US Civil Helicopter Emergency Medical Services Accident Analysis

1. Federal Aviation Administration US Civil Helicopter Emergency Medical Services Accident Analysis Presentation to: International Helicopter Safety Symposium Name: Matthew Rigsby Date: September 26 –29, 2005

2. FAA Aviation Safety (AVS) Rotorcraft Directorate Standards Staff, Safety Management Group - ASW112, Southwest Region • We are part of the service arm of the FAA family involved in the certification of new helicopters, modifications to and continued operational safety of existing helicopters. • Our mission is to provide the safest, most efficient aerospace system in the world. • Our vision is to continually improve the safety and efficiency of aviation, while being responsive to our customers and accountable to the public. • Our values are based on a passion for Safety, Quality, Integrity, and People. International Helicopter Safety Symposium September 26-29, 2005

3. FAA EMS Task Force Preliminary Findings • The number of Helicopter Emergency Medical Service (HEMS) accidents have risen dramatically in recent years. In August 2004, an AVS task force was assembled to review these accidents, to determine causal factors and make recommendations to reduce them. • Initial review shows that controlled flight into terrain, night operations, inadvertent IMC, andlack of operational control are predominant factors in the reviewed accidents. • The majority of these accidents occurred beyond the geographic boundaries of the Certificate Holding District Office (CHDO).

4. U.S. Civil Type Certificated Rotorcraft Accidents January 1998 – August 2005 Civil Rotorcraft Accidents: 1998 1999 2000 2001 2002 2003 2004 2005* Civil rotorcraft accidents: 166 172 182 177 192 207 171 120 Civil Fatal rotorcraft accidents: 29 27 33 28 24 37 30 10 Operation Types: External Load (Part 133): 12 12 11 9 8 13 5 2 Restricted Category (predominately Part 137): 25 25 25 14 14 19 11 9 Air Medical (Part 91/135): 7 10 12 10 13 18 13 9 Gulf of Mexico (Part 91/135): 3 9 9 8 6 16 10 6 Air Tour Operators(Part 135): 2 4 5 5 5 6 4 4 2003 - 2005 Rotorcraft Wire Strikes:11 9 7 Fatal Wire Strikes 2 2 1 Occurred during IMC 0 0 0 Data Sources: FAA, NTSB, HAI, and HSAC * 2005 Data through Aug. 31, 2005

5. Estimated Flight Hours Flown by EMS Operators “The airport runway is the Most important mainstream In any town.” -Norm Crabtree Data: Steve Ludwig, CJ Systems HAI presentation AMPA Nov 2002 & Multiple Sources

6. US Civil Accidents Compared to HEMS Accidents 1995 -2004

7. US Civil Fatal Accidents Compared to Fatal HEMS Accidents 1995 -2004

8. HEMS US Rotorcraft Accidents 98’ – 04’ Total HEMS accidents from Jan 1998 – Dec 2004 85 Total HEMS Fatal Accidents 98-0427 Total Fatalities 74 Total Night HEMS Accidents 45 Total Night Fatal Accidents21 HEMS Accidents Involving Part 91 Operations(18 fatal) 59 HEMS Accidents Involving Part 135 Operations(9 fatal) 26 HEMS Fatal Accidents VFR into IMC 11 Twins 7 Singles 4 HEMS Fatal Accidents IFR in IFR 1 Data source: FAA EMS Task Force Analysis

9. 2004 HEMS US Rotorcraft Accidents • All fatal accidents in VFR only aircraft. (3 B-407’s, 1 B-206, 1 BO-105, 1 AS-350) • None were equipped or using enhanced vision systems or terrain awareness warning system. • All the HEMS fatal accidents occurred at night. • Five of six of the fatal accidents appear to have CFIT characteristics. • None of the programs with fatalities are CAMTS accredited. • VFR only programs are the largest growth segment of the HEMS industry

10. International Helicopter Safety Symposium A quote heard several times at a recent air medical conference: “….. EMS is the only commercial carrier where the passengers, may have no choice in whom transports them…..” Why We are Here!!

