Disability Law

The Washington Post has a very interesting article about the medical transport helicopter business. Alarmingly, this "multibillion-dollar air-medical business" is "now one of the most dangerous jobs in America...with 113 deaths for every 100,000 employees." Here are a few more excerpts from the article:

The number of fatal flights has risen sharply, closely tracking the rapid growth of what is now a $2.5 billion industry. Nearly half of all deaths have occurred in the past decade. In 2008, the deadliest year ever, 23 crew members and five patients were killed.

Some calamities were the result of pilot errors. But many were predictable, pilots and safety experts say, and could have been prevented with stronger oversight and better technology.

Private, for-profit companies dominate the industry, with about 830 medical helicopters vying for patients. The number of aircraft has doubled every decade since 1980, leaving some firms with fleets as large as those of US Airways or JetBlue. Yet medical helicopters are permitted to operate without basic safety features that commercial flights must carry, such as black box recorders, collision-avoidance systems and radar altimeters.

More than half of fatal crashes occur at night, but only one-third of medical helicopter pilots are equipped with night-vision goggles to help them avoid power lines, towers and other obstructions.

Costs keep increasing, with a one-way trip running as high as $20,000. Medicare alone spends $220 million yearly to ferry patients -- 20 times higher than a decade ago, adjusted for inflation. Air Methods, the largest firm, has revenues of $500 million.

"A patient flown in by helicopter can mean thousands of dollars in downstream revenue" once the patient is admitted to a hospital, said Paul A. Taheri, a doctor who co-wrote a 2003 study on the subject. "That fact is not lost on hospital administrators."

In July 2008, Federal Aviation Administration officials hurriedly arranged a meeting with industry leaders to discuss a spike in fatal medical helicopter crashes. Only days before, two medical helicopters had collided in daylight over Flagstaff, Ariz., killing five crew members and two patients. A spate of earlier crashes had claimed 17 lives.

But instead of ordering changes, regulators asked companies to "refocus" on safety, according to a summary of the meeting. Stricter regulation was quickly ruled out.

That hands-off approach is typical of the FAA's history of deferring to the industry on safety matters, The Post found.