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Enough Is Enough! Night EMS Helicoptors Should Be IFR-Certified And Flown By Two NVG-Equipped Pilots

9-1-1 Magazine (photo courtesy of Dan Odom)

9-1-1 Magazine (photo courtesy of Dan Odom)

There have been three fatal night air ambulance/emergency medical services (EMS) crashes since December 2015.[1]  From July 2014 – July 2015 there were six fatal EMS flights (not all at night).  In 2014, the Federal Aviation Administration published stricter regulations for helicopter air ambulance operators, and per its own background and statement of the problem:

  • This rule addresses the causes of 62 helicopter air ambulance accidents that occurred during the period from 1991 through 2010. One hundred twenty-five people died in those accidents. The FAA identified four common factors in those accidents—inadvertent flight into IMC [instrument meteorological conditions], loss of control, controlled flight into terrain (which includes mountains, ground, water, and man-made obstacles), and night conditions.
  • Helicopter air ambulances operate under unique conditions. Their flights are often time sensitive, which puts pressure on the pilots. Helicopter air ambulances fly at low altitudes and under varied weather conditions. They must often land at unfamiliar, remote, or unimproved sites with hazards like trees, buildings, towers, wires, and uneven terrain. In an emergency, many patients will not have a choice of whether they want to be transported in a helicopter or not. They may be in a medical condition that prevents them from making decisions . . . They cannot choose between competing carriers because the company that responds to the scene may be either the first one called or the only one in the area. For these reasons, the FAA is establishing more stringent safety regulations to protect patients, medical personnel, flightcrew members, and other passengers onboard helicopter air ambulances.

Federal Register/Vol. 79, No. 35/Friday, February 21, 2014/Rules and Regulations/9935.

While the FAA has taken positive steps, U. S.-based EMS helicopter operations have not taken two essential risk mitigation measures that such operations in other countries and the U. S. military and Coast Guard, have implemented for night EMS‑type helicopter operations:  (1) two pilots; and (2) night vision devices, most commonly night vision goggles (NVGs).

If U. S. military pilots fly medical helicopter operations multi‑piloted, then why aren’t U. S. operators flying the same type of dangerous missions multi‑piloted? And, if U. S. military pilots use night vision devices when conducting these operations at night, again, why aren’t U. S. operators following the military’s lead?

Flying medical evacuation in bad weather adds to the pressure, chaos, and uncertainty involved in getting to the point of injury and airlifting a critically injured person to a medical center within the “golden hour.”  (“‘Weather’ or Not to Press,” Approach, July 2006.)  I’ve lost a few friends who died flying or air‑crewing these types of flights.  Some of the dangers include rapidly degrading weather and visibility, unmarked obstacles, power lines, and challenging steep approaches and landings to confined areas.  All of these hazards must be overcome when every second counts to save a patient fighting for his or her life.

A night medical helicopter flight is a varsity event.  However, in all of the recent EMS helicopter crashes, the crew was composed of only one pilot and two medical crew members.  Virtually across the board, U. S.‑based medical helicopter operations use a three‑person crew with one pilot and no dedicated aerial observer.  These pilots are predominately scheduled on a standby status, meaning they only fly if there is an actual EMS call.  Proper risk mitigation necessitates that night medical flights be multi‑piloted and flown with night vision devices to the maximum extent possible.  Flying medical helicopters single‑piloted at night exposes patients and flight crews to needless danger.  This unsafe practice needs to cease immediately.

Tragically, patients, flight crews, and/or their families can encounter unjust legal hurdles when seeking justice after a crash or fatal event.  Flight crew, patients, and their families do have several legal options.  At Bailey & Partners, we leave no stone unturned when finding liability and seeking maximum compensation for the injured persons and family members we represent.

By F. Phillip Peche, attorney at Bailey & Partners.


[1].  SkyLife crash in California on 12/10/15 killing three crew members and one patient; Air Methods crash on 12/15/15 in Arizona killing the three crew members; and most recently, a Haynes Life Flight crash on 3/26/16 in Alabama killing three crew members and one patient.

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