The only team of nurses in the state that helps transport critically ill children will not board another Hawaii Air Ambulance aircraft until further notice.

Mavis Nikaido, supervisor of the Kapi'olani Medical Center for Women and Children Transport Team, said the decision to keep the team's nine nurses from flying with the company follows Wednesday night's air ambulance crash on Maui.

"We don't take anything like this lightly," she said.

The crash killed all three people aboard — the pilot, flight nurse and medical technician. Another Hawaii Air Ambulance airplane crashed on the Big Island on Jan. 31, 2004, also killing three people.

Patty Dukes, city Emergency Medical Services chief, said two of her paramedics who moonlight for Hawaii Air Ambulance now refuse to fly as well.

"I can understand why they wouldn't want to fly anymore," Dukes said of the paramedics and nurses. "I imagine there will be a few people who won't."

Hawaii Air Ambulance chairman and CEO Andrew Kluger yesterday said he met with the Kapi'olani nurses and will meet with them again Tuesday. He said he also talked to Dukes.

Nikaido said the most recent crash brought things too close to home for the nurses. "It made us realize the next crash victims could be from our team," she said.

She stressed that the Kapi'olani team will continue to serve pediatric patients from the Neighbor Islands but is doing so with the help of the U.S. Coast Guard.

When asked what it might take to resolve the team's concerns, she said: "I really don't know."

The Kapi'olani team helps transport about 40 patients a month.

But Coast Guard Chief Petty Officer Marsha Delaney said there is no guarantee a plane and crew will be made available for each emergency.

"We will have to evaluate each request for assistance on a case-by-case basis," Delaney said.

While the Coast Guard's overall mission is to respond to people in need, it is a government agency and is not allowed to compete with a private business.

"It's not a case where we can just jump on the plane and go," she said. "If civilian assets are not available and there is a medical case where someone needs help, we go through our check list to see if we can offer assistance."

Delaney said Coast Guard C-130 airplanes flew three medical missions between noon and 10 p.m. on Thursday, bringing a total of eight patients to Honolulu — three from Maui, three from Kona and two from Hilo.

Kluger called the decision by some not to fly in Hawaii Air Ambulance planes "a comfort-zone issue."

"I don't want anybody on our aircraft who isn't comfortable to fly," Kluger said. "That is why I voluntarily brought in outside inspectors to ensure that they are air worthy."

He would not say how many nurses fly with the company, but he said his company has the equivalent of 40 full-time employees, including 12 pilots.

A statement released by the company said its total workforce is 100 pilots, physicians, flight nurses, flight medics, mechanics and administrative personnel.

The company provides virtually all of the interisland air ambulance services, and a normal flight complement is a pilot plus either a nurse and paramedic or two paramedics. Often, the medical team will consist of hospital, fire department or ambulance professionals, who work during time off from their regular jobs.

The company had five Cessna 414A Chancellor aircraft until the crash.

Killed in this week's crash were pilot Peter Miller, 32, of Kailua; assistant chief flight nurse Brien Eisaman, 37, of Waipahu; and Marlena Yomes, 39, a mobile intensive care technician from Wai'anae.

Autopsies were performed on all three yesterday, said Dr. Anthony Manoukian of the Maui County Coroner's office.

All three died from "multiple traumatic injuries" as a result of the crash and subsequent fire, he said, "although I believe all of them died on impact. ... Death came quickly to all three of them."

Manoukian said toxicology studies done on all three will be sent to the National Transportation Safety Board laboratory in Oklahoma City on Monday. Results typically take one to two months, he said.

He said evidence from the crash site shows the pilot was attempting to control the plane all the way down until impact, meaning Miller was conscious and didn't suffer a heart attack or otherwise lose consciousness.

"From the pattern of injury to his hands and his feet, it looked like he was attempting to control the aircraft right until impact."

EMS flights have attracted federal scrutiny recently.

On Feb. 7, the NTSB forwarded a report to the Federal Aviation Administration citing an increase in air ambulance deaths in the past five years and recommending tighter regulation.

Between January 2002 and January 2005, 55 EMS aircraft accidents resulted in 54 deaths and 18 serious injuries, according to the NTSB report.

Brian Alexander, a New York City attorney specializing in aviation law who once flew flights for a military transport detail, said air ambulance services tend to "fly below the radar" of federal and state scrutiny.

"Where there is smoke there is fire," he said by phone from Vermont. "It's safety first or safety not at all. You either make it the highest priority or it is not a priority. In the broadest sense, the trend is that for the last few years we've seen the results of everybody looking the other way."

Also, FAA officials confirmed Miller, the pilot, was flying a plane that was damaged during landing at Honolulu International Airport on July 1, 2005.

According to a preliminary NTSB accident report, Miller was at the controls of a privately owned, twin-engine Piper Apache airplane when the plane's landing gear collapsed during a landing.

According to a synopsis of the accident, Miller, a certified flight instructor, had a student with him in the plane and the two were practicing an engine shut-down procedure while in the air. Miller had the student shut down the plane's left engine, which subsequently could not be restarted.

Because the left engine powers a hydraulic pump that services the plane's landing gear, the pump had to be operated manually to get the landing gear into position for landing.

Miller took control of the plane and returned to the airport. When the airplane touched down, the nose gear collapsed and the airplane veered to the left. About four feet of the left wing tip were sheared off when the wing hit a taxiway light.

The preliminary report did not assess any responsibility for the incident to Miller or anyone else.

Miller had over 3,000 hours of flight experience and flew into Maui at night an average of 10 times a month, Kluger said. He was hired by Hawaii Air Ambulance in March 2005.

Kluger said one of his planes has been approved to fly by the independent consultant he hired to inspect them after Wednesday's crash.

A second plane is expected to be cleared for use today, he said. In the meantime, Kluger said he hired two private contract planes to keep his services running.

Staff writer William Cole contributed to this report.

Reach David Waite at dwaite@honoluluadvertiser.com, Peter Boylan at pboylan@honoluluadvertiser.com and Mike Gordon at mgordon@honoluluadvertiser.com.