What Can FAA & NTSB do to Reduce HEMS Accidents?

In the past week, we have had two fatal crashes of helicopters providing ’emergency medical services’. Historical data shows that many of these ‘HEMS’ fatal accidents happen at nighttime, when flying in poor weather, especially in dark (moonless) conditions.

20150312.. HEMS crash, west of Eufaula Lake, mapSuch was the case with this latest accident, on March 12th. A pilot and two crewmembers were flying from Tulsa back to their EagleMed base at McAlester, Oklahoma [KMLC]. The flight ended up crashed in terrain to the west of Eufaula Lake (green box area), minutes prior to their planned arrival at McAlester.

On this particular night, in the area around McAlester, the moon (which was waning and illuminated at 63%) rose at 1:03AM, nearly two hours after the accident. Thus, it was a dark night.

Also on this night, the weather was deteriorating. When weather is poor, helicopter pilots choose to fly at lower altitudes, to stay below the bottom cloud layer. In sufficiently dark night conditions and at low altitudes, even a seasoned pilot may not see a tall tree, an antenna tower, or a mountain until the last second, if at all. Such conditions make helicopter transport far more risky than ground transport.

In the HEMS industry, company owners rake in huge profits if they can get their crews to be the first medical transport at the scene of an accident. But, they also earn large fees (exceeding $10,000)contracting with hospitals to fly patients from point A to point B. The problem is, the profit motive is so intense that many pilots have found it difficult to say ‘no’, even in the worst flying conditions. And, this problem is amplified by FAA’s rules for helicopter flying, which allow pilots to fly at any level – right down to the surface – to dodge declining weather. In many of the resulting accidents, the helicopter proceeded in declining visibility, to lower and lower altitudes, then impacted guy lines that support antenna towers.

And then there is the media coverage. When these HEMS accidents happen, the news coverage tends to focus superficially on the physical tragedy, while failing to investigate a key question: was there a real benefit, and was it necessary, to use a helicopter for the specific incident? The media tends to not ask these questions and, instead, waits for FAA and/or NTSB to comment about the risks involved. The problem, though, is that both agencies are pressured to stay quiet, so as not to undermine the profit potential of the HEMS industry.

Also, the media tends to paint the crash victims as heroic in their service. We are led to believe that others would have died if the HEMS crew had not selflessly risked life and limb to respond. In truth, though, accident histories have shown time and again that most nighttime HEMS accidents would have been avoided – and patients would have been just fine, too – if pilots had simply accepted the real risks and elected to wait for conditions to improve.

FAA is very much to blame for the fact these HEMS accidents continue to kill so many in the United States. FAA has the authority to regulate this industry, but chooses not to. For decades, the pattern has been to delay tighter rules and keep the safety rules fuzzy and ambiguous. Chronically, FAA does their best to not interfere with this or any aviation industry.

In this latest fatal HEMS accident, it is again tragic that a pilot was lost, that two others were injured, and that families and friends have been made to suffer. But, if we are to move beyond repeats of these accidents, we need real and timely information. If there is evidence suggesting decisions were made that were too risky, that evidence needs to be revealed to the Public ASAP.

It would be helpful if the FAA and NTSB became more assertive in sharing information about these HEMS accidents. Perhaps, within 48-hours of each accident, they should post the preliminary information that helps the news media (and readers) to assess answers to the following questions:

  • What was the purpose of the flight? I.e., was it for routine transfer of a stable patient, or was it an accident response?
  • What was the specific urgency that necessitated use of a helicopter instead of ground transportation? Or, was there no benefit to a patient?
  • Was weather possibly a factor (i.e., what were the nearest reported weather conditions)?
  • Was darkness possibly a factor (i.e., what were the known conditions)?

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