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Ornge AgustaWestland AW139 at the Ottawa base, 3 June 2011

Key Information

Ornge facility in Thunder Bay

Ornge (pronounced Orange),[4] formerly Ontario Air Ambulance Corporation and Ontario Air Ambulance Service, is a Canadian not-for-profit corporation[2] and registered charity[1] that provides air ambulance and associated ground transportation services for the province of Ontario, under the direction of the province's Ministry of Health. The provision of ambulance services in Ontario is governed by the Ambulance Act, which states that the Minister of Health "has the duty and the power" to make sure Ontario is serviced by a "balanced and integrated system of ambulance services and communication services used in dispatching ambulances."[5] Its headquarters are in Mississauga, Ontario, Canada.

The name Ornge is not an acronym, but is based on the orange colour of the organization's aircraft and land ambulances. According to the organization, "The 'a' was removed from the name, partly to make people stop and take a second look, and also so that it could be trademarked."[6]

As of 2024, Ornge has the largest air ambulance and critical care land ambulance fleet in Canada, and employs more than 700 people, including paramedics, pilots, and aviation specialists. It serves more than 14 million people over one million square kilometres of land, deploying from 14 bases across Ontario as well as its Mississauga, Ontario, Canada headquarters. Ornge is responsible for approximately 20,000 patient-related transports per year. It also contracts some of its non-urgent patient transport service in Northern Ontario to private air carriers.[7]

History

[edit]
An early production Sikorsky S-76A owned by Canadian Helicopters and used in the Ontario air ambulance role in August 2007. The aircraft is in an earlier Ontario Air Ambulance paint scheme.

Prior to Ornge, the air ambulance program was established in 1977 to serve remote areas, primarily in Northern Ontario, that are inaccessible to land ambulances or that land ambulances would take too long to reach. Ontario was the first Canadian province to provide a helicopter-based air ambulance system to transport critically ill patients to hospital. Air ambulances are also used to transport medical teams and organs for transplant. A large part of the air ambulance service is involved in serving aboriginal communities, of which there are approximately 117, in 6 treaty areas of Northern Ontario.[8]

The first air ambulance, "Bandage One" a Bell 212, was operated out of Buttonville Airport by private operator Viking Helicopters Incorporated (later to become part of Canadian Helicopters).[9] A second Bell 212, "Bandage Two", was after one year pilot deemed successful and located in Sudbury, Ontario, followed by "Bandage Three" in Thunder Bay, "Bandage Four" in Timmins and "Bandage Five" in Sioux Lookout for a total of 5 by 1981.[9] Fixed-wing service began in 1978, provided by Austin Airways, with a Timmins based Cessna Citation I. Eventually almost 90 private aircraft would be employed.[10][11][12][13][14]

This arrangement lasted more than 25 years, until about 2005, as the Ministry of Health and Long-Term Care contracted with private operators to provide its air ambulance program's aircraft, pilots and paramedics. The Ministry directly operated the central air ambulance dispatch centre and was responsible for overseeing the overall effectiveness of the air ambulance program.[15]

In 2005, the Ministry announced that it was appointing a not-for-profit corporation called the Ontario Air Ambulance Corporation to be responsible for all air ambulance operations. This was done to establish clearer lines of authority among the different parts of air ambulance operations. An arm's-length corporation was also consistent with the Ministry's objective of moving away from direct service delivery. The corporation's name was subsequently changed to Ornge.[15] Ornge was described in 2012 as being neither a Crown corporation nor an agency directly controlled by the Government of Ontario, but rather a non-profit organisation incorporated under the federal Canada Corporations Act.[16]

The Ministry operated an air ambulance dispatch centre in Toronto until Ornge took over and MATC (Medical Air Transport Centre) became the Ornge Communications Centre.[17]

On 17 September 2007, Ornge Air was created. It would purchase aircraft and compete with the private-sector providers.[14] Today, the air ambulance program has become an integral component of the larger emergency health system in communities across the province.[18]

