Ambulances & Vehicle Ops, News, Operations

New Rules for Medical Flights

CHATTANOOGA, Tenn. — The collision that killed six people on two medical helicopters in Arizona on Sunday comes in the wake of similar crashes and should raise questions about the safety of the rapidly growing industry. The crash was the sixth since May and the ninth of the year involving emergency helicopters. Sixteen people have been killed in the crashes — 13 since May.

Crashes involving medical aircraft have been rising since the 1990s when the business began a rapid expansion. The growth was propelled in large part by the closing of emergency rooms and hospitals in rural areas and by an aging population that requires more emergency services. The chance to make a profit played a role, too. Medical helicopters help meet all those needs.

Chattanooga and the surrounding region are part of the growth. Both Erlanger and Memorial hospitals rely on helicopters to bring patients to their doors. Erlanger operated its own service for years but recently contracted with Med-Trans Corp. to operate its service. Memorial has been in the business for a shorter period. It does not have a contract with a single service. Its air service is provided by six carriers, according to a hospital spokeswoman.

Medical helicopters are big business. The National Transportation Safety Board says that there are about 800 medical helicopters currently operating in the United States. That’s double the number of less than a decade ago. Improved safety, though, has not accompanied industry growth. A reduction in the accident rate has remained elusive.

Mark Rosenker, chairman of the NTSB, says his agency is “greatly concerned” about the number of recent crashes. That concern is long-standing. The board first initiated investigations of industry safety after an alarming number of accidents in 2004 and 2005.

The ensuing report, issued in 2006, faulted operators for many of the problems and called for a variety of improvements, including stricter flight rules, better accident-avoidance equipment and the use of night goggles. The federal Aviation Administration accepted all of the NTSB recommendations about medical helicopters, but Mr. Rosenker says not all have been put into effect.

That seems likely to change soon. An FAA spokeswoman says the recent crashes had raised “attention and concern” at the agency. More regulations likely will be forthcoming to promote air safety. Better late than never.

Many providers of emergency air medical service meet or exceed current safety requirements, but others do not and are unlikely to do so without the force of law.

The helicopters operated by Med-Trans Corp. for Erlanger are equipped with systems to warn of approaching terrain and to monitor positions of other aircraft. Its pilots are equipped with night goggles — another NTSB recommendation. A spokeswoman for Air Evac, a company that frequently services Memorial, says its aircraft are similarly equipped. That should provide assurance to area residents who might use a local hospital’s air ambulance service in the future.

Even so, growing concern about the safety of medical helicopters is warranted. The NTSB reports that the accident rate for emergency helicopters is far higher than for commercial aviation. That’s unacceptable. Tighter regulation and more stringent rules are required. Without them, the number of people killed on what are supposed to be missions to save lives will remain far too hig