The Federal Aviation Administration has asked Hawaii Air Ambulance to ground its medical transport flights until inspections of its operations and maintenance records are completed, says company president and CEO Andrew Kluger.

The company halted operations of its fleet of three Cessna 414A planes after a March 8 crash on Maui that killed three crew members. Kluger said the company, based at Honolulu International Airport, was conducting its own inspections in an effort to restore public and employee confidence.

The FAA also is conducting an inspection of company records, said spokesman Mike Fergus at the Northwest region headquarters in Renton, Wash.

Legally, Hawaii Air Ambulance does not need FAA permission to resume service, according to Fergus. "They have not been told by us that they cannot operate." But if the company puts its planes in the air again, he said, "we're going to wonder why, after you thought you had to ground yourself, why are you doing it now."

He said the fact that the company had two fatal crashes in a little more than two years "raised a red flag."

"We don't have suspicions about any one thing. We just want to get ahead of it and increase our vigilance," Fergus said.

Fergus said the FAA inspection uncovered "issues and concerns." He would not specify what those issues and concerns are, but said they involve "operations and administrative" matters, which could include aircraft maintenance and accuracy of records.

Fergus also said Hawaii Air Ambulance has been "extremely cooperative" during the inspection.

Kluger said the lone issue to come out of the FAA's review involves using someone other than pilots to do "flight planning." He said the company is considering the FAA suggestion.

If the inspection turns up problems that involve FAA violations or other circumstances that affect the safety of flight operations, Fergus said, the agency would launch a more thorough investigation, separate from the crash inquiry being conducted by the National Transportation Safety Board.

The fatal crash occurred at 7:15 p.m. when one of the company's twin-engine Cessnas plummeted into a BMW car dealership in Kahului while preparing to land at Kahului Airport to pick up a patient. Witnesses said the Cessna's wings wobbled several times before the plane went down a mile west of the runway, according to a preliminary NTSB report.

Killed were pilot Peter Miller, 32, of Kailua; assistant chief flight nurse Brien Eisaman, 37, of Waipahu; and Marlena Yomes, 38, a mobile intensive care technician from Wai'anae.

On Jan. 31, 2004, a Hawaii Air Ambulance Cessna 414A smashed into a Laupahoehoe forest on the Big Island during a late-night flight for a patient pickup in Hilo. The pilot and two crew members were killed. The National Transportation Safety Board has not issued its final report on the probable cause of the crash.

Kluger said that while two fatal crashes in the past two years "is terribly, terribly tragic," they should be weighed against the fact the company completed more than 37,000 medical missions during the past 27 years.

Hawaii Air Ambulance has been in business since 1979 and is accredited by the Commission of Accreditation of Medical Transport Systems. It employs approximately 60 pilots, physicians, flight nurses, mechanics and administrative personnel.

Under an arrangement with the state Department of Health, the U.S. Coast Guard has been flying patients from the Neighbor Islands to hospitals on O'ahu until private aeromedical service is restored. Kluger said he hopes the company will be able to resume flights by this weekend.

The Coast Guard has agreed to provide helicopters, C-130 planes and flight crews to transport critical-care patients at no cost to the state as long as its primary mission of search and rescue at sea is not compromised, said Coast Guard Petty Officer Brooksann Epiceno. So far, 69 aeromedical missions have taken place.

Patients who need treatment on O'ahu but aren't considered critical-care cases have to wait to catch a ride on one of the critical-care flights, said Dr. Linda Rosen, deputy director of the state Department of Health and acting chief of the Emergency Medical Services Branch. As many as five patients have been on a single flight, she said.

According to Rosen, there have been no "negative outcomes" for patients as a result of the situation. Timeliness in getting off-island treatment always has been an issue on the Neighbor Islands because of aircraft availability and weather, Rosen said, "so having to hold patients for a day or two is not really new."

The Health Department is not seeking another private provider of aeromedical services, she said, although several companies have expressed interest. Rosen would not reveal the names of the companies.

None has applied for a certificate of need from the State Health Planning and Development Agency, a requirement for any major medical facility or service.

"We're just trying to meet the need right now and are hoping Hawaii Air Ambulance will be flying soon," Rosen said.

Since March 8, the Coast Guard has spent $800,000 on the aeromedical flights, Epiceno said. Medical personnel for the flights have been provided from among volunteers of the Disaster Medical Assistance Team for Hawai'i and the Pacific, under the Federal Emergency Management Agency. The state's volunteer Medical Reserve Corps is in the process of taking over those duties.

The Disaster Medical Assistance Team is usually activated by FEMA for events such as natural disasters, and Hawai'i members helped during the recent series of hurricanes on the Mainland. But this is the first time that the team has been called into action by the state to fill a medical-care gap, said Toby Clairmont, unit commander of the Hawai'i team.

Epiceno said the Coast Guard will continue to provide medical transports indefinitely, but she acknowledged that over time, the flights could stretch the agency's resources.

"It is not our place to do it all the time. We'll continue to help until a company steps forward," she said.

Reach David Waite at dwaite@honoluluadvertiser.com and Christie Wilson at cwilson@honoluluadvertiser.com.