Ontario’s Ornge air ambulance system remains under government scrutiny. In testimony before the Provincial Parliament’s Public Accounts Committee March 6, the then-head of the Ontario Provincial Police (OPP), Chris Lewis, said its anti-rackets branch is expanding its investigation to include interviewing witnesses in the U.S. and Italy and seeking documents from those jurisdictions. At issue is the conduct of former Ornge executives, including an examination of whether they orchestrated multimillion-dollar kickbacks from suppliers disguised as marketing agreements and charitable donations and also siphoned millions of public dollars into private entities they controlled. The OPP began its investigation of Ornge in 2012 after Ontario’s Auditor General uncovered financial irregularities. Following those revelations, the provincial Ministry of Health and Long Term Care replaced the leadership at Ornge. The OPP was expected to complete its work last year.

However, after 50 interviews and reviewing 22,000 pages of documents and 500,000 e-mails through early 2013, the investigation grew to include assistance from the Royal Canadian Mounted Police and the Federal Department of Justice as it spread to the U.S. and Italy. It then slowed under the weight of the Mutual Legal Assistance Treaty, invoked to compel the testimony and cooperation of foreign witnesses and entities. “This process is not timely and requires that a protocol be followed,” noted then-OPP Commissioner Chris Lewis in testimony before the Provincial Parliament’s Public Accounts Committee shortly before his retirement in March. “The investigation is still not complete,” he said. In January he had informed the committee he hoped the probe would be wrapped up in “early 2015.” The Public Accounts Committee finished its three-year probe of Ornge this spring but release of its final unanimous and all-party report was tabled when Premier Kathleen Wynne dissolved the government May 2.

Meanwhile, on May 29, Canadian federal labor authorities charged Ornge with 17 violations of the Canadian Labor Code relating to the fatal nighttime crash of one of its Sikorsky S-76As in May last year. The offenses included pairing pilots who both had inadequate currency, experience and training in the S-76, including one who had not passed all required proficiency checks and one with insufficient night experience; failure to provide the pilots with “a means to maintain visual reference” during night flights; and failure to adequately supervise the helicopter base. Ornge claims to have taken corrective measures following the crash.

However, citing the seriousness of those charges, on June 2 Frank Klees, a former member of the Provincial Parliament who sat on the Public Accounts Committee during its Ornge hearings, provided access to a copy of the committee’s final report to the media, including AIN.

The report repeatedly faults the Provincial Ministry of Health and Long Term Care for its lax oversight of Ornge. Witness testimony before the Public Accounts Committee revealed financial improprieties and poor operational practices and performance that contributed to patient deaths. Forty of those patient deaths were evaluated in a separate investigation launched by the Provincial Coroner. The Coroner’s 2013 report made 25 separate recommendations to improve Ornge, finding that Ornge operational practices were not a factor in 32 of the deaths because the patients were too ill or injured to survive, but that in the remainder there was possible, probable or definite impact on patient deaths.

The Public Accounts Committee report cites a litany of operational concerns, including “personnel shortages in the medical and aviation areas, specifically insufficient qualified medical staff, availability of paramedics, pilot shortages, aircraft availability and aircraft maintenance and ground issues” as well as potential flaws in the dispatch system. It recommended that specific members of Ornge’s former board, senior executives, staff and its accountants and attorneys be formally investigated for professional misconduct by their varying sanctioning bodies, including the College of Physicians and Surgeons of Ontario, the Law Society of Upper Canada, the Institute of Chartered Accountants of Alberta and the Institute of Chartered Accountants of Ontario. It also recommended that the Ontario Ministry of Health and Long Term Care recover excessive compensation and any misappropriated funds.