HEMS Accident in Maryland. 4 Killed

[Furia]

Sad news about another HEMS accident.

4 dead in medical helicopter crash - CNN.com (http://edition.cnn.com/2008/US/09/28/medivac.crash/index.html)

Seems it was a night flight and that weather conditions were not very good although drawing conclusions from that little information avalaible is premature.

Rest in peace

[4HolerPoler]

Another sad day for EMS -

A medevac helicopter taking accident victims to a trauma centre crashed early on Sunday in the United States, killing four of the five people aboard, authorities said. The accident killed two police officers on board, one of them the pilot. Also killed were a medic and one of the accident victims, said Mark Brady, a fire department spokesperson. A second accident victim survived the crash, which happened near Andrews Air Force Base in Maryland. Officials lost radio contact with the craft, known as Trooper 2, around 12:30 as it headed to the base, according to a Maryland State Police statement. The crew had radioed in that it needed to land due to weather conditions. After an intensive search, officials found the downed helicopter on a park trail.

I spent a week with them a few years back - extremely professional outfit with top equipment.

Condolences to family & colleagues.

[206Fan]

Ah flipn ekk.. :( RIP

Condolences to family & colleagues.

Any idea on what type of ship it was?

[otter712]

AS 365......... sorry for their loss.

Fly safe!

Maryland EMS Flyer.

[Furia]

Rest in peace!!

Too many fellow EMS/Rescue pilots are leaving us this year.

:uhoh:

[zalt]

Already posted earlier today with info on recent local safety standown:
http://www.pprune.org/rotorheads/306380-gom-air-log-crash-ael-ems-crash-4.html

Crew now named:
Medical Helicopter Crashes In Md. Park, Killing 4 - News Story - WRC | Washington (http://www.nbc4.com/news/17575275/detail.html?dl=mainclick)
UPDATED: 9:47 am EDT September 28, 2008

FORESTVILLE, Md. -- A medical helicopter carrying victims of a traffic accident crashed in a suburban Washington park early Sunday after reporting bad weather, killing four of the five people aboard, authorities said.

Stephen H. Bunker, the helicopter pilot; Micky Lippy, the co-pilot and a flight paramedic; Tonya Mallard, an emergency responder; and Ashley Youngler, one of the traffic accident victims, died in the crash, authorities said.

Jordon Wells, who injured in the traffic accident, survived, and was rushed to a hospital by ambulance. Wells, 18, was critically injured.

It was foggy and rainy in the area about the time of the crash, said National Weather Service meteorologist Jim Decarfel.

Maryland State Police fly the medical helicopters in the state, and it was their first deadly crash since 1986 when a helicopter went down in fog in West Baltimore.

Just before midnight Saturday, the helicopter reported bad weather on the way to a Prince George's county hospital and the crew said it needed to land at Andrews Air Force Base, where it was to meet ambulances to take the accident victims the rest of the way to the hospital, authorities said.

The helicopter then disappeared from radar and officials lost radio contact. Public safety officials found the wreckage about two hours later on a trail in a wooded area of Walker Mill Regional Park.

The National Transportation Safety Board and the Federal Aviation Administration were investigating.

Bunker, 59, of Waldorf, Md., joined the Maryland State Police in 1972 and later rejoined as a civilian pilot after retiring as a corporal.

Mallard, 38, also of Waldorf, is survived by her husband and two children.

Maryland State Police Aviation Command flies 12 twin-engine helicopters out of eight bases across the state. The last fatal crash in 1986 killed two troopers who had just transported a shooting victim. The command had two other fatal helicopter crashes in the 1970s.

A recent state legislative audit faulted the police agency for failing to document maintenance needs and costs and failing to comply with federal and manufacturer repair orders. Nine of the choppers are more than 18 years old.

But state police have defended the command, and the audit noted that the operation is highly regarded throughout the nation and has an "impeccable" safety record.

Only one pilot - is this usual? At night do MSP operate SP IFR or night VFR?
Did the ELT activate? Another press report talks of triangulating on the crews cell phones to find the wreckage.

[flyingfinn]

they operate SPIFR. Rumor is that they got vectored for the app. and missed, requested a second try. radar track shows accident site about 3 miles from departure end of runway.
Very sad.

[zalt]

Just Google Earthed the area.
AFW is at: 38°48′13″N, 76°52′17″W
The Walker Mill Regional Park is a pretty small wooded area surrounded by built-up area. Does it really take 2 hours to find an aircraft in the circuit of a major USAF base?

[darrenphughes]

RIP, this is very sad. Not wanting to seem insensitive here but....

