Government's Failure to Tighten Flying Rules Cited in Medical Copter Crashes

Through a cloud-choked and starless night in February, the crew of an emergency medical helicopter flew east on a 30-mile journey from Harlingen to South Padre Island, where a sick patient waited to be airlifted to a mainland hospital.

As the crew neared its destination, weather conditions forced a steep turn. The pilot, according to records, circled briefly in strong winds and at 8:54 p.m., the helicopter and its crew crashed into the shallow waters of the Laguna Madre bay.

All aboard died - the pilot and both paramedics - three people among 28 killed in medical helicopter tragedies in 2008, the deadliest year ever for such crashes.

According to a Chronicle review of fatal crashes, most of those 28 died in conditions known to be dangerous, conditions that repeatedly have been the subject of unfulfilled government promises for more stringent standards.

Two of the crashes, in which seven people died, took place in Texas.

Both happened at night. Both pilots faced reduced visibility.

And safety officials have cited both Texas crashes, along with others in recent months, as they question how many lives would have been saved if regulators had moved faster to require stricter flight rules and advanced sensor equipment to forewarn pilots of potential hazards.

The Chronicle reviewed 65 fatal medical helicopter crashes investigated by the National Transportation Safety Board since 1989 and found that the same problems - flights at night and in bad weather - long have been common contributors to air ambulance deaths.

Air ambulances have been credited with saving countless lives. Yet, each time the decision to dispatch one is made, operators face the critical task of balancing the welfare of the patient with the the safety of the pilot and medical personnel.

Those pressures have been ratcheted up by the explosion of operators available to fly for any given call. The air ambulance ranks have swelled from some 100 nationally in the 1980s to more than 900, operated by hospitals and independent companies, industry groups say.

"There is a pressure for things to happen quickly when people are dying," said Gary Sizemore, a Florida-based pilot and spokesman for the National EMS Pilots Association. "But there also is a competitive pressure with the greater number of (helicopters) out there."

Two-thirds of the 65 fatal flights began at night, half in adverse weather or reduced visibility, the Chronicle found. Seven of those crashes took place in Texas.

The most common non-mechanical causes for air ambulance crashes, according to NTSB investigators, are collisions with obstacles such as mountains and power lines, again mostly caused by weather conditions. In 21 crashes, safety board investigators found pilots flew too low or directly into terrain. In 10 others, pilots became disoriented because of fog, snow or rain.

The majority of fatal flights carried only crew members, usually on their way to pick up a patient. Under current regulations, helicopters carrying only crew members are allowed to fly under less stringent flight rules than those with patients on board.

Just one in three of the deadly crashes since 1989 carried a patient.

South Padre crash

The pilot and two medics on the doomed February flight to South Padre Island boarded the helicopter at Valley Baptist Medical Center with a plan to put down in the parking lot of the South Padre Island Convention Centre. There, they would pick up a woman having respiratory problems and return to Harlingen.

But before the crew could reach the island, it encountered strong winds and, according to local officials, decided to abort the mission. The helicopter turned after the pilot's last contact with air traffic controllers.

Witnesses watched its lights falling from the sky and into the brackish waters of the bay. A ground ambulance carried the woman to the hospital.