ANNAPOLIS, Md. -- Some of Maryland's 12 MedEvac helicopters were unavailable on multiple days last year because of maintenance problems, and state auditors were unable to verify how often emergency missions were completed within the crucial "golden hour," according to an audit released Thursday.

Medevac Audit Spells Out Problems

The General Assembly's Office of Legislative Audits noted that the operation is highly regarded throughout the nation and has an "impeccable" safety record.

However, the audit found that on 51 days in fiscal year 2007, fewer than eight of the 12 helicopters were available. The audit also found that on more than 120 days, six helicopters were unavailable.

The Department of State Police's Aviation Command helicopter operations was unable to identify the cost per flight hour, including the maintenance costs for each repair, the audit said.

Auditors also concluded that the program's management "was severely hindered" in making informed decisions about helicopter availability and maintenance, due to a lack of reliable and extensive data.

The program's command has reported that almost 95 percent of its MedEvac missions during fiscal years 2005 and 2006 were completed within the "golden hour." Under the "golden hour" theory, critically injured patients' chances of survival are best if they are treated in a trauma center within 60 minutes of being injured.

But the auditors said they were "unable to verify the reliability of these results due to data control issues."

"Specifically, quality control procedures had not been established by the command to verify the accuracy of the mission times recorded in the database used to determine the percentage of missions completed within the 'Golden Hour,"' the audit found.

The audit recommended that the command define the term and measure times accordingly. In response, state police commanders said it will measure the time as starting when a helicopter station receives a dispatch request and ending when the patient arrives at a trauma center.

The audit also cited turnover in positions of senior management, pilots, and maintenance technicians, calling attention to "management reassignment practices and comparatively low salaries, especially for pilots and technicians."

"One key impact of high turnover, at numerous positions and levels, has been a reduction in institutional knowledge, as many current employees have limited experience with the Command," the audit stated in a summary.

But state police commanders disagreed with the audit's turnover finding, saying the loss of experienced employees "is not significantly high."

"In most cases, these employees ultimately return to the command as more well-rounded managers after gaining invaluable experience on a more global operational perspective," the command said in response.

In the last legislative session, lawmakers struggled in tough fiscal times to carve out money to upgrade the fleet or buy new helicopters. The fiscal year 2009 budget has about $33 million for the fleet. About $110 million is planned over the next four years.

The late Dr. R Adams Cowley, who established Maryland's division of emergency medical services, developed the theory of the "golden hour." The first state police MedEvac flight in Maryland was in 1970.

The current fleet includes 12 helicopters flown from eight bases across the state. Nine of the choppers are more than 18 years old. State officials said $110 million has been approved to begin the replacement of the chopper fleet.

The audit was conducted June 2007 through February 2008. A legislative hearing on the audit will be held next month. One legislative source told WBAL TV 11 News it was not as bad as was expected.