The air-ambulance helicopter industry has jumbled oversight and poor organization that led to safety problems and a record number of fatalities last year, according to a safety review released Monday.
The report released by the Flight Safety Foundation, a research group, identifies eight "very high" risks within the industry and 18 factors it labels "high" risks.
Unlike the airline industry, which is a highly regulated business, air-ambulance companies are overseen by a patchwork of state and federal agencies that overlap or leave some areas untended, the report says.
The industry has so many different styles of operation -- from government-run programs to fiercely competitive for-profit businesses -- that regulation and standardization is difficult, the report says.
The report comes as tensions are brewing within an industry that is in the spotlight for a record spate of crashes. After nine crashes killed 35 people from December 2007 to last October, the National Transportation Safety Board held a public hearing to address the problem. Six patients were among the dead during that period.
The author of the study released Monday, Kimberley Turner, CEO of Aerosafe Risk Management, said that some unnamed air-ambulance companies had objected to the report. As a result, manufacturer Bell Helicopter, which paid for the report, was not a part of its release.
The Federal Aviation Administration, which regulates the industry's flight operations, issued a statement saying it welcomed the report. "It confirms what we believe: Reducing risk in helicopter EMS operations demands a systematic approach," the statement says.
The report was released prior to a congressional hearing scheduled for Wednesday on industry safety issues and two competing bills to reform the industry.
Many small and medium-size air-ambulance companies support a bill that would give states more authority to regulate medevac companies, limiting the number of bases and controlling competition.
"I'm no longer convinced that voluntary (reforms) will work," said Tom Judge, who runs Maine's air-ambulance operation and chairs the Patient First Air Medical Transport Alliance.
Larger companies, represented by the Air Medical Operators Association, object to the measure, Managing Director Christopher Eastlee said. "We believe it would result in a patchwork of 50 state regulations, making it extremely difficult to transport patients over state lines," he said.
Turner said the best way to improve safety would be to have hospitals and others in the medical community take a stronger role in demanding improvements and getting the industry to better coordinate its risk-reduction efforts.