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Lax government regulation and fierce competition for customers have created a disincentive for helicopter transport companies to invest in advanced pilot training and safety equipment to protect flight crews, medical personnel and patients from a crash such as the one Wednesday in Aurora, Ill., that killed a 13-month-old girl, the pilot, a nurse and a paramedic, several aviation authorities said.
Adding to the safety problem is the pressure pilots of medical evacuation choppers face when weighing a patient’s dire situation against their own judgment of whether conditions are safe to launch and if there is enough time to adequately plan for flying through dangerous or unfamiliar terrain.
Too often, the result is “a bush pilot mentality” that leads to dangerous flights, said Jim Hall, a former chairman of the National Transportation Safety Board.
While major airline crashes have become extremely rare in the last decade in the U.S., the fatal accident rate for medical helicopters is 6,000 times that of commercial airliners, authorities said.
“There were times when a dispatcher said to me, ’If you don’t fly, the patient will die,’ ” said Patrick Veillette, 48, a corporate pilot in Utah who worked as an emergency medical services pilot for five years. “It is almost impossible to isolate yourself from the patient’s condition, and you really want to save that life. But if I didn’t feel confident that conditions were safe, my answer back always was: ‘One may die, but if we fly four may die.’ ”
The first step to take in improving safety on medical helicopters should be to immediately require two pilots on all medical helicopter flights to end a chain of accidents — 15 so far this year — that stands in epidemic proportions compared to other segments of professional aviation, Hall said.
The National Transportation Safety Board has called on the Federal Aviation Administration to implement reforms over the last decade, including putting two pilots on board the medical choppers and phasing in other safety enhancements.
As is common in the industry, the Bell 222 helicopter that crashed Monday night in Aurora after clipping radio tower equipment was flown by a solo pilot, 69-year-old Delbert Waugh, authorities said. Waugh was responsible for flying the helicopter, navigating both visually and using instruments, communicating by radio with personnel in the copter and air-traffic controllers, and looking out to avoid other aircraft, trees, buildings and other obstacles.
Two pilots are mandated on all commercial airline flights, and the pilot retirement age is 65, recently increased from 60.
“If the public were informed, no one would ever get on one of these medical aircraft,” said Christine Negroni, an aviation safety expert who has compiled a database of medical aviation accidents and incidents over the last 21 years.
Some 193 medical helicopter accidents have been reported during those years, according to statistics recorded by Negroni in the Comprehensive Medical Aviation Services Database, a division of Humanitarian Research Services Inc.
Like Wednesday night’s crash, 90 of the 193 accidents occurred between 10 p.m. and 6 a.m., a period that authorities call the “back side of the clock” when fatigue is often a mitigating factor. In addition, 47 of the accidents involved the helicopters hitting obstacles, according to the database, which is drawn from government and industry records.
“We have seen tragedy after tragedy continuing to occur for a decade and a vacuum of leadership, action or change in culture by the industry or the FAA to promote safety,” said Hall, the former NTSB chairman who is now a consultant with Chicago-based Nolan Law Group.
Aviation safety experts blame the FAA for simply recommending — rather than requiring — sweeping reforms.
The FAA has encouraged medical helicopter operators to voluntarily upgrade pilot risk-assessment training and buy technology such as night-vision goggles and devices that warn pilots about obstacles and terrain.
The helicopter that crashed Monday night was not equipped with any warning system to alert the pilot about the whereabouts of the radio tower, FAA sources said.
Such warning systems contain updatable databases of all obstacles, man-made and natural, and terrain on Earth. The price of such a unit starts at about $15,000.