Feds Seek to Prevent Air Ambulance Crashes But Question is How

The 55 air ambulance accidents over the past three years didn’t have to happen, and federal safety investigators say they want to prevent future crashes with better pilot training, night vision goggles and crash avoidance systems.

Basic safety equipment found on commercial airplanes could have saved five lives on the moonless cloudy night of Aug. 21, 2004, the National Transportation Safety Board concluded. That night, a medical helicopter airlifting an 11-day-old baby from Battle Mountain, Nev., to a Reno hospital crashed in a remote hilly area, killing the pilot, two medical crewmembers, the infant and her mother.

The NTSB said that accident could have been prevented by a system that issues a computerized voice warning when an aircraft approaches an obstruction or the ground.

The Nevada crash and six other accidents, including the Jan. 11, 2005, crash of a Colorado air ambulance that killed three people near Rawlins, Wyo., were cited by the NTSB as “the best examples of the safety issues involved.”

The safety board this week formally recommended that the Federal Aviation Administration require such equipment. But the FAA says the technology doesn’t work well on helicopters because they fly low and around buildings, often triggering false warnings.

The disagreement about requiring safety equipment isn’t the only thing the NTSB and the FAA disagree about. The FAA, which regulates aviation safety, believes voluntary cooperation with its recommendations will improve air ambulance safety faster. The NTSB, which can only recommend safety improvements, says the industry should be regulated.

“The carrot hasn’t worked,” said safety board member Debbie Hersman. “We’ve got to pick up the stick.”

But Richard Healing, a former NTSB member and now am aviation consultant, said the voluntary approach works. “The people I’ve talked to in the air medical community are doing everything they can to voluntarily embrace the recommendations that the FAA made,” Healing said.

For example, Healing said, many air ambulance companies are starting to equip their pilots with night vision goggles, which are expensive and require training. The NTSB concluded that they could help prevent accidents, but didn’t recommend that they be mandatory.

A surge in air ambulance accidents beginning in 2001 prompted the NTSB to investigate the problem. The board found that medivac fatalities doubled to 62 in the 2001-05 period from the previous five years.

The safety board studied 55 accidents between January 2002 through January 2005.

“They shouldn’t be happening, and they are preventable,” said John Clark, NTSB aviation safety director.

Emergency medical services pilots, pressured to save lives, often fly in dangerous conditions: at night, in bad weather, over remote terrain.

Such was the case last year, when a Yampa Valley Air Ambulance from Steamboat Springs, Colo., crashed in the mountains near Rawlins, killing the pilot and two medical crewmembers. A third crewmember, Timothy Baldwin, of Steamboat Springs, used his cell phone to direct rescuers to the wreckage. The crew was flying to Rawlins to pick up a patient for transport to Wyoming Medical Center in Casper.

But EMS operators are under less government oversight than commercial airlines, and are subject to fewer government restrictions when they’re flying without a patient.

The NTSB recommended that the FAA require the same rules whether there’s a patient aboard or not. The rules would include how long a pilot can work and what kind of weather he can fly in.

The board said the FAA should require formal methods that EMS operators must follow and train pilots to follow to assess a flight’s riskiness.

The NTSB also wants the FAA to compel dispatchers to follow specific procedures that would force them to pay more attention to the weather.