Narrative:

We departed X medical center with the intent of transporting a patient from Y medical center to XXX. WX en route was clear with unlimited visibility. Upon our arrival in the ZZZ area we observed a small pocket of fog. The fog was confined to the river and downtown area. Although the fog was shallow and portions of the city were visible through it, the immediate area around the hospital was obstructed. We discussed several alternatives including landing at the airport about 5 mi to the north and landing at an unprepared site such as the fire department or a nearby parking lot. I tended to favor the first option given the coordination and response time involved necessary to prepare a landing zone. I also know from past experience that given the alternative of transporting the patient at an alternate location, YYY has elected to transport the patient entirely by ground to XXX. However, as we made our descent about 1/2 to 1 mi north of the hospital to evaluate the alternatives, we observed good ground references and lighting beneath the layer of clouds which appeared to be about 500 ft above the AGL with ragged bottoms and no more than 100 ft thick. At that time we proceeded underneath the layer and completed our descent and approach to YYY. We experienced a relatively short ground time (15-20 mins) and I felt that although marginal, the WX was still adequate for departure and that our best departure route would still be to the north. However, I also realized that there could be a possibility of some deterioration in the WX since the sun was starting to come up. Before and during liftoff I still observed good ground lighting to the north as well as pockets of ambient lighting under the layer of clouds. As I proceeded north, I observed my ground references start to deteriorate. At that time I felt that given the nature (depth and breadth) of the cloud layer, and my alternatives of going lower or further maneuvering beneath this layer, my safest option was to punch through the layer which we did. We were on top in less than 5 seconds and returned to XXX without incident. Pilot recommendation to prevent recurrence: this is a typical WX pattern for this area in the fall and spring. Alternate landing and transfer procedures should be established. Hospital personnel should provide an evaluation of the WX when a flight is requested and if the WX is marginal, a decision should be made to implement those procedures at that time. Medical center staff should be prepared to query the requesting staff concerning WX conditions and there should be an appropriate place on the flight information sheet to remind them to do this and to record the information. For my part, I do not feel I was unsafe. However, I will strictly adhere to operational policies and procedures to remove any doubt and to insure that I am not in this situation again. I will also involve the crew more in the decision making process with a more thorough discussion of other transport options and alternatives.

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Original NASA ASRS Text

Title: EMS PLT CLBED THROUGH CLOUDS WITH VFR FLT PLAN.

Narrative: WE DEPARTED X MEDICAL CTR WITH THE INTENT OF TRANSPORTING A PATIENT FROM Y MEDICAL CTR TO XXX. WX ENRTE WAS CLR WITH UNLIMITED VISIBILITY. UPON OUR ARR IN THE ZZZ AREA WE OBSERVED A SMALL POCKET OF FOG. THE FOG WAS CONFINED TO THE RIVER AND DOWNTOWN AREA. ALTHOUGH THE FOG WAS SHALLOW AND PORTIONS OF THE CITY WERE VISIBLE THROUGH IT, THE IMMEDIATE AREA AROUND THE HOSPITAL WAS OBSTRUCTED. WE DISCUSSED SEVERAL ALTERNATIVES INCLUDING LNDG AT THE ARPT ABOUT 5 MI TO THE N AND LNDG AT AN UNPREPARED SITE SUCH AS THE FIRE DEPT OR A NEARBY PARKING LOT. I TENDED TO FAVOR THE FIRST OPTION GIVEN THE COORD AND RESPONSE TIME INVOLVED NECESSARY TO PREPARE A LNDG ZONE. I ALSO KNOW FROM PAST EXPERIENCE THAT GIVEN THE ALTERNATIVE OF TRANSPORTING THE PATIENT AT AN ALTERNATE LOCATION, YYY HAS ELECTED TO TRANSPORT THE PATIENT ENTIRELY BY GND TO XXX. HOWEVER, AS WE MADE OUR DSCNT ABOUT 1/2 TO 1 MI N OF THE HOSPITAL TO EVALUATE THE ALTERNATIVES, WE OBSERVED GOOD GND REFS AND LIGHTING BENEATH THE LAYER OF CLOUDS WHICH APPEARED TO BE ABOUT 500 FT ABOVE THE AGL WITH RAGGED BOTTOMS AND NO MORE THAN 100 FT THICK. AT THAT TIME WE PROCEEDED UNDERNEATH THE LAYER AND COMPLETED OUR DSCNT AND APCH TO YYY. WE EXPERIENCED A RELATIVELY SHORT GND TIME (15-20 MINS) AND I FELT THAT ALTHOUGH MARGINAL, THE WX WAS STILL ADEQUATE FOR DEP AND THAT OUR BEST DEP RTE WOULD STILL BE TO THE N. HOWEVER, I ALSO REALIZED THAT THERE COULD BE A POSSIBILITY OF SOME DETERIORATION IN THE WX SINCE THE SUN WAS STARTING TO COME UP. BEFORE AND DURING LIFTOFF I STILL OBSERVED GOOD GND LIGHTING TO THE N AS WELL AS POCKETS OF AMBIENT LIGHTING UNDER THE LAYER OF CLOUDS. AS I PROCEEDED N, I OBSERVED MY GND REFS START TO DETERIORATE. AT THAT TIME I FELT THAT GIVEN THE NATURE (DEPTH AND BREADTH) OF THE CLOUD LAYER, AND MY ALTERNATIVES OF GOING LOWER OR FURTHER MANEUVERING BENEATH THIS LAYER, MY SAFEST OPTION WAS TO PUNCH THROUGH THE LAYER WHICH WE DID. WE WERE ON TOP IN LESS THAN 5 SECONDS AND RETURNED TO XXX WITHOUT INCIDENT. PLT RECOMMENDATION TO PREVENT RECURRENCE: THIS IS A TYPICAL WX PATTERN FOR THIS AREA IN THE FALL AND SPRING. ALTERNATE LNDG AND TRANSFER PROCS SHOULD BE ESTABLISHED. HOSPITAL PERSONNEL SHOULD PROVIDE AN EVALUATION OF THE WX WHEN A FLT IS REQUESTED AND IF THE WX IS MARGINAL, A DECISION SHOULD BE MADE TO IMPLEMENT THOSE PROCS AT THAT TIME. MEDICAL CTR STAFF SHOULD BE PREPARED TO QUERY THE REQUESTING STAFF CONCERNING WX CONDITIONS AND THERE SHOULD BE AN APPROPRIATE PLACE ON THE FLT INFO SHEET TO REMIND THEM TO DO THIS AND TO RECORD THE INFO. FOR MY PART, I DO NOT FEEL I WAS UNSAFE. HOWEVER, I WILL STRICTLY ADHERE TO OPERATIONAL POLICIES AND PROCS TO REMOVE ANY DOUBT AND TO INSURE THAT I AM NOT IN THIS SIT AGAIN. I WILL ALSO INVOLVE THE CREW MORE IN THE DECISION MAKING PROCESS WITH A MORE THOROUGH DISCUSSION OF OTHER TRANSPORT OPTIONS AND ALTERNATIVES.

Data retrieved from NASA's ASRS site as of July 2007 and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.