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A closer look at safety

Trend in crashes spurs nationwide NTSB air ambulance investigation

Christine Metz

— The Yampa Valley Air Ambulance crash is among 12 medical flight crashes in the past 12 months. Thirty-seven people, including three Steamboat Springs medical personnel, died in those accidents.

The National Transportation Safety Board is launching a nationwide study to better understand what’s behind the rash of accidents.

“We are looking for a common thread behind all the accidents, something we can learn to pass along to the industry to make it safer,” said David Bowling, NTSB regional director.

The common threads the NTSB has found so far are nighttime flying and bad weather, said NTSB spokeswoman Lauren Peduzzi.

Both of those factors were present when the Yampa Valley Air Ambulance crashed Jan. 11. The plane went down at about 9:45 p.m. near Rawlins, Wyo. It had been snowing periodically throughout the region on the night of the crash.

The flight crew left Steamboat and was en route to pick up a patient from the Carbon County Hospital in Rawlins and transport the patient to Casper. Pilot Tim Benway, 35, was killed in the crash. Also killed were air ambulance director and flight nurse Dave Linner, 36, and flight nurse Jennifer Wells, 30.

The sole survivor of the crash — Tim Baldwin, a 35-year-old emergency medical technician — remains in fair condition at Poudre Valley Hospital in Fort Collins. Baldwin has not discussed the crash with the media.

In its preliminary investigation, the NTSB found ice on the wings, tail, landing gear tires and propellers of the plane. The ongoing investigation is not complete, but Bowling said the ice and weather likely were factors.

2003 crash

This is the second time in less than two years that a Yampa Valley Air Ambulance has crashed. In March 2003, the air ambulance went down near Kremmling. The three people in that crash, including Linner, walked away with minor injuries. Pilot error was blamed for the Kremmling crash, and the pilot was terminated.

The Jan. 11 crash has prompted the NTSB to re-examine the 2003 incident, Bowling said. He plans to reinterview Dolores Gigliotti, a flight paramedic in the 2003 crash, about Mountain Flight Service’s operations.

Mount Flight Service, owned and operated by Bob and Cindy Maddox of Steamboat Springs, operates the air ambulance under a contract with Yampa Valley Medical Center, which provides the medical personnel for the flights. Bob Maddox also is chairman of the hospital’s board of trustees.

The NTSB’s report on the 2003 crash noted that the pilot saw the airport, but it was very dark and he could not see the terrain. He suddenly saw the ground and hit an 8,489-foot mountain ridge. The plane landed upside down and was destroyed. The pilot said the plane had experienced no malfunctions before the accident.

The NTSB already has questioned Gigliotti extensively, who last year expressed concerns about Mountain Flight Service’s operational practices and the Federal Aviation Administration’s oversight of the operator, an FAA case summary indicated.

Those concerns led to an inspection of Mountain Flight Service, which found that pilot certification and manuals were not up to date. The company agreed to correct the problems, the FAA reported.

Because of Mountain Flight Service’s “willingness to cooperate and prompt correction of the issues,” the FAA decided not to take any action other than to issue a letter of correction.

Air ambulance future

No decisions have been made about the future of air ambulance service in Steamboat Springs. Yampa Valley Medical Center CEO Karl Gills said the hospital will discuss the issue in the near future, but that the hospital’s focus has been on remembering the friends and coworkers who lost their lives in the crash.

Gills and Bob Maddox said safety is always a top priority for the air ambulance service. Gills said Mountain Flight Service reviewed its polices and procedures after the 2003 crash.

“Safety will certainly be part of the decision, as it was after the 2003 incident,” Gills said.

Before the Jan. 11 crash, Gills said the air ambulance program was preparing for a visit in February from the Commission on Accreditation of Medical Transport Systems. The flight crew thought the program was on target to receive that accreditation, which would have been one more seal of approval, Gills said.

Sense of urgency

One of the NTSB’s concerns is the sense of urgency that comes with medial flights, Bowling said. In its investigations, the NTSB looks at flight service operations, what preflight services were used, what services were available and what the Federal Aviation Administration could provide.

Similar to other air ambulance programs, Gills said YVMC’s policy is to tell the pilot only that he is about to fly a medical mission and the destination.

“The pilot is not aware of the patient’s condition and consequently that doesn’t play into the decision,” Gills said.

Maddox said his pilots, including Benway, have turned down flights because of the dangers they pose. Maddox turned down a flight to Rawlins the week before the Jan. 11 crash because he thought the weather was too dangerous.

“We tell pilots we feel they earn their pay checks when they make the decision it is not safe to conduct a flight,” Maddox said. “It takes a lot of courage to do that.”

Maddox said there was no indication that weather was a threat Jan. 11. Three different pilots, including Maddox, reviewed the information Benway had before flying to Rawlins. All said they would have made the trip.

Maddox also said an air ambulance crew from Casper, Wyo., had been en route to Rawlins before getting dispatched to another call. Maddox said the Casper flight crew indicated there was not severe weather in the area.

“It was nothing we saw. Nothing we predicted. Nothing we could discern from the information we had,” Maddox said.

Better reporting

Bowling noted that one of the recommendations coming from the nationwide study could be to improve the weather reporting systems in rural areas. Many medical helicopters and planes take patients from rural areas to metro trauma and specialty centers. The areas where they fly don’t have the radar and weather observation of more urban areas.

“The air ambulance crew could have flown into something they might not have known was there,” Bowling said. “For people in the industry, that is quite alarming.”

Maddox said his pilots have made many successful missions with the charts and information available to them.

“It you are going to be in a position to go help communities move patients, you have to work with the stuff that is available in those communities,” Gills said.

Clear benefits

Even in the face of the rash of fatal accidents, the benefits of having air ambulance service are clear, many say.

“The air ambulance industry produces very important services,” Bowling said. “It is something that definitely should not go away.”

Last year, 135 YVMC patients were flown from the hospital, and Mountain Flight Service has flown more than 1,200 missions since beginning its operations.

Having a medical flight service based in Steamboat Springs has saved lives, Gills said. The hospital has the flight crew on hand and can prepare patients for flight and have them at the airport in minutes. That can help ensure patients reach specialists within the critical “Golden Hour” of trauma care –the time period in which the lives of a majority of critically injured trauma patients can be saved if they receive proper care.

Without the local air ambulance, Gills said, significant time would be added to the transportation. The hospital would have to dispatch a plane or helicopter from the Front Range or Grand Junction. The flight crew would then fly into the Hayden or Steamboat airports, be taken to the hospital, prepare the patient for transport and return to the airport for flight.

The time difference between using an air ambulance based in Steamboat and using one dispatched from the Front Range or Grand Junction depends on the case, Gills said.

“The fact is, getting patients out of Steamboat faster and to specialty hospitals and trauma centers has without a doubt made a significant difference in patients’ outcomes,” he said.

As Maddox watched the outpouring of sympathy that came from air ambulance crews and EMS workers throughout Colorado and Wyoming after the deaths of the flight crews, he recognized the importance it plays in Northwest Colorado.

“Air ambulance (work) is far and away the most rewarding and satisfying,” he said. “What you do in the airplane … unbelievable things. Such miracles happen on airplanes. People’s lives are much better off.”


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