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Why Lee County EMS MEDSTAR Helicopter Program was Suspended…...The FACTS!

Get Involved!  Demand EMS Management be held Accountable!  No More Mistruths, Corruption and Mismanagement!

Pilot Training Explanation

The required training that is being spoke about in the media requires a little more explanation.  All MEDSTAR pilots were completely trained, licensed and certified above and beyond FAA requirements.  The training required by the FAA to allow for proper billing is recurrent training that is no different than what is required of commercial airlines (e.g. Delta, US Airways, etc.).  Each pilot is required by the FAA to have three-four hours of recurrent training every year with a certified company trainer pilot as outlined in the company training manual.  In order for this training to take place in the new aircraft (Bell 430) it had to be added to Lee County's FAA Part 135 certificate; this did not occur until February 8, 2011 by Director of Maintenance Greg Schiegner.  As explained in the next section below, in June 2011 MEDSTAR operation was shutdown for the first time in its 30+ year history.  No pilot training was allowed by EMS Management to be conducted during this "safety stand-down" until every flight team member agreed to "reset".  

After the safety stand-down the FAA designated company trainer pilot express concerns over the company's General Operations Manual (an FAA approved "living" document that outlines how the company is going to operate) and the company's Training Manual (another FAA approved "living" document that outlines how company initial and recurrent training will take place).  As one could expect, given MEDSTAR's history, these documents were not new to Lee County.  The problem came with the resignation of the former Director of Aviation Operations and promotion of the then current Chief Pilot; the electronic versions of these documents went missing and therefore had to be re-created.  This process is laborious at best given the 300 plus page length and process each manual must go through to become approved by the FAA.  Without an approved training manual and the new aircraft on the Part 135 certificate, initial pilot training could not be conducted.  To make matter worse, the concerns presented to the new Director of Aviation Operations by the trainer pilot went unresolved and the trainer pilot stated he "could not conduct the training".  

A few months later the new Chief Pilot request that the trainer pilot review the company pilot training records prior to an upcoming FAA recurrent inspection.  During this review the company trainer pilot identified that the former Director of Aviation Operations Rob Fulton conducted training with two other pilots without being an FAA approved company trainer pilot.  The trainer pilot sent an email (read the email chain here) to the former Director of Aviation Operations Rob Fulton, former Chief Pilot Bob Buss, EMS Chief Kim Dickerson, and Public Safety Director John Wilson advising of "potential FAA violations" and his legal obligation as an FAA Checkairmen to report these errors.  The trainer pilot was met with hostility regarding these "potential violations".  After reporting his intent to management, the potential violations were self-reported.  In an email reply from the FAA, the principal FAA inspector found, during his review, that the training and checkrides were in fact not legal and needed to be re-done by an FAA approved company trainer.  This illegal training and checkrides would have cost the Lee County taxpayers tens of thousands of tax dollars had it not been self-reported.  

Shortly after this self-reporting, the only FAA approved company trainer pilot was placed on administrative leave pending an investigation that lasted three months, only ending when the program was shutdown and all the pilots were terminated/ eliminated.  As stated on the home page under the Truth behind the Claims section, on the day the program was shutdown, the first of two checkrides were schedule which would have allowed for legal Part 135 billing and training.  EMS Management (Public Safety Director John Wilson and EMS Chief Kim Dickerson) fulling knowing the checkride was schedule, contacted former Director of Aviation Operations the day before the announced shutdown and directed him to cancel all checkrides.

2011 Safety "Stand Down"

EMS Management Team involved in the safety "stand-down": 

  • Public Safety Director John Wilson
  • EMS Chief Kim Dickerson
  • Former Aviation Director of Operations Rob Fulton
  • EMS Deputy Chief of Operation Scott Tuttle
  • EMS Deputy Chief of Training Warren Panem
  • MEDSTAR Supervisor Lieutenant Michael Hamel


On June 22, 2011 Lee County EMS implemented a safety "stand down" to address what EMS Management claimed was a "toxic environment between the pilots and paramedic" along with "concern of lasting issues from the 2009 EC145 crash".  The EMS Management team explained that they have been receiving reports from subordinate management that the environment between the pilots and paramedics was "toxic" and was believed to be, in part, because of a lack of closure from the 2009 helicopter loss.  At the meeting to announce the safety "stand down" to the flight team, EMS Management directed that the entire flight team collect their personnel belongings from the hangar as everyone would be reassigned to a road ambulance for two weeks.  To insure the flight team did not return to the hangar they (non-management flight team) were physically locked out.  EMS Management also outlined during this meeting that all flight team members, not management, will be REQUIRED to meet with a contracted helicopter aviation psychologist and critical stress team or lose their job.  

What upper EMS management failed to realize was there was no such "problem" or "toxic" environment between the pilots and paramedics.  The entire flight team at MEDSTAR shares a unique relationship, even to this day, that EMS management feared and frequently criticized.  Upper EMS Management (Director John Wilson, Chief Kim Dickerson, Deputy Chief of Operation Scott Tuttle, Deputy Chief of Training Warren Panem) failed to insure that the reported problems actually existed by asking the flight team themselves or visiting the hangar.  At the conclusion of the June 2011 meeting, EMS Management also reported that a contracted industry Part 135 expert would review the program's aviation performance/ compliance and recommend change.  EMS Management insured the flight team that these actions were not punitive and in our "best interest".  They [EMS Management] also made it clear that they were committed to the existing flight team, the MEDSTAR program and medicine that was being provide.

