Air ambulances often fly into rough terrain in bad weather at night to try to save lives. Those conditions, combined with heavy competition, can contribute to air ambulance helicopter accidents.
Air-ambulance operators, including Centennial Airport-based Air Methods, have been turning to better technology to try to increase safety. Air Methods is the largest air-ambulance operator in the country and has operations in Colorado known as Flight For Life and AirLife. But company officials know the tendency of pilots to fly in unsafe conditions is still a leading cause of accidents.
"We've been struggling with these issues for as long as I've been in this business," said Ed Stockhausen, Air Methods' director of safety. "The reasons we were having accidents 25 years ago are still the same reasons we're having accidents today."
After nearly two years without an accident for Air Methods, three people died in December in the crash of a helicopter based in Victorville, Calif., and operated by Air Methods subsidiary LifeNet Inc.
A Government Accountability Office report released to the public last month drew attention to an industry air-ambulance accident rate higher than historical norms and called for better oversight by the Federal Aviation Administration and more data on the industry's record.
The number of accidents involving air ambulances tripled from 6 in 1998 to 18 in 2003. It declined to 12 in 2004 and 11 in 2005 - still above 1980s levels. The drop may reflect increased industry safety efforts, the report said.
What is unclear is the rate of accidents per flight operation. There is no industry-wide flight-hour data, "making it difficult to determine whether the industry has become more or less safe," the report said.
A National Transportation Safety Board special investigation in 2006 recommended that the Federal Aviation Administration require air ambulance operators to comply with stricter regulations to improve safety.
In an air medical mission, there is a higher risk than other types of flights because of time pressure, operations at night and in bad weather and at impromptu landing sites. "The acceptance of that risk to bring these life-saving services to the communities across the country is absolutely justified," said Air Methods chief executive Aaron Todd.
But the FAA's oversight approach is not geared toward air-ambulance operators, and uses the same set of regulations as it uses for air-taxi services, according to the GAO report.
Air Methods and others in the industry are in the process of putting in new safety systems that follow recommendations from the FAA. The company is also gradually putting in place new technologies including night-vision goggles, although one of the problems is getting the goggles, Stockhausen said. "There's only a few companies that make them and the war effort has taken up a lot of that capability," he said.
Colorado requires licensing
State officials and the air ambulance industry in Colorado are also making efforts to improve safety.
In February 2006, the state started licensing air-ambulance services that operate within Colorado. More than 20 air-ambulance agencies have been licensed.
The efficacy of such licensing programs in improving safety depends on what kinds of resources the state puts behind it to rigorously review applications and enforce rules, said Michael Slack, an Austin attorney specializing in aviation law.
As the industry grows, the GAO and experts say, competition for customers has driven risky practices like helicopter shopping - where an agency calls a company for air-ambulance transport and gets turned down, but then calls another service that accepts, even if conditions are unsafe.
From 2003 to 2005, the number of helicopters used exclusively as air ambulances increased 38 percent, to 753 from 545. The number of locations they operate in increased 30 percent, to 614 from 472, according to the GAO report.
A recent report calls for more FAA oversight and better record keeping as accidents appear to be climbing.
Within 60 days, all operators will be required to use enhanced procedures for flying in challenging weather, at night, and when landing in remote locations.
The new rules would require stricter flight rules and procedures, improved communications and training, and additional on-board safety equipment.
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