A recent state legislative audit faulted the police agency for failing to document maintenance needs and costs and failing to comply with federal and manufacturer repair orders.

Whether it is or is not the cause of this accident(probably isn't). I believe "public use" aren't required to adhere to federal or manufacturer repair orders, but this is yet another argument for the Feds to actually step in and regulate these aircraft. Although this point is kinda pointless as I've been told in the past that federal regulation of "public use" aircraft would be unconstitutional. And as the constitution outranks logic here, the point is moot.

[airdoggy]

RIP, this is very sad. Not wanting to seem insensitive here but....

Quote:
A recent state legislative audit faulted the police agency for failing to document maintenance needs and costs and failing to comply with federal and manufacturer repair orders.
Whether it is or is not the cause of this accident(probably isn't). I believe "public use" aren't required to adhere to federal or manufacturer repair orders, but this is yet another argument for the Feds to actually step in and regulate these aircraft. Although this point is kinda pointless as I've been told in the past that federal regulation of "public use" aircraft would be unconstitutional. And as the constitution outranks logic here, the point is moot.

You are way off base. Maryland State Police, although they are a state run agency and provide services to the public, do not operate under "public use" rules. If they did so, they would not be able to transport patients as they do. Check out their website (type in Maryland State Police aviation into your search engine) and you'll see it appears they have a very good maintenance program. Yes, an audit uncovered some discrepancies, but I think any large aviation organization would suffer some discrepancies if a stringent audit was imposed. Case in point, would be the airline discrepancies that occurred last year where several were grounded.

I understand you were not trying to be insensitive, but I believe you failed in that regard.

[darrenphughes]

I stand corrected then. I assumed that they were public use as they were LE and made the statement after reading zalt's post. I guess I should have researched it a little more instead of diving in feet first.

Again, sorry if it came across as insensitive.

[airdoggy]

I stand corrected then. I assumed that they were public use as they were LE and made the statement after reading zalt's post. I guess I should have researched it a little more instead of diving in feet first.

Again, sorry if it came across as insensitive.

No apology needed. I know you were just trying to share information, which is what the forums are for, but sometimes facts get lost in translation. Cheers to ya!:)

[Shawn Coyle]

I don't know of any rules that prohibit the MS police from transporting injured folks in their helicopters and retaining 'public use'. California Highway Patrol does it, and they're public use.
They may have some features of other parts of the FARs, but they would most probably be public use.

[airdoggy]

I don't know of any rules that prohibit the MS police from transporting injured folks in their helicopters and retaining 'public use'. California Highway Patrol does it, and they're public use.
They may have some features of other parts of the FARs, but they would most probably be public use.

The California Highway Patrol does not operate its Medevac helicopters under "public use" rules. Of the CHP's 15 helicopters, only 1 is used under "public use". It is a military surplus OH-58 that does not do medical transports and is solely a law enforcement platform in a metropolitan area (L.A.). That being said, it is still maintained and flown to FAR Part 91 standards, with some limiting factors such as not being able to transport civilians, etc. The other 14 helicopters, of which 11 do Medevacs(all AS350 B3's), are operated under FAR Part 91. In some instances, due to internal policy and the interest of safety, the CHP guidelines are more restrictive than FAR Part 91.

Thanks for sharing and I liked your book(s).:)

[cptjim]

Very sad news, my condolences :sad:

Some more info...
Medevac crash kills 4 -- baltimoresun.com (http://www.baltimoresun.com/news/local/bal-te.medevac29sep29,0,677275.story)

R.I.P.

[havoc]

This link has an NTSB video briefing, some insight:

Authorities Identify Maryland Helicopter Crash Victims|ABC 7 News (http://www.wjla.com/news/stories/0908/557131.html)

[maxvne]

RIP Guys and Gals, as somebody already said an all too common occurance in this sector.
Max.

[zalt]

I see Trooper 2 "based at Andrews Air Force Base" is "the busiest Medevac helicopter in America".

Maryland State Police Aviation Command (http://www.mspaviation.org/section_query.asp?choice=2)

This page give a good idea of the relative status of pilots in the MSP too.

[Brian Abraham]

an all too common occurance in this sector
Amen, some eight accidents and the loss of thirty lives in the last twelve months.

[imabell]

same modus operandi, same result:ugh::ugh::ugh::mad::sad:

[ChopperFAN]

Devistating news... My condolences to all the familys :uhoh:

It apears from one of the photos on the Baltimore sun website, that the main gear is down? Was the pilot in the process of putting it down when it crashed?