In 2020, Dr. Homer Tien was appointed President and CEO, replacing Dr. Andrew McCallum (2013-2020). From 2015 to 2020, Dr. Tien served as Chief Medical Officer for Ornge, during which time, Ornge became the first air ambulance service to achieve accreditation in Ontario through Accreditation Canada, a third-party healthcare accreditation body.[19]

In 2023, the Government of Ontario announced it would fund the renewal of Ornge Air Ambulance’s fixed wing fleet with a new fleet of aircraft. During this announcement, the Ministry of Health also pledged an additional $10 million to facilitate the procurement of a larger hangar for their Sudbury base to accommodate the expanded fixed wing fleet (in addition to their existing helicopter fleet).[20] The Ontario Ministry of Health said that this $108 million investment will allow Ornge to provide safe and consistent air ambulance services to all Ontarians, especially in rural and remote areas of the province. By 2026, Ornge air ambulance service will have upgraded its existing fleet of eight fixed wing aircraft and will add four additional aircraft in Northeastern Ontario, adding two new 24/7 Critical Care crews to provide service in the region.[21]

COVID-19

[edit]

Operation Remote Immunity

[edit]

Ornge provided logistical and operational leadership for Operation Remote Immunity, a public health initiative launched on February 1, 2021, in response to the COVID-19 pandemic. This operation aimed to deliver COVID-19 vaccines to residents of remote Indigenous communities in Northern Ontario, which faced heightened vulnerability to the virus due to factors like overcrowded housing, limited healthcare access, and the remoteness of the areas.[22]

Operation Remote Immunity was co-led by Ornge in collaboration with Ontario’s vaccine task force, Indigenous leaders, Indigenous organizations including the Nishnawbe Aski Nation and the Weeneebayko Area Health Authority, and local health units and authorities.[23] Teams of healthcare professionals were trained before deploying to ensure that members were prepared to work respectfully and effectively within Indigenous communities.[24] Indigenous leaders were directly involved in the planning and execution of the vaccination campaign to ensure that it aligned with community needs and values.[22]

Operation Remote Immunity deployed over 800 missions,[22] reaching 31 fly-in First Nations communities and the town of Moosonee. By April 2021, nearly 25,000 doses of the Moderna COVID-19 vaccine had been administered, with approximately 14,000 people receiving their first dose and over 11,000 receiving their second dose. Over 90% of eligible individuals were vaccinated as a result of Operation Remote Immunity.[25] Ornge also provided leadership for Operation Remote Immunity 2.0 which delivered the vaccine to young people aged 12 to 17.[26]

ICU Transports

[edit]

During the COVID-19 pandemic, Ornge had a leading role in the transport and care of intensive care unit (ICU) patients across Ontario. Specifically, Ornge assisted hospitals in managing patient capacity during COVID-19 by 'decanting' patients, which refers to the process of moving critically ill patients from one hospital's ICU to another hospital with more available capacity. This was done to alleviate overcrowding in overwhelmed ICUs by redistributing patients to less burdened facilities. The practice became common during the COVID-19 pandemic, as surges in ICU admissions, especially among ventilated COVID-19 patients, led to capacity issues in certain hospitals. This practice ensured that hospitals with stretched resources could maintain the ability to care for incoming critically ill patients.[27][28]

In 2020 and 2021, Ornge experienced a significant increase in demand for its services as hospitals faced capacity challenges. Patients were transported as far as 110 kilometers from Toronto to other hospitals, including in locations such as Barrie and Kingston. During a COVID-19 wave of infections between November 2020 and January 2021, Ornge transferred approximately 240 ICU patients, representing a 60% increase from the previous year. Many of these patients were COVID-19 positive or exhibited symptoms, and most were sedated and on ventilators.[28]

Financial scandal and police investigation

[edit]

Executive compensation

[edit]

