Three people including two Mayo Clinic workers were killed in a Mayo Clinic helicopter crash in Florida on Monday. The cause of the crash and names of the victims are still unknown. But the accident will likely increase the already growing scrutiny on using helicopters for the transport of medical personnel.
The aircraft used in this flight was from a private service and is used for everything from emergency medical services to firefighting to corporate transportation. It’s been identified as a Bell 206. That’s not unique to healthcare, but it’s also not the “air ambulances” the public associates with medical transport.
It’s been an intense 18 months for the practice of using helicopters for healthcare. Medical helicopter pilots were labeled as flying the “most dangerous missions in aviation” and the “most dangerous profession in America” in a July 2010 article in Popular Mechanics. Some states were using helicopters unnecessarily, the article found, and they have fewer equipment requirements and poorer protocols — around things as pedestrian as weather checks — than other kinds of flights.
But there remains a consensus that, in general, helicopters used for medical purposes are not safe enough. The National Transportation Safety Board earlier this year said current helicopter EMS accident records are unacceptable.
More specifically, there’s a big difference in how safe one helicopter is to another. The NTSB pointed out that no matter the cost and makeup of the helicopter — a $800,000 single-engine model versus a $12 million twin-engine autopilot air ambulance — Medicare reimbursement is the same.
Monday’s Mayo Clinic organ transplant flight accident is different than many medical flights. But that won’t stop the safety debate from restarting. And even these flights aren’t without challenges. According to the Associated Press, a surgeon and an assistant flying to pick up a donor heart died in 1990 crash in New Mexico. In 2007, a twin-engine plane transporting a set of lungs crashed into Lake Michigan.
Key questions to be answered about any medical helicopter accident will involve:
It’s unclear what’s happened at the FAA in the past year. The Popular Mechanics article and intensified scrutiny around air ambulances triggered both voluntary safety measures and federal rule proposals. More helicopters came with helmets equipped with night vision goggles, for example. A rule proposed by the FAA in 2010 received final comments in January of this year. It included requirements around pre-flight checks, minimum weather requirements and training — some of which a trade association had already required or implemented.
But the FAA regulation bogged down — due in part to partisan issues around the FAA — and the rule has not yet been implemented.
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Comments
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It needs to be pointed out that this helicopter which crashed in Florida was NOT a medical air ambulance. It was a routine charter-type helicopter which just happened to be transporting transplant surgery providers. The helicopter was not licensed for air medical transport, there was no stretcher system for carrying a patient, and there were no flight paramedics or flight nurses on board. I suspect that it’s use in medical applications (i.e. organ transport) constituted less than 5% of it’s activity.
This accident, tragic as it may be, was not the same as the accidents which occur with traditional air ambulances. Comparing this accident to medical helicopter crashes makes about as much sense as comparing taxi-cabs to ground ambulances. Any activity on the part of the FAA to influence air ambulance operations will have nothing to do with what happened in Florida.
Comment by Larry Wilson — December 26, 2011 @ 3:35 pm
Larry: Thanks for the comment and I have fleshed out the latest version of the story to make sure people understand the difference. But charter flight or air ambulance, this tragedy will re-intensify the debate over healthcare personnel in the air.
Comment by Chris Seper — December 26, 2011 @ 4:39 pm
How many physicians die every year in car crashes, going to and from work?
Comment by Ian Curnow — December 27, 2011 @ 12:26 am
And I completely agree with Larry’s comment.
Comment by Ian Curnow — December 27, 2011 @ 12:27 am
Mayo Clinic should consider using a licensed air ambulance instead of an air taxi operator. HEMS pilots are trained specifically for dealing with urgent medical situations and the pressures that go into making an appropriate GO – NO GO decision on whether to accept a given flight. There are air ambulance programs with auto-pilot assistance that fly through fog and clouds regularly, and may stand a better chance of completing the transport than an air taxi operation that usually only flies in clear weather. Investigation of this accident will likely determine if another air service was contacted for this mission and declined to make the transport before this air taxi service was contracted. Such a situation could have serious ramifications. Ex-EMS pilot.
Comment by Mike — December 27, 2011 @ 4:35 am
I was a patient at Mayo for three weeks last January, and my room overlooked their helipad. At that time they were using an Agusta A109 (N35SK) from the same charter company for these flights. Don’t know why the Bell was making this run.
Comment by Jim — December 27, 2011 @ 9:02 am
Mike: I assume from your comment about Auto-pilot assistance that non-HEMS pilots are not required to have instrument ratings and normally will only fly in VFR conditions. I am not an HEMS pilot so don’t know any special rules for them. I would think non-Instrument rated pilots would not have much chance to fly anything.
Comment by Paul Davis — December 27, 2011 @ 1:46 pm
I work for an organization that does HEMS (along with fixed-wing and ground, but not in Florida). Our helicopter pilots are all instrument-rated and experienced, but our company policy is only to fly in VFR conditions.
Comment by Scott — December 27, 2011 @ 9:30 pm
Paul, I understand that the helicopter was a Bell 206B. I’ve never seen one that was certified for instrument flight, not that there aren’t any out there. Air taxi helicopter pilots are not required to have an instrument rating, HEMS or otherwise. Most employers require it. It’s easy to fly into clouds at night. Chances of surviving that encounter is increased if you have an instrument rating. Further increased if your aircraft has reliable flight instruments, and even better if you have an auto pilot. According to a recent statement by an NTSB on site, RADAR indicated that everything appeared normal up to the last few seconds (Youtube). This may be weather, equipment or pilot related. I’m sure that the pilot was instrument rated. Sad situation. My condolences to all affected.
Comment by Mike — December 28, 2011 @ 11:25 am
The Bell 206 is a single engine, single pilot, VFR (Visual Flight Rule) only aircraft. Charter or not, this is yet another sad example of a terrible practice being accepted in the helicopter EMS industry. This is simply the cheaper aircraft to operate. Professional organizations and Investigations by the NTSB have advocated for multi-engine, dual pilot, and Instrument Flight Rule capability for helicopter EMS – or at least terrain navigation, night vision, crash avoidance technology, autopilot, and other technologies to mitigate the known risk inherent to the current practice of single pilot, single engine, and VFR flight in helicopter EMS. This keeps happening and it is unacceptable. If the NTSB can’t fix this, I’m not sure who can. How many more people have to die? This is tragic and preventable.
Comment by Anonymous — December 30, 2011 @ 10:44 am
First, our prayers go out to these families. I do work in the Florida area where this crash occured, as a HEMS heli pilot. Unfortunately, all the IFR equipment may not have helped on this flight. Eventually, the actual weather report will be released. Even if he would have lost a blade, people in this occupation, have to wonder what he was doing taking that flight VFR, or even IFR.
Comment by Classified — January 6, 2012 @ 8:51 am
Who has actual different weather info than what has been reported? Visibility reports locally were listed at 3 miles to 5 miles depending on where you look. Conditions were overcast, light fog or misty (again depends where you look), no rain and little wind. Last poster has actual info that is different than this? Please share…
Comment by Chris — January 7, 2012 @ 10:42 am
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