Air ambulance safety addressed
Government urges tougher standards

Henry K. Lee, Chronicle Staff Writer

Thursday, January 26, 2006


Federal authorities must tighten regulation of air ambulances if they are to curb an alarming increase in fatal crashes involving such aircraft, the National Transportation Safety Board said Wednesday after reviewing 55 deadly mishaps, including a 2003 crash in Mendocino County.

The board, issuing its report in Washington, D.C., concluded that medical aircraft often fly under relaxed regulations when they are not carrying patients and that hospital employees and 911 dispatchers often lack aviation experience and cannot adequately judge when it might be too dangerous to fly or warn pilots of risks.

"The very essence of the EMS (emergency medical services) mission is saving lives. Operating an EMS flight in an unsafe environment just makes no sense," acting NTSB Chairman Mark Rosenker said in a statement.

The board recommended that the Federal Aviation Administration require operators of emergency medical flight services develop programs to assess risks such as nighttime flight, weather and spatial disorientation and formalize dispatch operations to assist pilots in assessing mission safety.

Aircraft also should be outfitted with night-vision goggles and crash avoidance systems, the board said.

Although the FAA has questioned the effectiveness of such tactics -- noting that medical helicopters often fly at low altitude -- many air-ambulance services have adopted the board's suggestions.

In preparing its report, the safety board reviewed 55 fatal incidents that occurred between 2002 and 2005 -- a rate officials said had not been seen since the 1980s.

The board focused on seven crashes, including a Dec. 23, 2003, accident in Mendocino County of an Agusta 109A medical helicopter in bad weather at night.

The crash killed pilot Arthur Gotisar and flight nurses Kelly Bates and Diane Codding. They worked for Redwood Empire Air Care Helicopter, known as REACH, in Santa Rosa.

The flight had departed Santa Rosa bound for Willits to pick up a gunshot victim. The pilot stopped in Ukiah because of inclement weather, decided to continue on to Willits, and then aborted the flight and turned back toward Ukiah without picking up the patient. The helicopter slammed into a hillside near Redwood Valley.

The safety board said the pilot's "improper in-flight planning" contributed to the crash. They also faulted him for continuing to fly only with visual cues -- instead of relying upon instrumentation for navigation -- even as the weather continued to deteriorate.

REACH spokeswoman Jennifer Hardcastle, a former company flight nurse, said Wednesday that the pilot had checked weather conditions before departing Santa Rosa and they were "completely acceptable."

But eyewitness accounts showed there were "rapidly changing conditions" the pilot couldn't have foreseen, she said.

Hardcastle said REACH supported the safety board's recommendations and said the company, which has transported 29,000 patients since 1989, is "well on our way, if not meeting them, to exceeding them. We are very motivated to remain proactive to enhance safety," she said.

Hardcastle said some of the safety board's suggestions didn't apply to the company. For example, REACH policy requires pilots to fly at all times as if a patient is aboard, Hardcastle said. And the company's flight dispatchers only coordinate requests for flights; only pilots decide whether conditions are safe for flight.

REACH operates six helicopters from Santa Rosa, Concord, Lodi, Marysville, Redding and Lakeport and has other aircraft on standby.

By next month, all of its aircraft will be equipped with night-vision goggles, and the company has begun retrofitting some of its aircraft with "terrain awareness" systems that help pilots avoid hitting the ground, Hardcastle said.

Nancy Sowers, director of Stanford Life Flight, which operates one helicopter, said Wednesday that the report would help air-ambulance services meet their goal for "zero accidents."

"I think just bringing it to the attention of the public is outstanding," she said.

E-mail Henry K. Lee at hlee@sfchronicle.com.