Lessons From a Plane Crash

One of the most vivid memories in my 25-plus years of service in the New York City emergency medical services was my response to the crash of a Boeing 707 in Cove Neck in January 1990. On the most recent anniversary of this MCI, I began collecting some of my thoughts from that day. I hope they may help current and future EMS leaders. 

The plane was en route to Kennedy Airport in New York City. It originated in Bogota, Colombia, and had 158 people on board. It crashed in a Long Island neighborhood on the shores of Oyster Bay in Nassau County, outside New York City. An investigation determined the plane ran out of fuel.

At the time I was an NYC*EMS deputy chief assigned to the Bronx. Earlier that Thursday I’d attended a continuing educational seminar at North Shore University in Manhasset, also on Long Island. As I was en route back to the Bronx, our communications tour commanders (TCs) received information about a possible plane crash in Long Island. Our medical director, Larry Mottley, and I were receiving media requests via the TCs on a secure radio frequency when the Nassau County Police Department’s 2nd Precinct sergeant requested NYC*EMS for mutual aid. The first request was for 50 ambulances.

Response and Scene

My hometown at the time was in Oyster Bay, so I was familiar with the area. The TCs directed me to respond and initiate contact with Nassau County first responders. At the same time, a deputy chief colleague started to form task forces of ALS and BLS ambulances at the Nassau County/Queens County border, where they waited for orders.

I remember proceeding eastbound on the Long Island Expressway near Little Neck Parkway, where I observed New York City Police Department (NYPD) emergency service units sitting ready to respond east. I gave a short blast of my siren and saw them follow my lead and head toward the disaster scene. While heading north on Route 106, I stopped at the Oyster Bay Fire Department, where I was a member, to notify them we had 2 strike forces of 25 ambulances ready to respond. 

Unfortunately, at the time, New York City and Nassau County did not have mutual-aid radio system capabilities and could not adequately communicate. As a result they could neither anticipate nor control that the 2-lane road leading to the crash site would become flooded with many well-intentioned people coming from as far away as Connecticut to help.

On my way to the crash site via Cove Road, I was stopped by 2 colleagues: Mark Henry, MD, emergency department director of a trauma center in Queens, and Detective Brian Mulhern of NYPD. Brian was often referred to as the “master of disasters” and could obtain any resource with just a phone call. The 3 of us proceeded to the scene. 

To suddenly see, in front of my eyes, an actual Boeing 707 sitting among the trees on a hilltop was breathtaking. Miraculously, the plane had split in half, allowing us to remove about 80 adults and children who had survived. More than 70 souls on board were not as fortunate.

Unfortunately, at the time, Nassau County police had only older helicopters without the sophisticated electronics of today. Because of the poor weather, landing a chopper was impossible. I also remember at the time  the closest trauma center (Nassau County Medical Center) could not support the size of the helicopters. A captain from NYPD’s Emergency Service Unit was on the scene with me and expressed reservations about the landing zones. We all worked together to begin creating zones that could accommodate larger aircraft.

Since this scene was extremely hazardous, the treatment, extrication, and patient transports went on for about 12 hours.

Lessons Learned

In retrospect, I think our response, and the accomplishments of bringing many different resources to work together, helped us to provide the best possible care for the crash victims. As I reflect on the day all these years later, a few topics come to mind.

First I think about the many people, including Henry, the New York chiefs, and the Long Island volunteers, whom I had worked with regularly before that event. I am confident those connections helped improve the EMS response that day. To current EMS leaders I emphasize the importance of creating and maintaining those networks. I had a career in one of the busiest EMS systems in one of the most intense cities in the world, and I think every day about how fortunate I was to have made the connections I made. They not only helped me be the best EMS leader I could be, but they also helped me to provide the best contributions I could to making NYS*EMS the best EMS agency it could be. In addition those connections helped me develop a wonderful group of lifelong friends. 

Second, as the EMS profession more and more embraces its tremendous public health potential, a lesson learned from this crash is the importance of having drills and other preparation exercises with neighboring EMS systems. Even a few exercises together can identify issues such as communication challenges. Exercises such as those, and the relationships and networks they foster, can help EMS professionals prepare for disasters and prevent fatalities.

Third, I would underscore the importance of recognizing that EMS is ultimately a team experience. When we learn to become EMTs and paramedics, we learn to be independent thinkers and clinicians. Those are critical abilities—when we’re alone on a scene with multiple casualties, they depend on us to be independent, competent clinicians. But a first step toward becoming an effective EMS leader is to recognize that health care, disaster management, public health, emergency services—all the things we really do on a daily basis—all require a team response. We can make a great impact on patients as independent clinicians, but we can have an awesome impact on our communities when we work together as a team. We saw the importance of that teamwork at the Avianca crash. Fostering it each day can help us be as prepared as possible.

Finally, I would like to share some thoughts on the stress associated with the EMS profession. When I began my career, the culture (at least in New York) was that you were supposed to go the most horrific calls, deliver your care, and then go on to the next call, and if that bothered you, you were in the wrong profession. Slowly, over the years, we began to realize that if those horrific calls didn’t bother you, you were in the wrong profession. So I think our profession has made great progress, but I urge current and future leaders to keep in mind that any of us or our colleagues can suddenly become victims of job-related stress. The cause could be a plane crash or other MCI, but it could also be a personal experience: a patient who reminds us of a family member, a single patient who’s horribly injured, or a culmination of multiple bad calls in a short time. There are many possible causes, and they do not have to be acute; we can develop effects even years later. So I share a heartfelt recommendation for each of us, every day, to look out for our colleagues and ourselves. EMS professionals can do a tremendous amount to help other people, but those efforts can take their toll. Let’s remember to take care of each other.

Peter M. Hosey, MS, EMT-P, is a fire and EMS community instructor for the Bluffton Township Fire District in Bluffton, SC. He spent 23 years (1977–2000) as deputy chief for New York City EMS and FDNY.

Brian J. Maguire, DrPH, MSA, EMT-P, is an epidemiologist with Leidos at a government medical research laboratory in Connecticut, and an adjunct professor at Central Queensland University in Queensland, Australia. He was a paramedic in the NYC EMS system for about 20 years.