In March 2016, a Haynes Ambulance LifeFlight medical helicopter crashed in a heavily wooded area in Southeast Alabama, according to the Jere Beasley Report. The air ambulance was transporting a motor vehicle accident (MVA) victim to a hospital in Montgomery. Darkness, rain and fog hampered the search for the downed flight, which wasn’t discovered for seven hours. The pilot, flight nurse, flight medic and MVA victim were killed.
The National Transportation Safety Board (NTSB) investigated the crash and released its final report last month. The investigation determined that pilot error combined with inadequate oversight by the operational control center (OCC) was the cause of the fatal crash. The report stated:
“The pilot’s decision to perform visual flight rules flight into night instrument meteorological conditions, which resulted in loss of control due to spatial disorientation. Contributing to the accident was the pilot’s self-induced pressure to complete the mission despite the weather conditions and the operator’s inadequate oversight of the flight by its operational control center.”
The report describes an “aeronautical decision-making” problem that plagues many pilots called “Get-There-Itis,” which it says is a “fixation on the original goal or destination combined with a total disregard for any alternative course of action.” However, others within the industry say that pressure to fly is not just a result of a pilot’s psyche, but also due to the nature of the industry.
Dr. Brandon Morshedi, MD, DPT, NREMT, an emergency medicine resident, says that the desire to save the most critically ill or injured patients couples with the financial incentives of an unregulated and lucrative business. The NTSB even described the “punitive culture and inadequate safety management” in a final report for a separate crash that occurred in November 2013.
The industry, which dates to World War I, has increased access to emergency medical services. Yet, the industry’s growth has outpaced its ability to provide an infrastructure for acceptable safety regulations – intensifying an already hazardous business.
One analysis of medical helicopter accidents estimated that an accident occurred every 40 days over a 10-year period (2006 – 2015). The Air Medical Physician Association analyzed medical helicopter accidents that occurred over a 20-year period, finding that the leading causes for most accidents included the time of day, environmental factors (such as weather conditions, flight altitude and geographic location) and time pressure due to the patient’s condition.
A spike in the number of air medical crashes in 2008 prompted an NTSB hearing the following year that resulted in 21 safety recommendations. The Federal Aviation Administration (FAA) later incorporated many of the recommendations in new flight regulations and procedures for helicopters to increase safety.
Jere Beasley Report (December 2016)
National Transportation Safety Board
Journal of Emergency Medical Services