Taxpayer dollars spent during safety "stand-down":

Item  CostFindings
Dr. Benjamin Bushman, PhD- PsychologistNot Released, estimated above $10,000Not disclosed
Part 135 ExpertNot Released,  estimated above $10,000 "Missing" per EMS Management

Chief Dickerson's promises/ commitments during the Safety "Stand-down" and her performance:

 Commitment   Outcome
Rebuild MEDSTAR with the current pilots/ paramedics NEVER COMPLETEDDickerson only attended approximately five meetings
Write a MEDSTAR business and strategic plan NEVER COMPLETEDBusiness plan started, however, never finished as Dickerson stopped scheduling meetings.
Create and all parties (MEDSTAR staff and EMS management) sign a commitment poster NEVER COMPLETED Poster completed by flight team, however, never approved by management or signed.
Foster a non-punitive, safety driven "Just Culture" at MEDSTAR FAILEDThe MEDSTAR culture became absolutely punitive and worse after the Safety Stand-down.
Begin MEDSTAR Staff Meetings to insure effective communication PARTIALLY ACCOMPLISHEDDickerson stopped attending after the second or third meeting.  Her subordinate mangers failed to listen, take notes and follow-up on staff's concerns and suggestions.

Flight Paramedic Training

All the flight paramedics were trained in critical care transfer medicine to a cost to taxpayers of over $100,000.  At the time of the shutdown, the MEDSTAR's critical care program was functioning without a documented incident since it was started.  In 2007, when the critical care program was started, every flight paramedic participated in hundred of clinical hours in the pediatric intensive care unit at Healthpark Medical Center and adult medical intensive care units at Southwest Medical Center/ Gulf Coast Medical Center.

The board certifications held by many of the former flight paramedics are listed in the CAMTs Accredication Standards as recommendations to demonstrate compliance.  More information on the training and certifications held by the former flight team can be found below:
Do in part to the expanded scope of practice, all flight paramedic were required to perform six to ten training competencies every shift to insure quality patient care.  Each flight paramedic was held to all the competencies and knowledge as every road EMT and paramedic, in addition to expanded clinical  knowledge, additional psychomotor skills and expanded treatment guidelines required for critical care transport. To fulfill critical care re-certification requirements, every month the flight paramedics completed continuing education modules and a test.

Critical Care Ambulance


In September 2008, Lee County put in-service its first and only Critical Care Ground Ambulance (known as CC20).  One August 21, 2012 with the shutdown of the MEDSTAR program, CC20 was also shutdown.  When the management team was asked why CC20 was also shutdown, a reason would not be given.  With MEDSTAR and CC20 shutdown, Lee County lost its entire critical care program.  The ability to transport critically ill patients to the national standard that had been done for over five years had been lost.  In the aftermath of the MEDSTAR and CC20 shutdown, non-critical care paramedics were being required to care for patient they were not trained to care for.  The health system had to respond by sending nursing that were not trained to national standard to perform out-of-hospital critical care transfers.  

On August 24, 2012 Deputy Chief of Training Warren Panem issued a memo (link here) stating that all Lee County EMS paramedic can, as of that memo, transport patient with infusing blood and blood products.  No training has been provided nor has any treatment guidelines been released with regards to blood and blood products.  MEDSTAR and CC20 met the national standard with regards to having treatment guidelines in place for infusion blood products along with appropriate training.

MEDSTAR Hangar Facility

The MEDSTAR hangar is the first county owned and built facility in the program's 30+ year history.  The facility is 7,916 square feet and was built in 2008.  This facility houses MEDSTAR management, aircraft mechanics, both aircraft, and the Critical Care Ambulance.  There was also extra space included in construction to house a future 9-1-1 ambulance; however, do to late construction changes, this has not been possible until the day after the MEDSTAR shutdown.  Just prior to ground breaking, a plan was developed by former Director of Flight Operations Rick O'Neal, MEDSTAR Supervisor Lieutenant Michael Hamel and Lee Memorial Health System (LMH) Transfer Center Director Andrea Snyder to house the LMH Transfer Center in the MEDSTAR hangar.  Four crew rooms were removed from the construction plans to create space for the transfer center.  

As 9-1-1 call volume increased since the facility was built in 2008, EMS Manager has been unable to station another 24 hour ambulance out of the MEDSTAR hangar because of this construction change.  Union Collective Bargaining Agreement and FAA Federal Aviation Regulations calls for a rest area for each crew member when a unit is not on a call to allow for crew rest (to reduce the chance of fatigue related mistakes).  Because the transfer center occupies the space originally planned for crew rooms, a 9-1-1 ambulance is sent to "standby" at the MEDSTAR facility upwards of 20-30 times a day during session.  It wasn't until the MEDSTAR shutdown that an ambulance could be placed at the MEDSTAR facility as space became available by the former flight team.  

The smaller red area shows the area taken up by the LMH Transfer Center.  The larger red box surrounding the helicopter silhouettes is the FAA restricted airport area that is only to be accessible by approved flight crew and mechanics; however, LMH Transfer Center Director Andrea Snyder has had unrestricted and unmonitored access to this area since the facility was constructed because of her relationship with MEDSTAR Supervisor Lt Michael Hamel.