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New Leadership of Ontario’s ORNGE Air Ambulance Service Pick Up the Pieces

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We would be remiss if we didn’t acknowledge the air ambulance debacle currently going on in Ontario. We discussed it a bit last month in a blog about the possibility that poor cabin design on ORNGE’s helicopters may have hindered paramedics and contributed to serious incidents on patient transports — but, unfortunately, that was only one of many problems facing the Ontario air medical service. It’s time to scratch the surface, and discuss what everyone in the air ambulance community up North has been talking about.

ORNGE, Ontario’s provincial air ambulance service provider, was established in 1977 as a purely helicopter-based air medical service out of Toronto, serving mostly remote areas. Over the following 35 years, the program grew to support a fleet of more and more aircraft at a variety of bases, with ties to multiple hospitals. The company employed well-trained, highly-educated paramedics and flight nurses, and provided air transport for critical-care patients across the 415,598 square-mile province.

Ontario air ambulance By Jason Bain (Flickr: New Air Ambulance Training) CC-BY-2.0 (www.creativecommons.org/licenses/by/2.0), via Wikimedia Commons

An AW139 ORNGE air ambulance helicopter lands at Lindsay Airport in Ontario.

ORNGE (which is not an acronym) was given the task of coordinating air ambulance services for all of Ontario in 2005, under founding CEO Dr. Chris Mazza. Naturally, Mazza has been at the fore of many of the accusations surrounding the company, some of which are still under investigation.

Outwardly, for years, it seemed the service was doing well under Mazza’s leadership, even turning some profits here and there — and that was part of the problem.

Secrets and Salaries

Mazza is no longer associated with the air ambulance service he helped get off the ground so many years ago. In late 2011, a veritable hailstorm of accusations, salary scandals, revealed secrets, and carelessly squandered tax dollars besieged the former CEO, along with other high ranking members of the corporation.

The scandal reached its peak in December, around when it was revealed that Mazza’s appointed yearly salary was $1.4 million; more than any other public sector worker in the country (the COO of the air medical corporation made a similarly inflated figure for her service to the company, however).

Furthermore, despite a healthy $150 million of yearly funding provided by now-outraged taxpayers, the organization, under Mazza’s CEOship, had set up a number of for-profit companies. Documents have now revealed that the publicly-funded corporation was only planning on giving 3% of their gross revenue back to Ontario.

A conspicuous red flag may have possibly been sent up, quite inadvertently, by the corporation’s own leadership – the headquarters of the air ambulance service were known for being notoriously posh. After a few months of noise being made about questionable practices and ridiculous salaries, it didn’t take much longer for government officials to clamp down on the company. Investigators have also looked into over a dozen incidents related to medical transports, involving three patient deaths.

Even further, investigators have found cases of wild spending by the company: one example being expensive mechanical devices meant to be installed on fixed-wing air ambulances designed to reach out and pick up the patient on the stretcher, bringing them inside the plane via hydraulics rather than manpower. These contraptions were too heavy for the small PC-12 planes, but Mazza’s ORNGE bought ten of them at $100,000 each – totaling $1 million.

The company released a public statement last week indicating that CEO Dr. Chris Mazza and COO Maria Renzella had been terminated, from their job, and were no longer officers of the corporation in any capacity. The statement also noted that no severance payments had been offered to them (likely by virtue of their outlandish salaries).

What Went Wrong?

Ontario air ambulance serviceShould former CEO Mazza should be made to shoulder the entire brunt of the charges against the former leadership of ORNGE? Scandals of such magnitude do, necessarily and generally, involve the cooperation of several entities after all. While several investigations are still in progress, Dr. Mazza has nevertheless certainly been thrust into the spotlight; a representative of the troubled organization’s internal problems.

In the wake of the series of revelations and general tumult, a scandalous cloud has been lingering over the air medical organization throughout early 2012. Nonetheless, it’s important to note that ORNGE’s board of directors has since been entirely reappointed, and the corporation’s other for-profit enterprises have been shut down by the government.

In a recent online article, Kevin Donovan of The Star (link) recounted the time Mazza purportedly stood up in the middle of a residents meeting for his home in Star Lake, telling others he had to step out with the claim “I am needed.” He then, the article claims, went down to the beach and talked on his cell phone for half an hour, after which he returned and told the other cottagers that there was a medical emergency and he was personally directing the air ambulance.

“I was telling the helicopter where to go,” others recalled him saying.

Of course, the others in the meeting rolled their eyes at the assertion. Were they really being asked to believe that the president and chief executive officer of ORNGE – with a salary of $1.4 million a year – was acting as a flight controller?

Extreme Expenditures

Others who worked alongside Mazza have come forward to describe what it was like working with the former CEO. After reading several anecdotes from one former employee (a V.P. who The Star described as Mazza’s right-hand man until 2008) the one that struck me the most involved the CEO paying private investigators to follow an employee who had criticized him. Extreme ethical violations aside, that documented, pointless excursion apparently cost the company about $15,000.

In the same article, Blum used the example of a $40,000 speed boat being purchased with ORNGE’s public funding to give an idea of the types of dealings that went on prior to his leave of absence (from which he never returned). He also claimed that Mazza worked his employees hard, pointing out that he – then a vice president – was required to be on call 24 hours a day, rarely seeing his family and being summoned by Mazza at any hour of the day or night on a whim.

That’s all over now, however. The ORNGE corporation has been decapitated, and a new board of governors with diverse backgrounds in healthcare has taken the place of the corporation’s disgraced former leadership. Government officials will be keeping an eagle eye on the air ambulance service’s activities for a while before things return to normal. Despite the complete change of leadership and a massive influx of new blood, ORNGE still has some key issues to deal with, including the helicopter cabin problems some paramedics have complained about.

Those running the new ORNGE air ambulance service have an opportunity to really turn things around and restore the public image of the company, and we wish them all the best in taking on the task.

What went wrong in the case of ORNGE? Can we prevent things like this from going unchecked for so long in the future? Is this a danger with any large air ambulance service, or was power simply too concentrated in this one instance? We’re especially interested to hear opinions from those in the Canadian air medical community, as it’s likely you have heard more information and can offer valuable perspective on this issue. Please feel free to share any comments, observations, or questions in the discussion area below.

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