For years, the National Transportation Safety Board (NTSB) has pushed the Federal Aviation Administration (FAA) to impose tougher regulations on the medical helicopter industry. In 2008 the board placed rules requiring terrain awareness technology, flight and weather tracking systems, and stricter weather minimums at the top of its "most wanted" list of changes to reduce fatalities. The board first recommended these changes three years ago. Had the FAA implemented them, 29 of the last 55 accidents could have been prevented, says NTSB vice chairman Robert Sumwalt. "We want to pressure the FAA to make changes so that these crashes stop occurring," Sumwalt says."We take this as seriously as the NTSB," counters Peggy Gilligan, the FAA's top safety official.
In January, the FAA agreed to make one of the changes, requiring helicopters to fly under the same weather rules whether or not a patient is on board. Other changes are being studied but will come slowly; the agency just released its first, voluntary guidelines regarding terrain awareness systems in December. "We don't feel that the FAA is moving fast enough," Sumwalt says.
In the meantime, some EMS chopper companies are deciding to spend lots of money to prevent what they believe is a common cause of many accidents. Air Methods Corp. of Englewood, Colorado operates 335 aircraft, the largest medical helicopter fleet in the U.S. Last year, the company experienced two fatal crashes in two months. The first accident, in May 2008, may fit the industry's crash profile. The helicopter went down on a night flight to the airport in Madison, Wisconsin, possibly as it encountered rain and fog, according to the transportation safety board's initial report. Three crew members died.
In June, an Air Methods helicopter crashed into another chopper in mid-air on a sunny day over Flagstaff, Arizona, killing seven. Even though the second crash did not fit the pattern, pilots experiencing emergencies when they hit low visibility — which is called "unplanned transition to Instrument Flight Rules" in industry parlance — "is a common theme," says Brian Foster, Air Methods' director of operations.
So the company is spending $30 million to upgrade most of its helicopters with night vision goggles, terrain awareness systems, and technologies that track flight progress and weather. Air Methods will spend another $30 million training its pilots to use the new systems, plus $1 million a year to equip and staff an operational control center that monitors all flights. "We're going above and beyond what the rules require," Foster says.
Should such expensive fixes be required? The FAA thinks not. For years the agency has worked collaboratively with the helicopter EMS industry, looking for ways to improve safety by passing voluntary guidelines and only occasionally resorting to the slow process of imposing new regulations. "We will continue to pursue a very aggressive voluntary campaign," Gilligan says. "Our goal is to identify what we can do quickly together to reduce risk."
All pilots interviewed for this story said they would prefer new FAA rules requiring night vision goggles and instrument flying technology on all medical helicopters. But some worry such rules might force companies out of business. "From a pilot's perspective, it's utopia" to have night vision goggles, says Gary Sizemore, a medical helicopter pilot and former president of the National EMS Pilots Association. "Is that fiscally realistic? I kind of doubt it. It's bad to say that we don't want to spend the money to save people's lives. But the reality is that somebody has to pay for it."
Companies that can't afford to fly safely shouldn't fly at all, some experts say. "I don't want to have the dead bodies keep stacking up and us say, 'Well, regulation costs money so we shouldn't have it,'" says Albert. "In aviation it's safety first and economics second."
As the FAA and NTSB clash this week, Stacey Friedman will fly from her home in Sacramento to attend the safety hearings in Washington. She will tell people that the helicopter her sister was riding in crashed into the Puget Sound in the middle of a heavy storm, that her sister's body was recovered in pieces. She probably will not cry. She has been telling the same story for years. "The industry is supposed to save people," Freidman says, "but actually it's killing people all the time."