By Gilbert M. Gaul and Mary Pat Flaherty
Washington Post Staff Writers
Friday, August 21, 2009
SANTA ROSA BEACH, Fla. Shortly after midnight on a storm-swept October
night in 2004, Tom Palcic, a medical helicopter pilot, started across
Choctawatchee Bay to pick up a hospital patient and transport him to a
facility 60 miles away.
Such flights are common in the highly competitive multibillion-dollar
air-medical business. Although the public profile of medical
helicopters has them swooping to crash scenes at the edge of highways,
most flights, like Palcic's, involve shuttling patients between
The director of the helicopter program for which Palcic flew called
these lucrative patients "golden trout" and pushed pilots to reel in
as many as possible. When pilots balked at flying in bad weather, he
called them sissies and second-guessed them, records and interviews
Palcic, 63, was just two minutes into the flight of AIRHeart-1 when
his crew radioed a dispatcher that he was turning back because of the
thunder and lightning.
Moments later, Palcic's helicopter banked in clouds and plunged 700
feet into shallow waters, killing him, a flight nurse and a paramedic.
A woman who lived nearby recalled that the vibration shook
candlesticks out of their holders.
For the medical helicopter industry, it was the fourth fatal crash
that year -- part of a legacy that has claimed the lives of 211 crew
members and 27 patients since 1980 and injured many others, The
Washington Post has found.
The number of fatal flights has risen sharply, closely tracking the
rapid growth of what is now a $2.5 billion industry. Nearly half of
all deaths have occurred in the past decade. In 2008, the deadliest
year ever, 23 crew members and five patients were killed.
Some calamities were the result of pilot errors. But many were
predictable, pilots and safety experts say, and could have been
prevented with stronger oversight and better technology.
"We've been killing ourselves the same way for 20 years," said veteran
pilot Ed MacDonald. "There's not a whole lot new about these crashes."
What began almost four decades ago as a way to save lives is now one
of the most dangerous jobs in America -- deadlier than logging, mining
or police work -- with 113 deaths for every 100,000 employees, The
Post found. Only working on a fishing boat is riskier. The rate for
airline pilots is 80.1.
In the 37 years helicopters have been used to transport patients,
pilots and crews have died in an almost unfathomable array of crashes.
In the past two years alone, medical helicopters have dropped into
pitch-black oceans, plummeted to the ground after losing rotor blades,
smacked into mountains and collided in clear blue desert skies.
Yet as crashes and deaths have mounted, top executives at the Federal
Aviation Administration and its parent agency, the U.S. Transportation
Department, have acted as partners with the industry, issuing reams of
voluntary safety advisories with little follow-up. The FAA has sent
poorly trained inspectors to monitor operators and used fines and
penalties as only a last resort.
"I'd rather use a carrot than a hammer," said John M. Allen, the FAA's
director of flight safety standards. "It's not like we do nothing and
then smack them with a rule."
Allen said the agency has to balance business and safety. "Even one
crash is too many," he said. "But there's a fine line on how far does
government go to impact business."
Private, for-profit companies dominate the industry, with about 830
medical helicopters vying for patients. The number of aircraft has
doubled every decade since 1980, leaving some firms with fleets as
large as those of US Airways or JetBlue. Yet medical helicopters are
permitted to operate without basic safety features that commercial
flights must carry, such as black box recorders, collision-avoidance
systems and radar altimeters.
Unlike an airliner, a medical helicopter does not fly a direct route
from one airport to another, seamlessly tracked by radar. Most flights
are at low altitude. There might or might not be an established
Because of their low flight paths, helicopters are especially
vulnerable to rapid changes in weather. Most flights are made under
visual flight rules, with the pilot using his eyes to pick through
clouds and around obstacles, and often are to out-of-the-way accident
scenes. Unlike commercial airline trips, only a fraction of helicopter
flights are conducted under instrument flight rules, which make it
easier to travel in inclement weather.
More than half of fatal crashes occur at night, but only one-third of
medical helicopter pilots are equipped with night-vision goggles to
help them avoid power lines, towers and other obstructions.
Industry officials are well aware of the risks, noting in public
statements that medical flights are inherently dangerous. They
emphasize the thousands of patients they safely transport each year
and the many lives that have been saved. They also say helicopters are
critical in rural areas.
Although the industry has not advocated for a specific federal safety
requirement, companies have made individual improvements and supported
voluntary guidelines, said Christopher Eastlee, a spokesman for the
Air Medical Operators Association.
The accidents last year "lend themselves to safety concern in the
industry, but I don't think that translates into a safety problem,"
said Eastlee, whose group represents more than 90 percent of the
industry, which is dominated by five private companies and dozens of
Industry officials have been slow to adopt safety technologies until
recently and urged more studies, citing the expense and readiness of
the equipment. Operators also have successfully sued state regulators
who tried to restrict the number of helicopters in their areas based
on a community's medical need.
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These copters and their crew are hazardous to a patient's future!
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