The team im sure will be remembered for helping others even when conditions they face put themselves at risk

Simon

[havoc]

somewhat long post in the link but an ATC insight to transponder codes and equipment capibilities at Andrews AFB.


http://currentandundertow.*************/

[havoc]

Unfortunate this is coming to light if true:

Whistleblower warned of problems before medevac crash (http://www.wtop.com/?nid=708&sid=1488142)

[Phil77]

WTOPnews.com article:
[...]Holt said he was familiar with the doomed helicopter. He said it had been so badly damaged after a collision with a building in 2000 while being taxied by another pilot that it had to be lifted off a landing pad with a crane.[...]


...I have not read the letter of Mr. Holt, nor do I know anything about maintenance procedures at the state police air support unit, but one thing that makes the whole thing smell kinda fishy:
Was there anything to report? (FAA § 830.2 Definitions: "Aircraft accident" means an occurrence associated [...] with the intention of flight [...]).
Aircraft have also been repaired or refurbished to great extends, fully complied with the manufacturers overhaul manuals, even after an accident - but hey! maybe there is something wrong in the books, I guess we'll find out!


"doomed helicopter" :yuk:

[Devil 49]

"Imabell", I don't know what the heck you're talking about. Care to expand on your comment "Same modus operandi, same result"?

Aside from being at night, and in the U.S., I see very little in common with most US EMS accidents:
This was an SPIFR program, most US EMS is VFR;
This was a twin, most US EMS is in singles;
This was a government program, most US EMS is 'for profit';
This pilot appears to have responded appropriately to a night IIMC encounter, and transitioned to IFR;
Had I the same decision to make, I might have accepted the run was in the accident pilot's situation. I don't see an obvious error right up until the call for a second approach- which is arguable.
I see a great deal wrong with the way my industry is run, but this one doesn't fit most of my issues. Please share what is so obvious to you. I'm really interested in your insight-I'm going on shift in 4+45 hours, flying an EMS night shift.

[Shawn Coyle]

As there is no FDR or CVR in this helicopter (unless the MD State Police were very forward thinking), we'll have a great deal of difficulty finding out what happened in this accident.
But I would ask how many fixed wing aircraft crash on a missed approach? What differences are there between fixed wing operations and helicopters in this regard? What does the go-around mode look like in this helicopter?

[rotorspeed]

Yet again what is so important in this crash is trying to understand what, specifically, might have caused it - and how it might have been avoided. Generalisations are not really very helpful. This does not seem to be the typical low level, night, very poor VMC going IMC, stumbling into the ground accident. It's hard to be sure, but from the little info that can be picked up it seems the 365 had correctly diverted due to poor weather, was trying to make a precision approach, had gone around because of lack of a reliable glideslope indication, and then crashed about 3 miles from the field while presumably making a second approach. When radar contact was lost at about 3 mile finals it was at 700ft - prob a bit low but given range tolerance not too far off for the distance to the field, assuming on either ILS or a standard approach.

Weather seems to have been 4 miles vis and 500ft base - not particularly bad for an airfield IMC approach, let's face it.

So what might have happened? Seems the G/S was known to be unreliable, so one presumes you'd back up a range to the field from GPS and DME with altitude checks and radalt height. Even with no ILS you could let down pretty easily with the A/P coupled to HDG and V/S, assuming that was all working. And this acft hit a long way out - not like it was at DA.

So what really might have caused it? Run out of fuel? No mention of pilot concern. Gyro/instrument failure causing loss of orientation? Major mechnical failure? Or perhaps pilot got vaguely visual so broke off an instrument approach to circle down with some ground lighting but then got into IMC with LOC again. 60kts was rather slow at 3 miles. Pilot incapacitation?

Ideas anyone?

[Phil77]

Ideas anyone?

Thunderstorm?

[anti-talk]

Min Airspeed for Autopilot in IFR - loss of aircraft control????
In the A109 60kt (55 kts on approach, Min IFR speed 50kts) is very close to the point where George falls over, anyone know what it is in the Dauphin??

[SASless]

Please read the article...and correctly identify the complainants. Pete Peterson is the fellow that has written to the FAA about general problems and mis-management while the other fellow is concerned about the aircraft having been involved in a blade strike incident/accident.

There have been rumblings for a while about the MSP operation and in the past they did in fact have some problems. A fatal accident that went un-noticed for quite a while and the reaction to that kick started them onto a much better path.

Overall they seem to be fairly well regarded for a Police/EMS operation despite the dual mission they perform. The old argument about j"acks of all trades" and such have to be considered applicable.

