Medevac Crash gets FAA Attention

[Widow]

Air-ambulance crashes trigger FAA's 'full attention'
By Alan Levin, USA TODAY

WASHINGTON — Federal aviation officials said Monday they are concerned medical helicopter accidents may again be on the rise now that four fatal crashes have happened in less than six months.
"The recent spate of accidents has the FAA's full attention," said Alison Duquette, spokeswoman for the Federal Aviation Administration.

A helicopter carrying a 58-year-old patient, along with a flight nurse, paramedic and pilot, crashed into a wooded area near Huntsville, Texas, early Sunday, killing all aboard. The helicopter struck trees, spreading debris over 600 feet, according to preliminary data from the National Transportation Safety Board (NTSB).

The accident and three others since Dec. 30 have killed 13 people and are similar to a pattern that prompted the NTSB to conduct a special safety review of the air-ambulance industry in 2006, according to preliminary reports and an industry association.

All four of the recent fatal crashes happened at night and in places where pilots had little or no visual reference on the ground, such as a forest or over water, according to NTSB files.

The NTSB said in 2006 that most crashes were preventable. It issued recommendations for better technology and new rules to force pilots to be more cautious, especially at night and in poor weather.

The FAA, which regulates the air-ambulance industry, has taken numerous steps to improve safety in recent years but has balked at the more stringent suggestions by the safety board.

No accidents are acceptable on the helicopters that increasingly ferry the nation's sickest patients from remote locations to top trauma centers, said Tom Judge, program director for LifeFlight of Maine and a safety adviser to the Association of Air Medical Services.

There is no evidence that the crashes are anything more than an "unfortunate cluster," Judge said. "I think all of us are puzzled and are trying to understand what this is."

"Night continues to be a very big risk area," he said.

After a flurry of attention from crash investigators and regulators, the number of fatal air-ambulance helicopter crashes fell to two in 2006 and two in 2007, according to NTSB data. In 2008, there have been three fatal crashes. Recent crashes include:

• On Dec. 30, in Cherokee, Ala., an air-ambulance helicopter assisting in the search for a missing hunter crashed in a wooded area at night, killing a pilot, paramedic and flight nurse.

• On Feb. 5, a pilot and two medical workers died when a helicopter crashed in a bay near South Padre Island, Texas.

• On May 10, an air-ambulance helicopter crashed into trees near La Crosse, Wis., shortly after dropping off a patient at a hospital. The pilot, a physician and a nurse died.

• An FAA inspector and a pilot suffered serious injuries on May 29 when a helicopter crashed on top of the Spectrum Health Butterworth Hospital in Grand Rapids, Mich.

The pilot was receiving a routine check by the inspector. The crash prompted the evacuation of some hospital patients.

The NTSB recommended that air-ambulance firms adopt new technology to warn pilots when they flew too close to the ground and pay more attention to high-risk factors such as poor weather before departing. The NTSB also voted to encourage the FAA to approve the use of night-vision goggles.

The new technology has proved difficult to put in place, according to FAA documents and Judge.

None of the pilots on the four recent fatal crashes at night was using night-vision goggles, according to Guzzetti.

This all reminded me of reading this:

Night-vision goggle shortage hits medivac pilots
Feds say, "Use them, " Denver-based company says, "We can't get them"

June 5, 2008

MADISON, Wis. (AP) — The pilots who fly medical helicopters on life-saving missions at night have been encouraged to wear night vision goggles -- but they're in short supply.

The National Transportation Safety Board has suggested the use of that equipment for the past couple of years, to reduce the risk of nighttime crashes.

But there's a major shortage of those goggles -- because of the war in Iraq.

Air ambulance services have been put on waiting lists of a year or more by the makers of night vision gear, because the U.S. military has contracts that give it priority.

Air Methods Corp., a Denver company that leased the aircraft involved in a fatal crash in Wisconsin last month, is the nation's biggest operator of emergency medical helicopters.

Its plans to install night vision goggles in its fleet of 348 had been slowed by the shortage. About 40 percent of its choppers have them, and the rest should be upgraded by the end of 2011, said Air Methods vice president Mike Allen.

Gary Sizemore, who heads the National EMS Pilots Association, estimates that only 25 percent of the emergency medical helicopters in the U.S. have the technology.

