Concerns over EMS air safety

WASHINGTON — An accident this week in Arkansas has boosted to 21 the number of people who have been killed this year in medical helicopter and plane crashes, renewing concerns about the safety of such operations.

"This is very alarming," National Transportation Safety Board member Robert Sumwalt said in an interview. "The safety board continues to be very concerned about the safety of this industry."

An Air Evac Lifeteam helicopter crashed Tuesday near Scotland, Ark., killing the pilot, a nurse and a paramedic. It was the fourth fatal accident this summer: A medical helicopter crash in Tucson, Ariz., killed three people on July 28; a crash near Kingfisher, Okla., on July 22 killed two people and seriously injured a third; and an air ambulance plane crashed July 4 in Alpine, Texas, killing five.

The number of deaths represents a sharp spike from last year, when six people were killed in one plane and nine helicopter accidents. There were 28 people killed in 2008 in EMS helicopter crashes, the most medical helicopter fatalities in any year, according to NTSB records dating back to 2000. Thirty-one people were killed in 2004 in a combination of medical helicopter and plane accidents, the most deaths in a year in the air medical industry in the last decade, NTSB records show.

The increase in accidents and fatalities reflects, in part, the growth in the emergency medical transport industry, which took off in the early 1980s. Today, there are about 800 helicopters and about 150 planes, according to an industry trade organization.

Sumwalt said he is concerned that the Federal Aviation Administration hasn't implemented numerous NTSB recommendations aimed at increasing the safety of the air medical industry. The board made a series of recommendations to the FAA in 2006, and then moved the recommendations to their "most wanted list" of safety improvements in 2008. Last year, Sumwalt chaired a three-day public hearing on the issue. That resulted in about 30 more recommendations.

FAA officials told Congress in April 2009 that the agency would propose new regulations addressing the safety issues by early this year.

The board wants the FAA to require EMS helicopter operators to install Terrain Awareness Warning Systems, or TAWS, on helicopters. The system warns pilots when helicopters are in danger of crashing into the ground, mountains or tall buildings.

Another recommendation is that EMS flights that carry only medical personnel, like the one in Arkansas, to follow the more stringent safety rules that apply to flights carrying patients and organs for donation.

NTSB also wants a formal evaluation be conducted before an EMS flight to determine if the flight is too risky.