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Flight Paramedic Took Controls After Pilot Incapacitation

A flight paramedic took the controls and attempted to land an air medical helicopter after the pilot became incapacitated during a return flight to base, according to a preliminary report released by the National Transportation Safety Board.

The accident happened on Nov. 8, 2025, near Lebanon, Tennessee, when an Airbus Helicopters EC 130 T2 operated by Air Methods, doing business as Vanderbilt LifeFlight, crashed following an in-flight medical emergency involving the pilot.

The helicopter, callsign LifeFlight1, had departed from its base in Gallatin, Tennessee, on a Part 135 air medical mission when the request was canceled shortly after takeoff. As the aircraft turned back toward Gallatin, the pilot suddenly became unresponsive, prompting the flight paramedic to intervene and attempt to slow and land the helicopter.

Pilot Became Unresponsive

According to the report, the helicopter departed Gallatin at about 1:34 p.m. local time in response to a launch request in Rutherford County. Three minutes later, the operator’s communications center, known as AIRCOM, advised the crew that the request had been canceled. ADS-B data showed the helicopter making a 180-degree turn back toward its base while flying at about 4,000 feet mean sea level.

At 1:39 p.m., AIRCOM received a radio call from LifeFlight1.

“Aircom…LF1…we have a medical emergency onboard with our pilot…uh we’re gonna…we will advise,” the transmission said.

No further transmissions were received.

In a post-accident interview, the flight paramedic told investigators that after acknowledging the cancellation and advising AIRCOM they were returning to base, he noticed the pilot fell silent and was not making any physical acknowledgments when spoken to, such as nodding or giving a thumbs-up. When the paramedic tapped the pilot on the shoulder and attempted to confirm the turn back to base, the pilot did not respond.

The paramedic said the pilot’s expression appeared to be a “complete blank stare,” with eyes open but showing no emotion. He said the pilot attempted to interact with GPS or autopilot equippment, but was unable to make purposeful inputs and was unable to actively control the helicopter.

Attempted Emergency Landing

The flight paramedic, who had no flight training, decided to make an attempt to fly and land the helicopter. He said he did not see indications that the autopilot was engaged and believed the helicopter seemed too high and fast.

Based on his observations of pilots during normal operations, the paramedic grasped the cyclic on top of the pilot’s hand and made control inputs, initially pulling back more aggressively than intended. He then made smaller adjustments and also reduced power by pressing down on the collective.

The helicopter entered stable but fast forward flight as the paramedic attempted to level it. Both the paramedic and flight nurse repeatedly told the pilot to land on farmland below. The paramedic pointed out a nearby field, while kneeling over the center console to reach the controls.

At this point, the pilot verbally indicated his preference for a specific field further away. The helicopter struck tree tops as it made its descent, leading the paramedic to execute a hard flare about 10 to 20 feet above the ground before the helicopter impacted terrain.

ADS-B data showed the helicopter’s final recorded position at 1:41 p.m. at a GPS altitude of 775 feet, about 0.31 miles from the crash site. AIRCOM determined within minutes that the flight made an unplanned landing and initiated emergency response procedures. The Air Force Rescue Coordination Center also contacted AIRCOM after the helicopter’s emergency locator transmitter activated.

The helicopter sustained substantial damage during the impact and subsequent rollover, though the airframe remained largely intact. The aircraft came to rest on its left side, with both skids still attached but compressed, and the left skid fractured near its center. The tailboom remained attached but was bent downward, and the tail rotor driveshaft was separated at a hanger bearing. Damage to the main rotor system was consistent with the blades being under power at impact, while the engine and fuel system showed no abnormalities and there was no post-impact fire, according to the NTSB.

The flight nurse was killed, and both the pilot and flight paramedic were seriously injured.

The NTSB investigation is ongoing, with a final report to follow.

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