The January crash of a Yampa Valley Air Ambulance flight is one of 12 accidents driving the National Transportation Safety Board's recommendations for changing the nation's air ambulance industry.
After nearly eight months of investigation and more than 50 interviews, NTSB officials are expected to release a report about the Yampa Valley Air Ambulance crash in the next week.
NTSB Regional Director David Bowling said the finishing touches are being made to the report that will review the Jan. 11 crash in Rawlins, Wyo., that killed three Steamboat Springs residents and seriously injured another.
"This is one of several cases that are driving specific recommendations for change in the industry," Bowling said. "The industry needs new regulations."
Shortly after the Yampa Valley Air Ambulance accident -- its second in two years -- NTSB officials began a national investigation of the air ambulance industry. The Yampa Valley Air Ambulance accident was the last of 12 medical helicopter or plane crashes that killed 35 people during a 12-month period.
At an NTSB public meeting next spring in Washington, the Yampa Valley Air Ambulance crash will be among the crashes reviewed, Bowling said.
"This case had a lot to do with some of the changes proposed," Bowling said.
The Yampa Valley Air Ambulance went down at about 9:45 p.m. Jan. 11, about three miles northeast of Rawlins Municipal Airport. The flight had left Steamboat earlier that evening, and its crew members were en route to pick up a patient from Carbon County Hospital.
Pilot Tim Benway, 35, air ambulance director and flight nurse Dave Linner, 36, and flight nurse Jennifer Wells, 30, were killed in the crash.
The sole survivor was Tim Baldwin, a 35-year-old emergency medical technician who suffered severe injuries.
In their preliminary investigation, NTSB officials found ice on the plane's wings, tail, landing-gear tires and propellers. Bowling said early on in the investigation that ice and poor weather conditions likely were factors in the crash.
Although the report is expected to be released in about a week, it could be another three to four months before NTSB officials release what they think the probable cause of the accident was, Bowling said.
He said that during the past few months, NTSB officials have interviewed current and former employees of Yampa Valley Air Ambulance operator Mountain Flight Service, Yampa Valley Medical Center employees and Federal Aviation Administration and Denver Flight Standards District Office officials.
The investigation encompassed a detailed look at what happened the night of the crash, and investigators reconstructed the flight, listened to phone calls made to YVMC during the night of the crash, examined the flight plan and reviewed recovery efforts.
NTSB officials also conducted a mechanical test to see whether airplane equipment failure could have been a factor in the crash.
"It's a pretty exhaustive background," Bowling said.
The investigation also looked at the March 2003 Yampa Valley Air Ambulance crash near Kremmling, which was blamed on pilot error. The three people involved in the crash walked away with minor injuries.
"We are trying to understand if the problem goes industry-wide or to the operator, if it is something we find in air ambulances across the country," Bowling said.
NTSB officials also looked at Mountain Flight Service's relationship with YVMC and compared that relationship to ones other air ambulance operators have with hospitals across the country.
Mountain Flight Service had a contract with YVMC to operate the Yampa Valley Air Ambulance. Mountain Flight Service provided the plane, pilot and most of the on-board equipment, and the hospital provided medical crews and portable medical supplies.
The partnership between the two began in 2001. Mountain Flight Service had operated the air ambulance since 1994. Bob and Cindy Maddox purchased the company in January 1997.
Bowling said having a hospital provide medical crews to an air ambulance service is typical, but he said doing it under contract is unique.
Another unusual trait, Bowling said, was that the hospital used the air ambulance to transport patients who were not always in critical condition.
"It is a unique operation. We haven't found too many operations like it in the country," Bowling said. "It took basically not just emergency care patients, it used the air ambulance for the purposes of transporting any patient out of the Yampa Valley, whether in critical care or not. Rather than ground transport, they preferred to fly them."
Since the crash, YVMC primarily has used Front Range and Summit County air ambulance services to transport patients.
Many of those transports involve helicopter landings in the hospital's emergency room parking lot, YVMC public relations director Christine McKelvie said. The fixed-wing planes that fly into Routt County from the Front Range have landed and taken off from Yampa Valley Regional Airport because of their size, Bob Maddox said.
Air ambulance future
The Maddoxes have decided not to bear the responsibility of continuing to operate the air ambulance service, but they said they would love to help bring another one back to Steamboat.
"It does have to be someone other than a mom-and-pop business, because it is crushing for us," Bob Maddox said. "Something like this, it is still hard."
McKelvie said hospital officials have talked to other air ambulance services to see whether there is a way to partner or coordinate services.
"With a local option removed, that is what we have been pursuing. The potential for it, I don't know," she said. "Establishing some sort of shared service, that has been the focus of our research."
Maddox and McKelvie said they knew that the investigation of the Yampa Valley Air Ambulance crash would be among those investigated by NTSB officials in their national review of air ambulances.
Maddox said they expected the crash report to be released by the end of July.
"Like everybody else, we are waiting for the report to come out," Maddox said. "I would love to know what we could have done procedurally to have a different outcome or what to do to prevent it in the future."
Maddox noted that FAA officials found that Mountain Flight Service's operations were in full compliance with federal regulations at the time of the crash.
Bowling said the Yampa Valley Air Ambulance crash had similarities with other air ambulance crashes. He pointed to Air Methods, a large air ambulance company that he said might have grown faster than demand warranted. He said Yampa Valley Air Ambulance followed a similar model.
Bowling noted that NTSB officials are suggesting new regulations for the FAA, which gives guidance to -- but not many regulations for -- the air ambulance industry.
The NTSB recommendations, Bowling said, will be based largely on the similarities among the 12 accidents that occurred across the country in that 12-month span.
"It is going to drive the future of air ambulance," he said about the upcoming NTSB report and recommendations. "It is going to make the industry safer. That, I believe, will prevent accidents from happening so I will not have to talk about things like Rawlins and Kremmling."
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