Medical Helicopter Safety

Yesterday’s Washington Post carries an article on the medical helicopter industry: “The Deadly Cost of Swooping In to Save a Life”. A few interesting excerpts:

  • a medevac helicopter pilot has a 113/100,000 chance of dying each year; the Post reporter compares this to 80 for an “airline pilot”. This is clearly a mistake given that scheduled airline crashes are infrequent. Probably the 80/100,000 figure refers to all commercial pilots (the Bureau of Transportation Statistics says that there are approximately 800,000 airline flights each month in the U.S. (source); to kill off 80 airline pilots per year you’d need to have 7 pilots die each month or 3.5 airliner crashes per month (two pilots per airplane); the NTSB shows that the actual number is more like 3 per year (source)).
  • “With a population of 4.2 million, Kentucky has 26 medical helicopters — more than many nations. Canada, which is about nine times as large with a population of 33 million, has 20. It has never suffered a fatal crash.”
  • Medicare pays $220 million per year for medevac flights

My personal theory about safety in this industry is that it could be significantly enhanced if pilots had the “Microsoft Flight Simulator” view on a big LCD screen in the instrument panel. When a helicopter goes into the clouds it is usually close to terrain and radio towers and the pilots weren’t expecting to fly on instruments. That is a completely different task than going airport-to-airport on a planned IFR flight in an airplane. The typical medevac helicopter, even if equipped for instrument flight, has basically the same instruments that an airplane from World War II had (plus a moving-map GPS, which does not help the pilot keep the helicopter under control). Thanks to the miracle of government regulation, the Microsoft Flight Simulator view costs a kid $28, the pilot of a Garmin G1000-equipped four-seat piston airplane about $10,000 and maybe $50,000 to install in the panel of most helicopters.

4 thoughts on “Medical Helicopter Safety

  1. Obviously the cost is higher due to regulation, but where do we draw the line as to what is acceptable? If Microsoft gets some terrain or obstruction wrong in flight simulator, it is hardly a big deal. However, if a pilot flies into a mountain or radio tower in IMC because the virtual terrain screen showed the obstruction being somewhere else, there would be hell to pay all around.

    In your opinion, what is an acceptable amount more to pay for the certification that everything is correct? Using $100 as the baseline (cost of Microsoft flight simulator plus tying it into a simple GPS), would $500 (5x as much) be an acceptable cost for the regulatory guarantee? $1000 (10x)? Sure $10,000 (100x) seems like a lot, but for the reliability and correctness guarantee, it doesn’t seem to be in the wrong ballpark for what one would expect to pay.

    Just my opinion.

  2. Joshua: Implicit in your comment is the assumption is that filing a few notebooks worth of paperwork with the government guarantees reliability or correctness. There are plenty of certified aircraft that contain horrifying design flaws, some of which do lead to accidents. The Wild West of kit airplanes certainly suffers from even more problems with design and construction, but at least when it comes to electronics it seems doubtful that the regulatory process and American tort system makes things safer. By making modern avionics prohibitively expensive, these drags on innovation ensure that many commercial operators will continue to fly with 1950s or 1970s technology (I looked into a medevac jet air ambulance the other day and was confronted with a panel full of small round dials).

    Remember that a guy who owns a Cessna worth $50,000 is not going to be able to justify the $60-90,000 that it costs to install a modern certified panel. The certified instruments in his 1970s Cessna include a vacuum-driven attitude indicator that will stop giving him correct information as soon as its mechanical bits fail or when the notoriously failure-prone vacuum pump (attached to the engine) fails. The vacuum pump and the mechanical gyro were certified by the FAA despite the fact that failures within 500 hours of operation are common.

  3. Having flown the G1000 with Synthetic Vision (SVT), it certainly helps in situational awareness, but I wouldn’t use it tactically at low altitude for obstacle avoidance. It would be like using XM / Nexrad to navigate through thunderstorms instead of onboard RADAR. Enhanced visibility (FLIR, night vision goggles, etc.) that doesn’t rely on a database would be much better.

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