In 2011 Ornge was involved in a controversy regarding executives' compensation, including President and CEO Chris Mazza. The Toronto Star uncovered that Mazza was receiving $1.4 million a year while remaining off the "sunshine list" of public employees earning over $100,000. That salary made him the highest publicly paid official in the province. Ontario Health Minister Deb Matthews stated that Mazza's salary was "outrageous, shocking and unacceptable". On 9 February 2013 Dr. Chris Mazza received $4.6 million in public dollars in his last two years at Ornge, including salary, bonuses, cash advances and two housing loans. In 2013, it was revealed that Mazza made $9.3 million over six years at Ornge.[29][30] Mazza expensed ski trips and international junkets, often with his girlfriend; hotel room bills of $2,400 were reported.[31]

Other executives were "highly paid", but Ornge failed to disclose their salaries. Chairman Rainer Beltzner received $232,757 in 2011.[30] The board members received almost $2 million between 2007 and 2011.[30] In 2011, 50 executives received a total of $11.8 million (average $238,000) which was not disclosed on the Sunshine list.[30]

Executives were granted company-paid executive MBA educations, at a total of $600,000. Kelly Long, Mazza's girlfriend[30] and an ORNGE vice-president, received an MBA from Western University in London.[31]

Mazza went on an indefinite medical leave on 22 December 2011 at the height of the scandal.[citation needed]

Kickback allegations

[edit]

After Ornge bought helicopters from AgustaWestland for $144 million, AgustaWestland then made a $4.7 million payment to Mazza-controlled ORNGE Global. A later additional payment of $2 million was promised. Allegedly, the payment was for "marketing services". It was found that this "consisted of a small binder of information pulled together by Long."[31] Subsequent Ornge leader Ron McKerlie said the two small binders do not justify the large payment. The binders are said to be in the possession of the OPP.[32]

Later, a former executive indicated that Ornge had paid AgustaWestland $7 million more than should have. It was this allegation that prompted the OPP investigation.[31] Tom Rothfels indicated that Mazza insisted on paying about $600,000 extra per helicopter (roughly $7 million).[33] Rick Potter, former COO, indicated about $10 million extra.[33]

AgustaWestland also agreed to donate US$2.9 million to Ornge's charitable foundation.[34]

Inappropriate purchases

[edit]

Ornge paid $28 million for 11 used helicopters, believing this to be cheaper than renting. The fleet was subsequently sold for less than $8 million.[35]

Ornge purchased 12 helicopters from AgustaWestland, although only 9 were required.[34] Two of the units were not equipped to carry patients; these were sold in 2013.[34] The remaining 10 were found to have a poor cabin layout which made CPR difficult.[34] In 2015, Ornge was looking at replacing the AW139s, citing complexity and fuel consumption concerns.[34]

Ornge purchased 10 Pilatus PC-12 airplanes, although only 6 were needed.[34] Two of the 10 were for sale in 2015.[34]

The auditor general noted that "an open public competitive tender was not used" and Ornge overbought.[33]

Ornge planned a "Transport Medicine Centre of Excellence" in Hamilton.[36] Ornge spent approximately $600,000 leasing hangar space that went unused, due to construction delays.[37] Approximately $1.9 million was spent on hangar renovations.[38] The move from Toronto to Hamilton was later cancelled.[39]

Questions arose about the decision to open a base in Oshawa. Rick Potter, aviation chief (COO Ornge Air), stated the site does not have an instrument landing system, has many noise complaints and was not one he would recommend.[40][41] Hangar space was purchased in 2011, then subsequently sold for a $130,000 loss when plans were cancelled in 2013.[41]

Ornge purchased lifting devices, dubbed Ornge pickers, that were to lift patients into aircraft. The devices never worked.[42] There were also issues with the de-icing system for the AW139s, which never worked.[42] The company also apparently spent on orange painted tractors to move aircraft.[43]

Operational issues

[edit]

