Maryland Defends its Medevac Program

BALTIMORE --

If you're critically injured in a crash and need to get to a hospital fast, the WBAL TV 11 News I-Team discovered that the closest medical helicopter may not be the one called.

Geary Hoover, a Washington County resident, said he still has nightmares about a fatal crash that unfolded in front of him on a section of road many residents near Boonsboro call Dead Man's Curve.

"The accident happened right here as you come around the curve," he told I-Team reporter David Collins when they returned to the crash site.

"The two in this vehicle here that got hit were alive. She was unconscious at first. The gentleman over here in the other car was still alive. He looked up at me. I told him that help was on the way. I held his hand, and we prayed," Hoover said.

Emergency Medical Service crews requested a Medevac through SYSCOM, the state's helicopter dispatching center, but were told all Medevacs were grounded due to poor weather problems.

But Hoover said he recalled that the weather was OK at the crash scene.

"The visibility was fine," he said.

EMS command at the scene said they then pleaded for a commercial Medevac and eventually prevailed. SYSCOM dispatched Stat 12, a private Medevac based at the Hagerstown Airport. They flew the sole survivor of the crash to Shock Trauma in Baltimore.

In October 2006, Charles County EMS drove a pediatric patient to a landing zone at Maryland Airport. Medstar, the commercial Medevac based at the airport, wasn't allowed to transport the victim. Records show that the patient waited 21 minutes for a state police helicopter.

Two months later, Medstar was on the scene of a high-speed rollover crash that happened behind the airport's hangar, but Medstar wasn't allowed to transport again.

The state Medevac arrived 11 minutes later. State Police claimed they still had to wait for the patient to be extricated, but an EMS responder recalled that the patient was ready and waiting.

There's no way to determine if wait time made a difference in any of these cases, Collins reported.

Collins said that the state police and commercial Medevacs are in a turf battle. Private companies contend that, in all other emergencies, the first available and closest crew is dispatched to the scene -- but that's not the case with air ambulances.

According to a memorandum of understanding, the state gets all calls for critically ill patients unless its helicopter is more than 25 minutes away. If that happens, SYSCOM will call a private Medevac, but only if it is less than 10 minutes away from the scene.

If the private helicopter is more than 10 minutes away and still closer, the state police dispatcher decides who to call.

Overall, a state Medevac is almost always called, Collins reported. From January 2006 through September 2007, they flew more than 8,000 missions. Private companies got the call 44 times.

"I would argue that the system is working very well," said Dr. Robert Bass, director of the Maryland Institute for Emergency Medical Services Systems, or MIEMSS.

"If the patient comes first, why not use the first available aircraft to transport?" Collins asked Bass.

He responded, "We've got a very good response time on a statewide basis. And we track those response times very closely. We track when there is a delay. We review all cases of delays."

Bass said that one of the incidents in Charles County prompted an amendment to the memorandum of understanding. If a commercial Medevac is already treating a victim at the scene, it may transport the patient.

"We think it has been operating very well. We know of no incidents where a patient has been affected adversely because of our policy," said Maj. Ken McAndrew of the Maryland State Police Aviation Unit.

But commercial Medevacs claim that the system is set up to keep Shock Trauma in business and doesn't put the patient first.