Date: 201911
Local time of day: 0601-1200
Location: ZZZ.Airport, US
Flight conditions: VMC
Light: Dusk
Aircraft: Helicopter
Operator: Air Taxi
Operating under: Part 135
Mission: Ambulance
Flight phase: Takeoff / Launch
Airspace: Class E ZZZ
ATC / advisory: Center ZZZ
Reporter organization: Air Taxi
Reporter function: Captain; Pilot Flying
Reporter qualification: Flight Crew Commercial; Flight Crew Rotorcraft
Human factors: Confusion; Communication Breakdown
Anomaly: Deviation / Discrepancy - Procedural Published Material / Policy; Flight Deck / Cabin / Aircraft Event Other / Unknown; Inflight Event / Encounter Other / Unknown
Detector: Person Flight Crew
When detected: In-flight
Contributing factors: Company Policy; Human Factors; Procedure
Primary problem: Company Policy

Narrative: Our crew accepted an inter-facility flight to [a] hospital. Upon arriving; a Nurse advised the crew the patient 'has a bed bug problem and they found multiple bed bugs on the patient and in his clothes.' Prior to making contact with the patient; our crew discussed the bed bug situation and decided it was in our best interest to not fly the patient. I called our Area Manager and advised him of our situation and told him our crew did not feel comfortable transferring the patient for the risk of contamination of the aircraft; the crew; and the receiving facility. At this time [the Area Manager] advised me to standby and he was 'getting the Medical Director involved.'[The Area Manager] called me a few minutes later advising me the Medical Director he spoke with approved the transport as long as we placed the patient in a cocoon with a hair bonnet. I disagreed with [the Area Manager] that this was inadequate protection from bed bugs and we still stood a chance at becoming contaminated. During the conversation I voiced my concerns for the 'risks involved in transporting a patient with bed bugs and the risk of our base potentially being out of service for a long period of time for decontamination of the crew and the aircraft.' Again; [the Area Manager] told us we need to complete the flight and told me he was going to 'contact [the Chief Pilot] if I thought there were risks involved in completing the flight and I was refusing.' I then advised [the Area Manager] that I didn't see a need to contact [the Chief Pilot] as it wasn't a safety of flight issue as much as it was a medical/contamination issue. The crew then went inside and made patient contact. While the crew went bedside; I contacted our Mechanic and advised him of our situation and asked what steps are involved in decontaminating our aircraft after transport. [The Mechanic] strongly advised us not to take the patient via helicopter due to the amount of time our aircraft will be out of service for cleaning/replacement of the seat belts. After the medical crew went bedside; they determined the patient was stable and non-emergent and offered to go with a ground crew instead of contaminating our aircraft.Once again; I called [the Area Manager] and asked if ground transport was an option so our aircraft wouldn't become contaminated and advised him of what our Mechanic said. [The Area Manager] once again told us 'the patient needs to be transported via helicopter; not a ground unit.' After being pressured to fly this patient; we completed the flight following [the Area Manager's] orders and transported the patient to [the] hospital. After unloading the patient at [the hospital]; the Medic and myself noticed several bed bugs on the sled. We returned to base and began to decontaminate ourselves and our aircraft. All the restraints on the sled had to be removed by a Mechanic and washed; putting our base out of service for an extended amount of time. Pressure to fly should not occur from upper management about a hazardous situation. The Nurse/Medic offered to travel with ground transport to ensure the safety of our crew; helicopter; and receiving facility. After the flight occurred; [the Company] should have a procedure in place to deal with bed bugs as the crew does not have proper tools/equipment to decontaminate the aircraft after this type of flight.




Synopsis: Helicopter pilot reported potential bed bug contamination on helicopter and crew.