Los Angeles, California April 2007
| The development of aeromedical services both in and out of the US is fragmented, unregulated and in many cases dangerous services surface because of the lack of supervision and the enticement fo "quick money" . Health and travel insuracne companies who usually contract with these types of services fail to distinguish between quality and mediocruty because there are no firm ways of double-checking the validity of their information or claims. Besides, these payors, or payers, really want to watch the bottom line and always, approve the 'lowest bid" regardlesss of their quality. And even worse, they have no idea what type of equipment is used or wheteher the medical personnel is properly trained. Being a nurse, paramedic or doctor does not an aeromedical specialist make. It takes traiing, education, exposure to actual situations that could be faced by real crews during aircraft or patient emergencies including being exposed to hypoxic episodes in an altitude chamber. The reason for ALSAM to have taken the many years of experience in this field and translated them into a training manual and taught iit n Castilian Spanish all over Latin America is to reeducate health care providers involved in the coordination, service delivery and or aeromedical operations, in the proper methods of conducting this type of medical transportation. During the various courses taught in Venezuela, Colombia Mexico and other countries where international professionals have opted for our training, we have been able to observe the fallacies and attempted to correct them with our training. But, as would happen in the US, most operators do not want to invest in improving their care or operational methods; rather they spend their time and money in increasing the volume of calls and decreasing the costs by reducing maintenance to a minimum....or as we have seen, delayed it until it became dangerous or even fatal. It is the responsibility of those who call for services to be firm in requesting safety and medical protocol docuementation, medical director's name and experience and the qualifications of the med crew and their related equipment. You'd be surprised how many do not have what is required, like a medical conversion that complies with FAA regulations or the proper equipment to care for the patient..including drugs that have expired. But the real problem, begins with the aviation operator.... Read on: Compared with crowded commercial flights, cushy charters are an $8,000-an-hour trip into airborne luxury--with a startlingly higher chance of dying in a fiery crash.
Forbes magazine. Compared with crowded commercial flights, cushy charters are an $8,000-an-hour trip into airborne luxury--with a startlingly higher chance of dying in a fiery crash.
Louise Babb never knew what killed her. The private jet her family had chartered took the 77-year-old retiree from her home in Marco Island, Fla. to Lexington, Ky. for cancer treatment, but on landing something went horribly wrong.
With just one-third of the runway remaining at touchdown at Lexington's Blue Grass Airport, the Learjet was still barreling forward at 115 miles an hour. After the reverse thrusters failed to deploy, the pilot ordered his co-pilot to engage the emergency brake, sending the plane into a skid. The jet clipped an airport navigational tower with its right wing, then hurtled off the runway onto a local highway in a blaze of smoke and fire. Babb's chest was crushed. Her husband, the two pilots and a flight nurse suffered severe injuries but survived.
Only now, almost three years after the crash on Aug. 30, 2002, has Babb's family claimed they've discovered a startling secret: The co-pilot's records had been "pencil whipped," or falsified, to indicate he had fulfilled Federal Aviation Administration requirements for annual proficiency flights with a certified inspector, the equivalent of a driving test for pilots. In a lawsuit filed in Florida state court, the family alleges the co-pilot was inexperienced and misused the emergency brake, causing the deadly skid. "A thing like this doesn't happen unless someone screwed up," says the Babbs' lawyer, David Rapoport of Chicago. The FAA is investigating the allegation, he says.
For the FAA and its sibling, the National Transportation Safety Board, the ill-fated flight is one more statistic in an alarming increase in accidents and deaths involving charter planes. Although the total flight hours reported by charter operators rose only 5%to 3 million last year, fatalities on charter planes jumped 55%, to 65 deaths out of 68 separate accidents. To be sure, there is a great deal of randomness in the annual death count, which was only 35 in 2002. But there is no denying the huge gulf between charter and scheduled airlines in safety. Commercial airlines flew almost six times as many hours as charter planes but logged only 21 accidents last year, with 13 fatalities (all in a single accident).
So for the privilege of spending $59,000 (on a cross-country round-trip on a Gulfstream II), charter passengers were 18 times as likely to end up in an accident, fatal or otherwise, per 100,000 hours, according to the NTSB, as those who suffer screaming babies, security goons and the other indignities of commercial travel.
It isn't clear whether the surge in accidents is merely an anomaly or a sign of deep problems. But the FAA is so concerned that it organized a roundtable of experts in February to discuss what officials characterize as a "rash of accidents" in the past several months, including the crash of a Challenger CL-600 jet in Montrose, Colo. that killed one pilot, a flight attendant and the 14-year-old son of NBCSports President Dick Ebersol, who has since recovered from his injuries.
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"We're in trouble here," Steven Wallace, director of the FAA's Office of Accident Investigation, told an audience of charter owners at an industry conference in Las Vegas in March. "We don't see a silver bullet,"he added. "There's no question the perception in Washington, aided by the press, is we really have to do something." The FAA is undergoing its biggest overhaul of the charter rules in 27 years, but improvements aren't expected for another two years.
Meantime the charter industry struggles with rising fuel costs and cutthroat competition among some 3,000 charter outfits, with new inroads being made by the rival business of fractionally owned jets from such players as Warren Buffett's NetJets. Some pilots and others argue that the crunch forces charters to cut corners on maintenance and pilot training and give in to fat-cat clients who demand that flights proceed even in unsafe weather.
Yet the FAA is ill equipped to ride herd over charters. The big commercial airlines get the closest scrutiny because they fly the most passengers, but for charters the FAA depends on an honor system of spot checks, audits and certified agents to oversee operators and their aircraft.
The FAA has a hard time simply measuring the scope of the industry. It pegs total charter revenue at as much as $13 billion a year (or maybe as low as $4 billion), split among not quite 3,000 carriers. Even that vague take, in a 151-page report released last fall, took almost five years to produce. The NTSB says the FAA's method of surveying charter companies to estimate flight hours is so "imprecise"--and charter services so unresponsive--that "accident-rate calculations are not accurate enough"to analyze properly. The hard part is knowing whether that means the picture is better than the data show--or even worse.
In order to assist those who make the difficult national or international medical evacuation arrangements we have established a monthly In-Service to educate transport cordinators in the proper methods of arranging for medical transportation by air. The Free In-Service includes: - Understanding legal issues
- Providing a list of questions to ask of potential providers
- Developing a written schedule of events in order to reduce duplication of tasks or calls.
- Introducing what an air ambulance looks like and what it shouold contain
- Offering a one-number contact for all arrangements dor specific missions
- Giving a checklist of questions to be asked of the "air ambulance" or aviationoperator.
or.... - Allowing our coordinators to take on the challenges of making all the arrangements in our Learjet Fleet or on Commercial Vessels.
Hospital discharge planners can call 562 746 9442 to schedule an in-service. A minimum of 5 coordinators from various ares of hospital services is requested ALSAM, The Aeromedical LatinAmerican Association provides a forum for international aeromedical evacuations and services with personnel and entities that have achieved a high level of quality under our own TQM and Aeromedical Training programs. For further information or to schedule a pre-flight assessment meeting or a Free Aeromedical In-Service, please contact us via our Contact Us page |