Correction to This Article
A chart with an article on medical helicopters, and a reference in the story to the same data, cited occupational fatalities for airline pilots. The figure of 80.1 deaths per 100,000 people over the past 10 years is for all professional aircraft pilots, not just those working for airlines.
FATAL FLIGHTS A Perilous Rush to Profit

As Medical Helicopter Industry Has Grown, So Have Fatal Crashes

By Gilbert M. Gaul and Mary Pat Flaherty
Washington Post Staff Writers
Friday, August 21, 2009

SANTA ROSA BEACH, Fla. Shortly after midnight on a storm-swept October night in 2004, Tom Palcic, a medical helicopter pilot, started across Choctawatchee Bay to pick up a hospital patient and transport him to a facility 60 miles away.

Such flights are common in the highly competitive multibillion-dollar air-medical business. Although the public profile of medical helicopters has them swooping to crash scenes at the edge of highways, most flights, like Palcic's, involve shuttling patients between hospitals.

The director of the helicopter program for which Palcic flew called these lucrative patients "golden trout" and pushed pilots to reel in as many as possible. When pilots balked at flying in bad weather, he called them sissies and second-guessed them, records and interviews show.

Palcic, 63, was just two minutes into the flight of AIRHeart-1 when his crew radioed a dispatcher that he was turning back because of the thunder and lightning.

Moments later, Palcic's helicopter banked in clouds and plunged 700 feet into shallow waters, killing him, a flight nurse and a paramedic. A woman who lived nearby recalled that the vibration shook candlesticks out of their holders.

For the medical helicopter industry, it was the fourth fatal crash that year -- part of a legacy that has claimed the lives of 211 crew members and 27 patients since 1980 and injured many others, The Washington Post has found.

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.

"We've been killing ourselves the same way for 20 years," said veteran pilot Ed MacDonald. "There's not a whole lot new about these crashes."

What began almost four decades ago as a way to save lives is now one of the most dangerous jobs in America -- deadlier than logging, mining or police work -- with 113 deaths for every 100,000 employees, The Post found. Only working on a fishing boat is riskier. The rate for airline pilots is 80.1.

In the 37 years helicopters have been used to transport patients, pilots and crews have died in an almost unfathomable array of crashes. In the past two years alone, medical helicopters have dropped into pitch-black oceans, plummeted to the ground after losing rotor blades, smacked into mountains and collided in clear blue desert skies.

Yet as crashes and deaths have mounted, top executives at the Federal Aviation Administration and its parent agency, the U.S. Transportation Department, have acted as partners with the industry, issuing reams of voluntary safety advisories with little follow-up. The FAA has sent poorly trained inspectors to monitor operators and used fines and penalties as only a last resort.

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