[havoc]

2007 pilot training memo story,

Video (http://www.wbaltv.com/video/17614428/index.html)

If I recall our base received a similar memo last month from company and we started questioning but it fell on deaf ears.

[Overdrive]

Almost incredible that beneficial if not vital training/practising already in place within the ops system and budget should be removed like that.

Almost a year on from that video, what's the more "structured & consistent" training that's replaced it? Are the instrument flight & landing sessions back?

Or is there more to it... further improved training available now?

[Eboy]

News story on NTSB preliminary report:

Pilot Concerned About Weather Before Chopper Crashed, Tapes Reveal|ABC 7 News (http://www.wjla.com/news/stories/1008/565890.html)

[WhirlwindIII]

Very sad news.

I'm not clear as to whether this helicopter crashed on missed-approach, or on a second approach attempt.

Assuming the crash was during an approach attempt I can say that I have seen times when being vectored to ILS with an on-field VOR pilots dialing in the intended ILS freq. but leave that primary ILS box with the on-field VOR active thus no chance of receiving the glideslope.

This provides the ability to lock on to what can proximately be considered the inbound course. It could explain the lack of receiving the glideslope. It sounds brain-dead not to put the ILS freq. active, but it does happen.

I've also seen pilots revert to flying the non-precision minimums of a localizer (with or without that particular approach clearance) when not receiving the glideslope and thereafter do a sloppy job of altitude management. Human factors? Not enough time to shift gears from one approach monitoring mentality to the other? Too many distractions like talking to dispatch, the medical crew, etc.?

All speculation with respect to this accident but human factors generally play a large role in accidents and I think this could be one of them.

[Eboy]

An air traffic controller was removed from his regular duties after giving the pilot of a state medevac helicopter a weather report based on hours-old information shortly before the helicopter crashed in Prince George's County, according to records made public yesterday by the National Transportation Safety Board.

The pilot decided to land at Andrews Air Force Base after the controller reported clouds starting there at 1,800 feet, according to the records. In fact, conditions were far worse. Fifteen minutes later, at 12:06 a.m., a different controller, based at Andrews, noted that thick, dense clouds started at 500 feet.

washingtonpost.com (http://www.washingtonpost.com/wp-dyn/content/article/2009/01/15/AR2009011504142.html?hpid=moreheadlines)

[SASless]

Just before midnight, the base's fire chief asked Hyman where the helicopter was. She told him it was "somewhere out on final" descent and said she couldn't see anything because of the fog.

A properly trained and certified FAA Air Traffic Controller since 1985 this person was...."Ah...he is out there on final somewhere..."

Five hour old weather given.

Tower Cab window fogged up all day and not able to see out...

It took the Fire Chief to kick off the missing aircraft procedure?

Relieved from duty.....now that is a punishment that fits the crime if I ever heard of one!:mad::mad::mad:

Here I was thinking of some nice wooden crosses up on a hill somewhere...a bucket of iron spikes....a three pound hammer....and a nice view of an airport..:ugh:

[cptjim]

Air controllers 'sloppy' in medevac crash -- baltimoresun.com (http://www.baltimoresun.com/news/nation/bal-te.medevac16jan16,0,3390725.story)

[zalt]

From the Baltimore Sun on an issue not touched upon by NTSB:

How much Bunker knew about the conditions before the flight was a subject of the NTSB's investigation. Because of a faulty switch at a data relay center in Nebraska, precise weather data collected by the Air Force at Andrews was not transmitted to the National Weather Service from 6:55 p.m. the night of the crash until 10:55 a.m. the next day. Whether the glitch made any difference in Bunker's understanding of the weather conditions is unclear from the documents released yesterday.

[SASless]

As I sat here listening to the taped conversations between Dispatch and the other parties....a movie scene like image formed in my mind.

It was quite vivid....darkness, wooded area, odor of raw jet fuel, smell of hot hydraulic fluid, small scattered flickering smoldering fires, the sound of light rain drops falling, either tinkling on sheet metal or hissing from landing in the fires or on hot metal, the crackling of cooling engine exhausts.....and a cell phone ringing....and ringing....and ringing. Soft moans and someone crying out for help fearing no one is hearing them.

In the background you can hear the chatter on the phones and radio going....of a an attempt to determine where "Trooper 2" is? Each negative response adding to the worry....and in time....to the fear....finally to the acceptance that the worst of the fear and worry is realized....."Trooper 2" is down.

The sound track changes to a last conversation....as the scene fades to darkness...."If they can do it....so can we!" followed by laughter.

[SASless]

Several changes being made following the fatal crash that killed four.

