pilot to use.

The FAA could cure this but hasn't figured how. Even though the technologies have been there for about a decade, the FAA will not even let the rules be written to use them.

[SASless]

Nick.....Nick....Whoa!

Criticism of the FAA....hold on Nick ol' bean....you are mooching on my turf.....back Fella...Back!:E

[Devil 49]

Nick-
Amen, brother.

[SASless]

When I owned a large over the road truck I had much better navigation capability than I have ever had in a helicopter.

I managed to find a location in Wisconsin during a blizzard when all of the street signs were blanked out due to snow sticking on them. In the middle of the night I found the location and pulled into the driveway only to get lost in the parking lot due to the lack of visibility. The beauty of a GPS linked moving map display on a laptop computer in action. Communication and monitoring of the truck was done by satellite. On some trucks the office not only can tell exactly where you are...but how fast the truck is moving...what gear it is in....the fuel quantity, oil pressure, Engine RPM...all sorts of historical data....hours in operation, hours driven that day....percentage of idle time.

Combine that with e-mail type messaging and again...much better than any helicopter I have ever flown.

The technology is out there....why does the FAA have such problems in approving it? Deal with the FAA and find out....too many of the FAA guys are afraid to make a decision....make come back and haunt them some day..thus no decision made.

[ShyTorque]

Some of the "tossers" in my part of the world need more than a soft glove.........especially the complete tossers...

(Nick, the word means something slightly different on this side of the Atlantic). :p

[SASless]

I fear there are more than a few of us Rotorheads that could qualify under the "Toss Pot" concept.....not speaking of me self mind you.;)

Certainly not Nick....as I have heard from reliable sources he is a complete TeeTotaller.:E

[Screwed™]

"About two-thirds of the fatal crashes occurred in poor visibility." Says it all.
A case in point. I was watching Air Crash Investigation last night. About a 707 running out of fuel in New York on ILS finals. In the hold for too long as very poor WX, blizzard ect, all the jets missing out on the ILS and getting re-stacked. (Actual news footage now) At the crash scene shortly after the accident, at night, in a blizzard where jets are missing out on an ILS approach due vis, are Jet Rangers flying around. WTF????
THAT mentality is why you guys have so many EMS acccidents.

[High Nr]

Whoa: Its not just that simple.

I suspect the ILS to be around 5-8 nms long and assume this 707 was established, then that could put the accident within a few miles of the airport.

VFR Helicopters can operate with reduced [not Nil, as in black] visibilty, and here in Oz that is called Helicopter VMC.

"Daylight Hours" Only
Below 700 ft AMSL
800 mts Vis.

However at night, when most of the accidents happen, this does not apply and therefore if not IFR then 5000 mts vis applies, plus clear of cloud, in sight of ground/water etc.

Its the night VFR helicopters pushing into the dark black nights that have killed a bunch of people here in Oz over the last 5 years or so. However these news guys, would be within a few miles of an airport, and may [I did not see what you saw] have had surface lights and underneath the ILS minima and may be legally visual.

But I agree, its a rather dumb idea to plod around in such circumstances, even if it made the news coverage look good.

Over to someone that knows the FAA rules.