Various cases of delays in moving patients were revealed. It was found that dispatch operators were under pressure to cut costs by reducing helicopter launches. A policy existed that a helicopter would not be dispatched until a land ambulance had confirmed the need.[44] The policy was changed in 2012 to immediate launch when the 911 centre requests it.[43]

It was reported that the helicopter based in Thunder Bay was unable to fly about one quarter of the time due to lack of paramedics. The Star found the helicopter grounded 237 times for a total of 1300 hours over 10 months. "It's also a waste of public money. You have a helicopter and two pilots sitting there unable to do their jobs," stated a paramedic union leader.[45][46][47]

Web of companies

[edit]

Critics charged that Ornge had created a "web"[35][30] of companies. The auditor general found at least 14[48](20 by another source)[49][30] different corporate entities, among them JSmarts, Ornge Peel (later Ornge Global), Ornge Global Real Estate, Ornge Global Holdings LP, Ornge Issuer Trust, Ornge Global Air, Ornge Global Management and Orgeco.[48][50] Some of these companies were for-profit. The auditor general was denied access to financial records, given some of the entities are privately held.[48] The structure was described as a "complicated network".[48] "In fact, much of Ornge's operation is being delivered by these other entities, which bill Ornge for those services."[48]

Auditor General Jim McCarter described Ornge as a "mini-conglomerate" and believed the audit might not have found all the corporate offshoots.[35]

It was found that taxpayer dollars had flowed to for-profit Ornge companies.[49]

Some of the companies were owned by Chris Mazza, other executives, and board members.[49][30]

Corporate offices

[edit]

The building for Ornge's head office was bought for $15 million, using borrowed money. Ornge then created a complex deal with other Ornge companies to sell the building and lease it back to itself.[49][48] An independent real-estate appraiser estimated that Ornge's rent was 40% higher than the fair-market rent.[49][35] This amounted to a $2 million overpayment in five years. This allowed Ornge Global Real Estate to obtain $24 million in financing. The "extra" $9 million flowed to another company, Ornge Global Holdings LP.[49][35] The OPP was to look into the missing $9 million.[35] Auditor General Jim McCarter said this deal was one of several that did not "pass the old smell test".[35] Ornge's 25-year lease agreement was unusually long.[48]

The building itself was dubbed the "Crystal Palace" for its opulence and recreational facilities. Nearly $500,000 was spent on renovations. Ornge also apparently paid to renovate its previous office space, then paid $760,000 extra to break the lease early.[51][52][35]

[edit]

From 2005 to 2012, Ornge paid "well connected" law firm Fasken Martineau over $9 million in legal fees for 22,000 hours of work, including organizing the for-profit companies.[53] Other law firms received a further $2 million. Much of the money was spent creating the "web" of companies.

Alf Apps, former president of the Liberal Party national organization, was a Fasken lawyer. Apps boasted of the success of the deal structure.[54] Integrity Commissioner Lynn Morrison indicated she believed Apps had lobbied the government without registering.[55] Apps denied the allegation in testimony before legislative committee. Apps resigned from FM in Feb 2012, moving to another firm.[56]

Don Guy, chair of three campaigns for Dalton McGuinty, billed FM over $100,000 in legal fees.[53]

Lynne Golding, a Fasken partner (married to Tony Clement[55]), helped craft the 2005 performance agreement. She testified that she thought the agreement gave the government strong powers over Ornge, contradicting minister Deb Mathews.[53] Guy Giorno, a Fasken lawyer and ex chief of staff to Mike Harris and Stephen Harper, advised Ornge on compliance and disclosure.[56][53]

Chronology

[edit]

Ornge Global, Ornge's for-profit division, also received $6.7 million in a contract from Anglo-Italian helicopter manufacturer AgustaWestland, which is also part of the audit by the provincial auditor general.[57] Ron McKerlie, who was at the time Deputy Minister for the Ministry of Government Services, Associate Secretary of Cabinet and Secretary of Management Board of Cabinet for the Government of Ontario, was appointed as the Interim President and CEO.[58]