Just over one-third of emergency medical flights occur at night, but they account for half of the crashes, studies show.

"Nighttime is a problem time in this industry," said David Kearns, a flight nurse in Denver. His crew uses the goggles to navigate the mountains.

"It greatly enhances the safety of nighttime operations," he said. "We find the goggles to be extremely useful."

Do Canadian Medevacs use night vision goggles? Is this being looked at for approval by TCCA as it seem the NTSB has suggested to the FAA?

[Justwannaflyfloats]

STARS in Alberta uses Night Vision Goggles with there BK117's.

From their website:

All STARS helicopters are rotary wing Eurocopter BK117 models. The aircraft is well suited to air ambulance duties because of its high performance, rotor design, most poor weather capabilities and its rear clamshell doors. The STARS fleet is also equipped with night vision goggle capabilities. We are the only civilian night vision goggle program to regularly fly in mountainous terrain in Canada.

[Widow]

Helicopter Safety Campaign Has Been a Struggle

By ANDY PASZTOR and CHRISTOPHER CONKEY

The National Transportation Safety Board's impending public examination of helicopter safety lapses caps many years of an uphill struggle by the agency to understand the causes of high-profile crashes and persuade industry officials to correct the problems.

This week's focus on a spate of fatal emergency medical chopper crashes will produce various new safety recommendations, likely ranging from calls for improved weather forecasting to demands for tighter controls on hospital decision-making about patient evacuations. Board member Robert Sumwalt, a retired commercial-jet pilot who will chair the sessions, has called the recent accident rate "totally unacceptable."

In coming months, board officials are looking to expand their scrutiny to other types of helicopter services.

But it took a long time for the NTSB's campaign in this area to gain some lift. Although the safety board began looking at helicopter accidents decades ago, some of its early work amounted to little more than educated guesswork because the wreckage often was too broken to provide much help. Moreover, early choppers didn't have flight-data recorders to help investigators unravel what happened.

Officials say it wasn't until the summer of 2005, while investigating the fatal crash of a U.S.-built passenger helicopter flying from Estonia to Finland, that board experts had their first chance to examine a crash from a helicopter that was equipped with such an onboard recorder. That investigation revealed hydraulic controls for the main rotor blades malfunctioned in flight, killing 14 people. The board's recommendations were embraced by regulators and quickly helped make the rest of the fleet safer.

NTSB officials said that probe highlighted the different standards used by the Federal Aviation Administration to approve designs for helicopters versus airliners or business jets. Before jetliners carry passengers, "they undergo so much more rigorous failure analysis and testing" than newly introduced helicopter models, according to David Hoeppner, a University of Utah engineering professor with long experience in the rotorcraft arena.

In other cases, NTSB investigators capitalized on luck to solve crash puzzles. When a Japanese student pilot happened to take a portable tape recorder aboard his single-engine craft, experts ended up making extensive use of the intact recording recovered from the wreckage. They deduced from the tape that a slipup at the controls caused the rotor blade to slice through the cockpit, killing the pilot in mid-sentence conversation with air-traffic controllers.

Despite today's advanced onboard crash-detection devices, the board and air-safety experts emphasize that pilots often keep making the same categories of mistakes – particularly when flying in poor visibility and stormy conditions. Sandra Kinkade, a former flight nurse who now heads the Association of Air Medical Services, estimates that 80% of air ambulance crashes stem from human mistakes.

George Ferito, director of business development for helicopters at Flight Safety International, a leading provider of simulators and training services, said there is a growing realization that "very similar accidents are being experienced by new people."

Most of the recent accidents "involve decision making problems in the cockpit," according to Fred Brisbois, director for aviation product safety at Sikorsky Aircraft Corp., a unit of United Technologies Corp. Noting that "regulation has a role to play," he adds that Sikorsky feels "there's a responsibility to try and reduce those type of accidents."

After investigating an accident in Huntsville, Texas, that killed four people last June, the NTSB concluded that the probable cause was "the pilot's failure to identify and arrest the helicopter's descent, which resulted in its impact with terrain." Similarly, the NTSB determined that a crash nearly a year ago in South Padre Island, Texas, that killed three crew members was likely due to "the pilot's failure to maintain aircraft control resulting in the helicopter impacting the water."

