Federal aviation accident investigators continue to gather evidence into the cause of the March 26 crash of a medevac helicopter which killed its pilot, flight nurse, medic and the patient they were transporting. The aircraft went down in a heavily wooded, marshy site near Goodman, about 30 miles west of Dothan, Alabama, three minutes after picking up a 27-year-old man who had crashed his car into a utility pole.
The midnight crash in Alabama was the sixth fatal accident involving a medevac helicopter in the past year. The National Transportation Safety Board says 13 people have been killed and several injured. The other fatalities occurred in or near St. Louis; Austin; Phoenix; McFarland, Calif.; and Eufaula, Okla.
As in all air-ambulance crash investigations, the NTSB and the Federal Aviation Administration have many questions about the downing of the Haynes Life Flight helicopter. They range from the obvious potential causes such as weather, equipment failure and pilot error, to murkier yet equally relevant issues such as whether the flight was really necessary.
This 1987 editorial cartoon was done by The Pittsburgh Press editorial cartoonist Rob Rogers and used with his permission
According to the Alabama Law Enforcement Agency, the young victim, when found after his car crash, was unconscious and had a broken leg.
The NTSB is expected to examine why the patient was being flown to a hospital 30 miles away in Troy rather than the 131-bed medical center in Enterprise, just 10 miles from the accident scene. The nearby hospital said it has a well-staffed emergency department but declined to comment on why the helicopter was called, beyond saying it wasn’t their decision.
There is no doubt that lives are routinely saved by the sophisticated intervention of multiple medical specialists found at trauma centers and the helicopter’s own medical team while airborne. However, if weather conditions present a safety concern for the flight crew, even some seriously injured trauma victims can often be safety stabilized until flight hazards are reduced.
Because fog and intermittent rain was reported in the area of the Alabama crash, some aviation safety experts say it’s important for the federal accident sleuths to probe whether the pilot had become disoriented, unable to discern where the ground was. The mangled wreckage of the Eurocopter AS350 indicated a high-speed impact, according to a first responder from nearby Enterprise.
Having ridden on hundreds of medevac flights in the U.S. and overseas over the past too many decades, I’ve repeatedly seen the courage of these aviators and the medical crews who staff these flying critical-care units.
But also, it is acknowledged in the industry that there are adrenaline-generated cowboys among these crews, but they don’t last long. What does remain is the fact that the vast majority of the 75 air-ambulance companies or hospitals operating 1,510 helicopters are for-profit businesses.
It used to be that in some of these programs, there was often enormous corporate pressure on pilots to fly when weather or visibility was questionable.
In the infancy of the civilian flight programs, competing helicopters rushed to the accident scene to be the first to grab the victim. One often-repeated tale involves a traffic accident on a major highway outside Atlanta where crews from rival helicopters actually fought over the potential patient. For the most part, the days of “swoop and scoop” are long gone. Today, almost all medevac flights are staffed with highly trained flight nurses and paramedics, and, in a few cases, physicians.
Sustaining a medevac program can be costly. Doing so with extra attention on safety equipment and flight restrictions can cost even more. Yet flight programs are often major money-makers. Patients can find themselves billed a liftoff fee, mileage charges, and the cost of medical supplies, and this can add up to bills that most insurance companies do not pay. A flight can run from $5,500 to $60,000 or more. Add to this the routine hospital charges incurred by a seriously sick or injured patient, and it’s obvious why many hospitals embrace this flying cash cow.
Like old-time fire departments offered a century or more ago, some flight programs solicit annual subscriptions costing $50 to $150 per family to those living in their area for free or greatly discounted service should a flight be necessary.
There are about 100 taxpayer-financed air-ambulance flight programs, such as the 10 aircraft run by the Maryland State Police, seven by the Los Angeles Fire Department, several operated by the National Park Service and the ubiquitous, distinctively colored U.S. Coast Guard Jayhawks and Dolphins.
Even when the helicopters are operated safely, this is an inherently dangerous profession. The NTSB reported 10 years ago that helicopter ambulance crews had a higher death rate than any other profession, including commercial fishing and logging. Last week, an agency investigator told me there is “no information that this much-needed service has dropped from the top position of most hazardous profession.”
No, I wasn’t there in the early 1950s. However, I was told that some of the pilots who darted around Korean battlefields in their tiny, fragile, bubble-fronted Bell helicopters scooping up the horribly wounded and delivering them to the closest combat hospital painted “That Others May Live” on the side of their live-saving birds and their tents.
I did watch later generations of medical aircraft morph into Hueys, the Air Force’s unusual HH-43 Huskie, the Jolly Green Giant, huge Chinooks, the Pave Hawk and various models of the Black Hawks. The motto became linked forever with the Air Force’s uniquely skilled Pararescuemen, whose patch shows an angel holding the globe.
The military continues to rely upon and refine its aeromedical evacuation operations and what can be accomplished to save the lives and limbs of the injured while they are being flown to high-level care. Today, a similar level of advanced airborne trauma care is available throughout the U.S. The Association of Air Medical Services (AAMS) said that last year 400,000 patients were transported by helicopter ambulances.
It’s a popular but incorrect belief that these patients were swooped up from highway accidents. But AAMS said about 70 percent of the missions are actually from one hospital to another, carrying either patients or human organs for transplantation. The remaining 30 percent are “scene runs,” which transport patients from a traffic or industrial accident scenes.