Date: 201205
Local time of day: 0601-1200
Location: ZZZ.Airport, US
Flight conditions: VMC
Weather elements / visibility: 10
Light: Daylight
Aircraft: EC145
Operator: Air Carrier
Operating under: Part 135
Flight plan: None
Mission: Ambulance
Flight phase: Cruise
Airspace: Class D ZZZ
ATC / advisory: TRACON ZZZ
Second aircraft: Beechcraft Single Piston Undifferentiated or Other Model
Reporter organization: Air Carrier
Reporter function: Pilot Flying; Single Pilot
Reporter qualification: Flight Crew Commercial; Flight Crew Rotorcraft; Flight Crew Instrument; Flight Crew Flight Instructor
Human factors: Communication Breakdown; Situational Awareness; Time Pressure
Anomaly: ATC Issue All Types; Conflict Airborne Conflict; Deviation / Discrepancy - Procedural Published Material / Policy
Detector: Automation Aircraft TA
When detected: In-flight
Result: Flight Crew Took Evasive Action
Contributing factors: Airport; Human Factors; Procedure
Primary problem: Human Factors

Narrative: We had a close call with a Bonanza airplane about 1 mile off the approach end of Runway 21 in Tower controlled airspace. We were on the return leg of a medical flight with a patient on board. Approximately 20 miles out I contacted Approach Control and advised them of our position; destination; and that I had the current ATIS information. I was using our designated transponder code and designated call sign to signify that we were a Lifeguard aircraft. The Approach Controller directed us to proceed direct to the hospital which is 3 miles South of ZZZ.A few minutes later I heard a VFR Bonanza contact Approach. He was 30 NM Northeast and wanted to land at ZZZ. Approach directed him to make straight in for Runway 21. I looked at the TCAS and saw that the Bonanza was a couple thousand feet above and behind our aircraft in about the seven o'clock position at that time. Closer in the Bonanza and I were advised of each other's position by Approach Control. At the time he could not see us and I could not see him due to his position being above and behind our aircraft. About a minute after that I was requested by Approach to turn left to a heading of 170 to pass behind the Bonanza which I still did not have in sight; but was on the TCAS off to my left and slightly above. My current heading was approximately 190; and this would have created a hazard in my opinion. I politely asked the Approach Controller if he was aware that we were a Lifeguard aircraft. After a short pause we were told to proceed direct to the hospital and contact the Tower. I contacted the ZZZ Tower with our Lifeguard call sign and advised them again of our hospital destination. Tower told me to report short final to the hospital. A couple seconds after that I heard the Bonanza contact the Tower. The Controller alerted the Bonanza to our position and then alerted me to his position. At this time I visually acquired the Bonanza at our ten to eleven o'clock and a couple hundred feet above us; I also received an audio TCAS warning alerting me to its close proximity (Less than 1 mile).The Bonanza continued his descent to Runway 21 across our flight path which I believe created a collision hazard as the Bonanza was less than 1 mile away; descending through our altitude and converging with our course. I immediately started a right turn to parallel Runway 21 and advised the Tower of our heading change due to the traffic. I received a 'Roger' from the Tower. After the traffic descended over the runway to land and no longer created a hazard I turned back on course; reported our final approach and landed at the hospital. At the closest point; as I turned to parallel the runway; our aircraft were probably less than 1/2 mile apart; at the same altitude and on a course that would have resulted in a collision--or at the very least a near miss--with less than 100 FT of separation. Pertinent regulations require that ATC provide priority to civilian air ambulance flights under a 'LIFEGUARD' call sign. The order also states that heavy traffic flow may affect the controller's ability to provide priority handling; but as we were the only two aircraft currently talking to Approach and Tower this should not have been a problem. I believe this situation could have best been avoided by the controllers to have the other aircraft that was VFR in VMC on a VISUAL approach slow down or alter course.




Synopsis: An air ambulance helicopter pilot had to take evasive action to avoid a conflict with a Bonanza inbound to an airport for which it had been cleared for a visual approach. The reporter believed he had the right of way through the arrival path due to his flight's Lifeguard status.