But this week hospitals also are expected to be targets of criticism. With the board expanding its scrutiny to local management decisions about how helicopters are used, the hearing is expected to delve into questionable practices dubbed "helicopter shopping." That occurs when hospitals seeking flights in potentially hazardous conditions call around to several helicopter operators until they find a company willing to accept the business.

Wall Street Journal

[sky's the limit]

While NVG's and a/c capabilities have a lot to do with improving things, they are not the main factors in these accidents, the FAA knows this. STARS flies with TWO pilots, as does every other dedicated Medivac provider in Canada, and they are not subject to changing regulations during the flight, or ludicrous paid-by-the-loaded-mile schemes.

stl

[Widow]

SEPTEMBER 1, 2009, 1:32 P.M. ET.

NTSB Urges Operational Changes for Emergency Medical Helicopters
By ANDY PASZTOR

Federal aviation-accident investigators called Tuesday for various equipment and operational changes to improve the safety of one of the most dangerous jobs in America: piloting emergency medical helicopters.

National Transportation Safety Board approved recommendations for the Federal Aviation Administration to require operators of helicopters flown for emergency medical services to, among other things, install automatic pilots, terrain awareness monitors and night-vision systems. The board also agreed to develop recommendations for the Department of Health and Human Services to provide Medicare payments only to emergency helicopter operators who pass safety audits.

However, even before the NTSB hearing, industry officials and government regulators have already begun to adopt some of these same measures.

The hearing comes nearly seven months after the NTSB highlighted safety problems faced by this segment of the industry, which suffered 13 crashes and 29 fatalities in 20008. By some measures, pilots of emergency medical helicopters had the most lethal jobs in the U.S., racking up fatalities at a faster clip than loggers and other historically risky professions.

But partly prompted by the board's efforts, the FAA in February dropped its previous policy of focusing largely on voluntary compliance by industry as a way to quickly phase in safety improvements. At the time, FAA officials said the agency was working on new rules requiring beefed-up training for both pilots and dispatchers, as well as use of night-vision goggles and ground-collision avoidance warning systems.

Since then, industry officials also have embraced some of the same concepts and sketched out plans to speed up changes to reduce risk.

For example, on Monday The Flight Safety Foundation, a leading nonprofit international safety advocacy organization, announced that it is teaming up with several equipment suppliers and other industry groups to conduct a major test of the feasibility of installing data-recorders on medical helicopters. The recorders would be similar to the "black boxes" required on commercial airliners. The objective, according to the foundation, "is to determine if enough data can be collected from helicopters to determine trends and ultimately, make operations safer."

Among the challenges are making data-recorders for choppers rugged and inexpensive enough to encourage their widespread deployment. Some manufacturers already install them on the assembly line, but in the past some operator have balked at retrofitting the devices into older choppers.

The industry also has created a broad-based data collection and analysis team to look at operational trends, spot developing hazards and make recommendations about fixes, which would be voluntarily put in place by the air ambulance industry.

With the assistance of the Flight Safety Foundation, an industry group in April released what it called the most comprehensive report ever about enhancing safety for patients and crews alike, Prepared by Aerosafe Risk Management Inc., a consulting firm that has done helicopter safety studies world-wide for commercial and military operators, the report identified more than two dozen structural and financial issues that raise risks for emergency helicopters. The study, among other things, suggested that risk levels may not go down significantly until reimbursement rates for transporting patients are adjusted to better reflect operating costs and the price tag for upgrading onboard safety equipment.

http://online.wsj.com/article/SB125181334087776105.html

[just curious]

If you watch early episodes of ER, you'll notice the helo on the roof was labelled with the University of Chicago logo.

That was when Helos were operated by health care providers. Two crew, IFR platform.

Now, helos are provided by competing HMO's (insurance companies). Single pilot, single engine. Things fixed wing pilots take for granted on the smallest single (attitude indicators) are rare in single engine single pilot helos. Paying pilots more by the mile when the helo is loaded, or even paying by the mile isn't really conducive to safe operations.

In Canada, well in Ontario, medevac machines are 2 crew, two engine, IFR platforms. Have been for a long time now. Could they be safer... I dunno. But at least where we have civilian air ambulance the crew and machines are better suited for the op.