As the scandal spread on 24 January 2012 Ornge fired 18 managers and closed the J Smarts charity program. The next day a new board of directors was named, including former provincial cabinet minister Charles Harnick. A complete forensic audit was also started. On 2 February 2012 Ornge President and CEO Chris Mazza was fired without compensation, as was the chief operating officer of ORNGE Global, Maria Renzella. ORNGE Global GP Inc. and ORNGE Global Holdings LP were placed in bankruptcy under the oversight of a trustee. The bankruptcy move does not affect the provincial air ambulance service, which is operated separately.[59][60][61]

On 2 February 2012, the Ontario Health Minister Deb Mathews stated, "Today, the for-profit ORNGE Global GP Inc. and ORNGE Global Holdings LP went into receivership, essentially ending their existence. As a result, Dr. Chris Mazza, president and CEO, and Maria Renzella, chief operating officer, have been terminated and ORNGE has advised us that no severance has been offered. These are vitally important and necessary steps needed to restore the confidence of Ontarians in the leadership team responsible for Ontario's air ambulance service. The forensic audit continues and we look forward to their findings and the auditor general's value-for-money audit. We continue to seek and support the changes at ORNGE and continue to work with the new leadership as they strengthen Ontario's air ambulance service."[61]

On 16 February 2012 Ornge became the subject of an Ontario Provincial Police investigation for "financial irregularities". Neither the police, Mathews nor Ornge would provide details about the nature of the investigation. The minister indicated it was as a result of the preliminary findings of the forensic auditors in examining the organization's financial records. Aside from the police investigation there are two other investigations underway. The Ministry of Health's emergency health services branch is carrying out an investigation of 13 incidents related to air ambulance operations, three of which involve the deaths of patients. Also provincial Auditor General Jim McCarter is investigating Ornge and will present his final report in March 2012.[62]

On 17 February 2012, amidst calls for her resignation from the opposition, Ontario Health Minister, Deb Mathews announced that the government would greatly tighten control over Ornge, including new legislation and a new performance agreement to increase oversight and limit what it can do without government approval, including preventing the sale of assets, such as helicopters and the taking on of debt.[62]

On 23 February 2012 allegations surfaced of unqualified staff running the air ambulance service and of a questionable $14,000 payout to a Brazilian law firm by an Ornge spin-off company. More information became available about the nature of the OPP investigation, including that the subject is alleged kickback payments for helicopter purchases as well as interest-free loans and cash advances from Ornge to Mazza. Filed bankruptcy documents indicate that Mazza is a creditor of one of Ornge's now-defunct for-profit companies and that he is owed $1 in the proceedings. The opposition continued calls for the minister's resignation as news of medevac operation disruptions in recent weeks surfaced.[63]

On 21 March 2012 provincial Auditor General Jim McCarter released a report that heavily criticized the provincial government for lack of oversight of Ornge's operations. The report details that the government paid Ornge C$700 million over five years and that Ornge also borrowed an additional C$300 million for aircraft purchases. The report details how air ambulance costs increased 20% while transporting 6% fewer patients. McCarter reported how Ornge, "soon became a mini-conglomerate" with virtually no government supervision. He stated, "Of particular concern to us was the fact that certain of these companies were owned by Ornge's president, senior members of its management team and its board of directors. To the nose of this watchdog, this didn't pass the smell test." The report also details how Ornge bought more aircraft than it needed with government money with the aim of renting them out. Health Minister Deb Matthews said that the province will act on all of McCarter's recommendations.[64]

The police investigation continues.[65]

In February 2017, the OPP stated that the five year long kickback investigation was close to completion, but would not say whether charges will be laid.[31]

Whistleblowers

[edit]

Allegations were made that whistleblowers were harassed or fired. Lisa Kirbie, hired in March 2010 as the director of government and regulatory affairs, alleged in a lawsuit that Mazza was volatile and sexist, firing her without cause after she cooperated with the auditor and police probes.[66] Kirbie was the partner of Liberal strategist Warren Kinsella.[67]