11. “The airport runway is the Most important mainstream In any town.” -Norm Crabtree Pyote, TX March 2004 4 Fatal

12. Evansville, IN April 2004 1 Fatal

13. Newberry, SC July 2004 4 Fatal

14. Battle Mt., NV 2004 5 Fatal

15. Santa Rosa, FL October 2004 3 Fatal

16. Apache Junction, AZ. 1 Fatal

17. How the Helicopter Emergency Medical Services (HEMS) Community has Grown • From the mid 1990’s to present, HEMS increased +100% • Currently, there are approximately 660 RW aircraft flying HEMS, • that number is increasing daily. • Estimates of +300,000/hrs annually. • Approximately 300,000 patients transported annually. • An EMS aircraft takes off every 90 seconds in the United States. • No formal method of tracking, hours, missions, usage. • Single engine, non-IFR certified a/c is where HEMS is going. • HEMS medical is changing to the “Independent Provider” model.

19. FAA EMS Task Force Initial Recommendations • Industry cooperation and participation is critical to resolving the • issues. • Joint FAA/Industry working group for accident root cause • analysis and Intervention Strategies. • Apply System Safety Risk Management principles to HEMS • operations. • Improve FAA oversight/knowledge. • Approved Enhanced Vision programs. • Investigate technology enhancements. (Aircraft & Infrastructure) • FAA/Industry Part 135 Aviation Rulemaking Committee (ARC). • Enhanced training and pilot pool.

20. FAA EMS Task Force Initial Initiatives • Developed Helicopter Air Ambulance Accident Analysis and • Recommendations (Remains in Draft) • Received support from Mgr Flight Standards (AFS-1) to partner • with the air medical community to resolve HEMS issues and • reduce the number of Accidents. • Developed & Released Flight Standards Notice 8000.293; • Helicopter Emergency Medical Services operations • Participate in Air Medical Community Working Groups. • Air Medical Transport Conference • AAMEs Safety Committee & HAI Air Medical Committee • AAME’s NVG Safety Symposium • Air Medical Safety Advisory Committee (AMSAC)

21. On-going FAA EMS Task Force Activities • Continue cooperation and development of intervention strategies • with the EMS community. • EMS Task Force developing example Risk Assessment tools. • AAMS NVG Symposium, FAA / Industry Participation • Complete Air Medical Resource Management Advisory Circular. • Completed Risk Management Notice 8000.301. • Participate in the AMTC conference, FAA System Safety Risk Mgt. • presentations. • Complete a review of HEMS VFR Operations Specification A021(c) • weather requirements. • Complete a Notice for Controlled Flight Into Terrain (CFIT) accident • avoidance.

22. On-going FAA EMS Task Force Activities (cont’d) • Complete a Notice for Loss of Control Accident Avoidance. • Decision-making training • Emergency IFR Recovery Procedures • Qualifications/Checking • Based on existing aircraft equipment and technology • Complete a Notice for Part 142 Training Centers which Conduct • training for HEMS Operators. • Risk Assessment • CFIT Accident Avoidance • Loss Of Control Accident Avoidance

23. 2005 Jan - Aug HEMS Accidents • EC-135- N135NW; Native Air/Omni Flight- Maintenance, lower right lateral • control link bolt came out in flight. Two pilots on-board, non-fatal. • AS-350D – N350RM, Air Methods. The pilot fatal. • EC-135 – N136LN, Air Methods, Aircraft over the Potomac River below 200ft, • impacted the water unknown circumstances. Pilot and Flight Nurse fatal, • paramedic survived. • AS-350B3 – N351LG, PHI Air Medical, Reposition flight under NVGs • pilot became disorientated and impacted terrain. Pilot non-fatal. • B206L-1 – N5734M, Air Evac Lifeteam, Aircraft spun on departure, impacted • terrain hard. Patient fatal. • A119 – N403CF, Tri-State Care Flight, on approach, rapid decent witnessed, • impacted terrain hard. Pilot, paramedic, and flight nurse fatal. • * The information herein is preliminary

24. 2005 Jan - Aug HEMS Accidents • BK117B-2 - N440HH; Hermann Hospital- Airframe component (door) failure. • flight. No injuries. • AS-365N – N365S, CJ Systems, loss of “tail rotor” control, impacted heliport • rolled over. No injuries. • BK117B-1 – N117US, CJ Systems, No. 1 engine lost power, on landing • rolled over. No injuries. • * The information herein is preliminary

25. Questions?

26. Contact Information matthew.rigsby@faa.gov or Southwest Region Aircraft Certification Helicopter Directorate Safety Management Group 9-ASW-ROTOR-SAFE@faa.gov