Medical Emergency Causes Helicopter Loss of Control During HEMS Loading

Casualties unknown • im alpinen Gelände, Gemeinde St. Anton am Arlberg, Tirol, AT

A medical emergency involving the pilot led to an uncontrolled rotation of an Airbus Helicopters EC 135 T2+ during a patient loading operation in the Austrian Alps.

What happened

On May 23, 2019, an Airbus Helicopters EC 135 T2+ operating as a Helicopter Emergency Medical Services (HEMS) aircraft was engaged in a rescue mission near St. Anton am Arlberg, Tyrol. After an initial landing on a forest track, the crew decided to reposition the aircraft closer to the patient's location to shorten the transport distance. To prevent the aircraft from sinking into the soft ground, the engines were left running during the second landing.

While the medical crew was loading the patient through the left sliding door, the aircraft began to slide. As the physician attempted to alert the pilot via radio, they observed the pilot experiencing a medical episode, characterized by physical convulsions and a loss of control. Consequently, the helicopter underwent an uncontrolled rotation of approximately 270 degrees around its vertical axis. During this movement, the patient was displaced from the aircraft, and the flight medic sustained minor injuries. The aircraft eventually came to a halt after the Fenestron struck an embankment and collided with a snow wall.

The investigation

The SUB investigation focused on the pilot's medical history and the environmental conditions. Investigators examined the possibility of flicker vertigo, noting that the rotor blade flicker frequency for this aircraft type (26.3 Hz) falls outside the critical 4–20 Hz range. Furthermore, sunlight was entering the cockpit from behind rather than frontally, making flicker vertigo unlikely. The investigation also reviewed the pilot's medical records, noting a significant head injury sustained in a domestic accident in 2017, which involved an open traumatic brain injury.

Findings

  • The primary cause of the loss of control was a medical emergency involving the pilot, specifically a tonic-clonic seizure.
  • The seizure was likely triggered by the pilot's previous history of traumatic brain injury.
  • The aircraft sustained damage to the Fenestron and its housing (tail bumper and structure).
  • The engines were running during the loading process to maintain stability on soft ground, which contributed to the aircraft's ability to slide during the event.

Probable cause

The pilot suffered a tonic-clonic seizure, likely related to a previous traumatic brain injury, resulting in the loss of control of the aircraft during patient loading.

Frequently asked questions

What happened in the 2019-05-23 Eurocopter EC 135 T2+ accident near im alpinen Gelände, Gemeinde St. Anton am Arlberg, Tirol, AT?

A medical emergency involving the pilot led to an uncontrolled rotation of an Airbus Helicopters EC 135 T2+ during a patient loading operation in the Austrian Alps.

What aircraft was involved and where did it happen?

The accident on 2019-05-23 involved a Eurocopter EC 135 T2+, at im alpinen Gelände, Gemeinde St. Anton am Arlberg, Tirol, AT.

What was the probable cause of the accident?

The pilot suffered a tonic-clonic seizure, likely related to a previous traumatic brain injury, resulting in the loss of control of the aircraft during patient loading.

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