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Kelly Long, who was hired and became a VP of the embattled medical transport company Orng, is photographed on May 2, 2012 while testifying at a hearing into the accountability of the company.Fred Lum/The Globe and Mail

On a narrow stretch of rural road near Stouffville, Ont., paramedics attending a horrific collision decided a seriously injured man needed to be airlifted to the nearest trauma centre.

But when the call was made Wednesday morning to Ornge, Ontario's embattled air ambulance service, there was a helicopter ready – but no pilots to fly it.

The service's two pilots were not starting their shift until later after working overtime the previous day.

The lack of key, front-line staff raises fresh questions at Ornge, which has been embroiled in controversy for months over a series of private, for-profit ventures created by former insiders that are now at the centre of an Ontario Provincial Police probe.

Revelations of the latest problem go to the heart of Ornge: The Ontario government provides it with annual funding of $150-million to manage all aspects of the province's air ambulance service.

But Ornge is operating with a shortage of pilots and paramedics, which critics say is causing it to compromise patient care. Ornge interim chief executive officer Ron McKerlie acknowledged in an interview on Wednesday that it does not have enough pilots, but he said the stream of negative headlines makes it difficult to recruit new employees.

Health Minister Deb Matthews said she has asked Barry McLellan, chief executive officer of Sunnybrook Health Sciences Centre and a new Ornge board member, to look into the matter.

"There is a shortage of pilots trained to fly on this particular aircraft," Ms. Matthews told reporters. "It's an issue that Ornge is dealing with."

Sources close to Ornge and opposition members questioned why the service does not have a contingency plan to deal with crew members who start their shifts late.

"If it's now to the point where Ontarians have to arrange their emergencies in accordance with the shifts at Ornge, that's not very reassuring," said Progressive Conservative MPP Frank Klees, who raised the matter in Question Period on Wednesday.

Even if Ornge had enough pilots, Mr. McKerlie said, it does not make sense to have them fill shifts for short periods.

"It's pretty expensive to have spare pilots sitting around just in case," he said.

The collision Wednesday involved a 28-year-old Whitby man who was behind the wheel of a white cube van, heading home after working an overnight shift on a construction site in Toronto, police said. As he travelled east on Bloomington Road, in a rural area near Stouffville, he crossed the centre line and into the path of an oncoming dump truck.

The dump truck went into the ditch, sending a cloud of dust and debris into the air. The cube van was totalled, with the sides torn off and the back wheels separated from the truck.

Novak Kalezic, who lives nearby, was jolted out of bed by the crash. "It literally shook the house. It felt like an earthquake," he said.

Mr. Kalezic said he went to the road, where the driver of the cube van was still trapped in his cab. It took about 15 minutes for emergency crews, using a jaws of life, to free the man, he said.



Paramedics at the scene concluded the man needed to be airlifted to the nearest trauma centre, but when the call came into Ornge's dispatch centre at 6:44 a.m. – 15 minutes after the accident – there was no helicopter ready to respond. One of the two helicopters at Ornge's nearest base in Toronto was on another call, transporting a patient from Wiarton to Kitchener.

The second helicopter was sitting idle on the tarmac, unstaffed. Pilots were not starting their regular 6 a.m. shift until 7:15 that morning. They needed to meet the minimum rest period under Transport Canada rules.

Paramedics at the scene decided they couldn't wait. They transported the van driver by land ambulance to Sunnybrook about 50 kilometres south. The man, identified as Richard Ribeiro, a married father of a young child, died of his injuries at the hospital.

Reached by telephone Wednesday evening, his family was too shaken by the tragedy to comment.

The driver of the dump truck was taken to hospital with minor injuries.



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