Md.-Run Medevac Practices At Issue (http://www.washingtonpost.com/wp-dyn/content/article/2009/03/07/AR2009030701842_pf.html)

[WhirlwindIII]

Read it. Interesting bit of political spin.

Heard there is a bill pending in Md legislature to end their State Police Medevac program by October 1st.

For all the chest pounding Md State Police exhort that program is no better than anyone else, a second pilot is not going to get a helicopter any place a single pilot cannot, and having only one medic, as they vociferously tout, is an exercise in swoop-and-scoop - seems private industry went the way of two medical providers aboard each HEMS helicopter a long time ago - why not MD? Two providers tends to bring a higher level of care to the patient - two minds, two opinions, two medical professionals working things for the better of the patient, etc.

I'm told they have it in process to requip with AB139s. As outfitted each would cost @21 mil US $ x 10! Give me a break; or, rather, give the taxpayers of MD one! At that cost the entire program could be set up with more suitable medevac helicopters, two pilots, and two medical providers aboard each, at @35% of the cost - do the math! Ridiculous state flying club, and they know it! Love to see CAMTS go in to see what level they really happen to operate on at the present!

Wonder what all the state residents with such programs would say when they saw the breakdown of patients flown from out-of-state who need such transport while transiting or visiting such as MD, or DE, or NJ, or wherever. Tax dollars at work, for everyone!

Needless to say I am not an advocate of government doing things private providers can do.

[Sebastian-PGP]

A little more info on this unfortunate incident (http://www.baltimoresun.com/news/maryland/bal-medevac1027,0,5318728.story).

[Phil77]

Here is the probable cause published by the NTSB
(NTSB Abstract MAR-09/05 (http://www.ntsb.gov/Publictn/2009/AAR0907.htm))

PROBABLE CAUSE

The National Transportation Safety Board determines that the probable cause of this accident was the pilot's attempt to regain visual conditions by performing a rapid descent and his failure to arrest the descent at the minimum descent altitude during a nonprecision approach. Contributing to the accident were (1) the pilot’s limited recent instrument flight experience, (2) the lack of adherence to effective risk management procedures by the Maryland State Police, (3) the pilot’s inadequate assessment of the weather, which led to his decision to accept the flight, (4) the failure of the Potomac Consolidated Terminal Radar Approach Control (PCT) controller to provide the current Andrews Air Force Base weather observation to the pilot, and (5) the increased workload on the pilot due to inadequate Federal Aviation Administration air traffic control handling by Ronald Reagan Washington National Airport Tower and PCT controllers.


Sadly so many times in the recent past our fellow EMS colleagues (mostly, but not exclusively) have fallen in the same trap over and over again and yet every time we try to analyze the chain of events, try to learn from it, try to make out the horrific mechanical or procedural or whatnot failure (or the combination hereof) so we can avoid it.
Turns out the it's the same f*** cause yet again! Flying a perfectly serviceable aircraft into the ground because "the pilot thought he knew the area" and could duck beneath the weather.
Although the contributing factors in this case make up for a pretty scary read (the ATC screwups for example): NTSB - Board Meeting - Aircraft Accident Report - District Heights, MD (http://www.ntsb.gov/Events/2009/District-Heights-MD/presentations.htm)

(for the record: I still think one can learn a lot from the discussions/educated guesswork about the cause of each new accident)

[Shawn Coyle]

A second pilot would also imply that the organization is paying more attention to proper cockpit procedures and drills and crew cooperation, etc.

[Devil 49]

As far as I can tell by looking at the stats, a 2 pilot crew is the safest possible configuration, single/twin, VFR/IFR or day/night. Some of that data is affected by the profile in which 2 pilot crews are commonly used as the industry presently exists, and 2 pilots isn't an absolute protection against risk in that skewed data, it appears to be the safest single variable.

[helmet fire]

I would love to see those stats D49. I would be very intrested in comparison of accidents that are more comparable: say compare rates for SPIFR equipped twins.
Crewed by one pilot V one pilot and trained front seat crewmember V two pilots.

[SASless]

Shawn,

I would beg to differ with your statement as written. In theory it would seem so but we have to remember the "bottom feeding" mentality of EMS operators when it comes to costs.

The norm would be to hire minimum time co-pilots, usually part-timers with no benefits, poor pay, and use the lure of hours building as the lure. At least that has been my past experience.

That practice might work for a fixed wing operation that flies into airports but for EMS operations far more experience is needed due to the nature of the flight operations conducted.

The avoidance of IIMC events alone.....would pay far more benefit to improving safety than anything else the industry could do.

If that second pilot/crew member achieved that.....I would agree with your statement.