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Although they have saved thousands of lives, the medical choppers that rescue and transport patients have also claimed the lives of hundreds of crew members in the past 29 years. The $2.5-billion-dollar private industry often pressures inadequately supplied pilots to fly under dangerous conditions, according to a Washington Post investigation published online today.

A ride in a medical helicopter can cost as much as $20,000, much of which goes to the copter company, so pilots are pressured to give lifts to as many patients as possible. And the industry is growing rapidly. In 1980, the Post reports, the U.S. had about 40 medical helicopters. That number has grown to more than 800 today, with many states having more than 40.

But unlike commercial airplane flights, these helicopters are not required to have some of the basics, such as collision-avoidance systems, radar altimeters or black boxes, the Post reports. And even though a majority of deadly accidents happen at night, fewer than half of helicopters have night-vision goggles for pilots. One Florida-based pilot told the Post: "I'm hoping we will get them before long. Because a lot of the areas we fly are dark, it would be a great help."

As underscored by the fatal tourist helicopter crash earlier this month over the Hudson River in airspace between Manhattan and New Jersey, helicopters of all sorts frequently take low-altitude and hazardous routes that can be congested with other aircraft.

The Federal Aviation Administration (FAA) doles out relatively low fines to the industry when accidents do occur. "I'd rather use a carrot than a hammer," John Allen, the FAA director for flight safety standards, told the paper. The agency has refrained from creating sweeping regulatory changes for these companies. As Allen told the Post, when the FAA "starts asking for data from the industry, they get very nervous."

Basics, such as flying hours and pilot fatigue, have proved difficult for the FAA to investigate. "You don't have to be a math wizard to understand that missions equal revenue, and revenue equals survivability in the air business," Randy Layman, a ground coordinator for a fatal 2004 chopper flight, told the paper.

And income isn't confined to the helicopter companies. "A patient flown in by helicopter can mean thousands of dollars in downstream revenue" for the hospital where the person is admitted, Paul Taheri, of the University of Vermont, who wrote a paper on the subject, told the Post. "That fact is not lost on hospital administrators." Neither does it appear to be lost on the emergency dispatchers who often select which helicopter company is called to the scene.

Despite the occasional rap for being hovering hazards, medical helicopters are frequently symbols of rescue and heroics, which improves the images—if not the bottom lines—of all involved, notes the Post. "It's the equivalent of a medical centerfold," Thomas Judge, executive director of a Maine helicopter company, told the paper. "It's sexy advertising." 

Image courtesy of audreyjm529 via Flickr

6 Comments

1. 1. quincykim 05:32 PM 8/21/09

   I'm puzzled by the reference to the Hudson River accident, which was a midair during daylight in a VFR corridor. I don't believe midairs are a prime source of HEMS accidents, day or night. Perhaps I'm wrong in that, but it seems out of place, like they wanted to tie in the most recent famous helicopter accident with this article, regardless of relevance.
   
   

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2. 2. j.quasimodo 07:06 AM 8/22/09

   This is "Scientific" American, which apparently applies the science of dragging in readers with sensationalism. But they're out of their league; the National Enquirer applies that science much more effectively. But "eyeballs"="ad revenue" in the e-mag business, and you did read it, didn't you.
   

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3. 3. jbairddo 09:17 AM 8/22/09

   You know what I hate? When a writer of a supposed scientific journal starts an article with a phrase that is neither verifiable or referenced. Katherine Harmon makes use of the same BS that is rife in all discussions of our current medical system (i.e.-our system is must be good because we are Americans-regardless of the cost). "Although they have saved thousands of lives..." is not referenced, and probably is more opinion than fact. Go to Google scholar and type in "medical helicopter survival data" and few articles would tend to support this assertion. There is just no overwhelming data to support this statement. Most patients who were flown out of or rural ER were do to "standard of care" issues and lawsuits. Many trauma patients were flown out before they were even worked up due to the risk of a family suing for a bad result even if nothing could be done. Chronic congestive heart failure was another condition which kept the air guys busy and never changed how the patient would have been managed, but the standard of care says you need a cardiologist and medical boards are vindictive bastards (so call an airplane for an hour trip to Phoenix-but a ground ambulance was often more expensive, who would have thought). And while we will never no how many lives have been saved, we do know that when a life flight crashes, that patient is dead so we can count that number.

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4. 4. brynn217 07:40 PM 8/23/09

   Ok.. last year we had a resuce copter crash in this area, Baltimore/Washington... So the source of the orginal data coming from the Washington Post is a result of the Maryland investigation on that crash since 6 people died including the 2 passengers of a car crash that had been picked up... FYI- the Investigation here said the crash was caused by malfunctioning equipment that HAD BEEN previously reported to the company and not fixed...
   
   In any case, the FCC needs to step in and do something... To allow these crafts to fly with no required federal inspections or certifications or pilots not to be up to date on training, sleep or even DUI's is a problem... My sister-in-law in one the the medics who fly and she and her crew works a regular shift of 3 24's a week...
   
   James
   

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5. 5. brynn217 07:40 PM 8/23/09

   Ok.. last year we had a resuce copter crash in this area, Baltimore/Washington... So the source of the orginal data coming from the Washington Post is a result of the Maryland investigation on that crash since 6 people died including the 2 passengers of a car crash that had been picked up... FYI- the Investigation here said the crash was caused by malfunctioning equipment that HAD BEEN previously reported to the company and not fixed...
   
   In any case, the FCC needs to step in and do something... To allow these crafts to fly with no required federal inspections or certifications or pilots not to be up to date on training, sleep or even DUI's is a problem... My sister-in-law in one the the medics who fly and she and her crew works a regular shift of 3 24's a week...
   
   James
   

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6. 6. Surtur 12:51 AM 8/24/09

   As a retired law enforcement officer in a rural area, I have assisted in over a hundred Life Flights. The majority were due to either requirements for specialized trauma care, or specialized medical care not available locally. None of these flights ended in misfortune, and the crews I saw were always sharp and brisk. This article paints with a broad brush, and stains the professionalism of the whole with the misdeeds of a few.

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