Fatal Scottish Air Ambulance Crash Tied to Fatigue

Pilot fatigue, high workload and a lack of recent flying practice may have contributed to an air ambulance crashing into the sea while on a medical mission, an official accident report said today.

The pilot, Captain Guy Henderson, 40, and paramedic John McCreanor, 34, were killed when their Glasgow-based Islander aircraft went down in poor weather at night near Campbeltown airport in Scotland.

The two men were flying to Campbeltown for the Scottish Ambulance Service to collect Craig McKillop, 10, who was suffering from suspected appendicitis, and fly him to Glasgow for treatment.

Poor weather at Campbeltown airport on the night of March 14/15, 2005, meant the pilot had to approach using instruments, the report from the Air Accidents Investigation Branch (AAIB) said.

Because there was no radar or air traffic control at the airport, the pilot was receiving information from a flight service information officer in accordance with procedures, the report said.

The AAIB added that the pilot, from Broxburn, West Lothian, had indicated that he was inbound to the airport and commencing an approach.

The report went on: ``Nothing more was seen or heard from the aircraft, and further attempts at radio contact were unsuccessful.''

Emergency services were alerted and an extensive search was mounted. The aircraft wreckage was found on the seabed about eight miles from the airport.

The body of Mr McCreanor, from Paisley, Scotland, was found shortly afterwards, but Mr Henderson's body was not found until late December, 2005.

The AAIB report said:

The pilot allowed the aircraft to descend below the minimum altitude for the aircraft's position on the approach procedure, and this descent probably continued unchecked until the aircraft flew into the sea

A combination of fatigue, workload and lack of recent flying practice probably contributed to the pilot's reduced performance

The pilot may have been subject to an undetermined influence, such as disorientation, distraction or a subtle incapacitation, which affected his ability to control the aircraft's flightpath.

The report said that Mr Henderson had not flown for 32 days before the day of the flight. Visibility was at or above the minimum required for landing on either runway at Campbeltown.

At the aircraft's last recorded radar position it was 200ft below the minimum altitude and still descending.

The AAIB said that it was probable that the pilot had flown comparatively few instrument approaches on the Islander aircraft, and ``was suffering, at least to some extent, from the effects of fatigue.''

The AAIB added that although there were signs of overload and fatigue, it was unlikely that the pilot became so focused on one aspect of flying the aircraft that he neglected to monitor its altitude for a protracted period.

The report went on: ``It is therefore possible that a further factor such as distraction or disorientation may have played a part.''

The AAIB said Mr McCreanor was probably rendered unconscious in the impact when his head hit the pilot's seat in front due to the lack of an upper torso restraint in the aircraft.

The report also said that that the presence of a second pilot ``may have prevented the accident.''

In its recommendations, the AAIB said that aviation authorities should look at fitting upper torso restraints on these types of aircraft and at the possibility of having a second pilot on air ambulance flights.

The AAIB also said that authorities should consider mandating the carrying of a radio altimeter or other independent low-height warning device for single-pilot planes operating under instrument flight rules.

Airline pilots' association Balpa said aviation authorities should heed the call over the crewing of air ambulances.

``We are demanding that air ambulances always have two pilots, not one,'' said Balpa's general secretary Jim McAuslan.

``Had there been a second pilot, he or she would almost certainly have prevented the aircraft's descent into the sea and those on board would be alive today. When is the industry going to learn from previous similar fatalities?

``Six years ago, following a similar accident, the AAIB recommended a review of the circumstances in which a second pilot is required for air ambulance flights. But no action was taken.

``Ambulance flights are by their very nature likely to be flown in adverse weather conditions. We, like the AAIB, want current practices looked at again.''

Mr McAuslan added that Balpa also wanted to see rules changed so that the wearing of shoulder harnesses is mandatory.

Speaking in Scotland today, Lorne Blyth, who was the fiancee of Captain Henderson, said: ``I feel very strongly that everything possible should be done to ensure that future tragedies are prevented and therefore call on Transport Secretary Douglas Alexander to implement the recommendations from the AAIB report.''

Ms Blyth also called for air ambulance flights to be equipped with personal local beacons.

She said: ``These are inexpensive but highly effective. Such equipment may not have saved Guy's life, but it almost certainly would have led to the recovery of his body in days rather than months.''

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