Bruce Wade, a Thunder Bay helicopter pilot, was suspended with pay after testifying at a Queen's Park committee.[68]

Opposition critics charged that the governing Liberals tried to intimidate whistleblowers during legislative committee testimony. Former paramedic Trevor Kidd was asked to disclose the names of other workers who had information about problems at Ornge. Kidd had testified that he quit Ornge in 2009 after the death of a patient. Kidd's father, the mayor of Temiskaming Shores, discussed Ornge's problems with former Liberal MPP David Ramsay in 2009.[69][70]

Ornge belatedly announced whistleblower protection in 2013.[71]

Motorcycles

[edit]

Ornge commissioned two custom-built Orange County Choppers, allegedly gifts from Agusta, one of which was prominently displayed in the company's lobby. Mazza had posed at a Toronto Blue Jays game with the bike. The "chopper" became a focus of critics after the scandal was discovered. "That chopper is simply a reflection of how business was done. There are still a lot of people, let alone the chopper, in those offices who should not be there," noted PC MPP Frank Klees.[72] The bike, valued at $50,000, was eventually auctioned for $30,000. The second bike, valued at $100,000 is thought to be owned by Agusta. The Ornge charity JSmarts also owned a $50,000 speed boat.[73][74]

Nepotism allegations

[edit]

Critics noted the rapid ("meteoric"[75]) rise of girlfriend[75][30] Kelly Long to corporate power. A former water-ski instructor,[76][30] she had apparently met Mazza while she worked as an account manager at a water-ski club.[75] Pathway Group, a consulting firm used by Ornge, was asked by Mazza to hire Long.[75] Pathway did so in January 2006 as a "favour".[75] At Pathway she organized golf tournaments and did administrative work from home.[75] Mazza was unsatisfied with the work assignments Long was given. He had her seconded to Ornge in September 2006.[75] Pathway was paid nearly $9000 per month for this.[75] Long was then hired by Ornge in December 2006.[75] After that, she received a rapid set of four promotions between the various Ornge companies, rising to associate vice-president by 2012. Her salary had doubled during this time to $120000.[75][76]

Long defended herself in testimony at a legislative hearing. She stated she felt had done a great job for Ornge and was qualified with a BA. She stated: "The media is insinuating I rose quickly because of my relationship ... with Dr. Mazza."[77]

Carrie Anne Brunet was a junior Ornge executive who is the daughter of former chairman Rainer Beltzner.[78] She assisted Long with the Agusta research.[32] Beltzner would claim Brunet got the job via a newspaper ad.[79]

Both Brunet and Long benefited from the MBA program. (Brunet graduating in 2012).[32]

Hallie Beecher McClelland, the daughter of HR vice-president Rhoda Beecher, became the executive director of Ornge's foundation.[78] Beecher defended the hiring process as "rigorous".[80]

Coroner's investigation into patient deaths

[edit]

An initial review of 10 deaths found that none had been "materially affected" by problems at Ornge. A second review explored all deaths involving Ornge between January 2006 and June 2012. By November 2012, this investigation was "taking longer than expected"[81]

After a year long investigation, a special panel did find links between Ornge and patient deaths. Eight cases were found, although "scant" details were provided. Two cases were blamed on inadequate staffing of paramedics qualified for the mission. The interiors of the AW139 helicopters, making it difficult to perform CPR, were flagged as a serious problem. The panel made 25 recommendations for improvements.[82][83]

2013 Ornge air ambulance Moosonee crash

[edit]
2013 Ornge air ambulance Moosonee crash
C-GIMY, the helicopter involved in the accident, photographed May 2008
Accident
DateMay 31, 2013 (2013-05-31)
Site
Aircraft
Aircraft typeSikorsky S-76A
OperatorOrnge
RegistrationC-GIMY
Flight originMoosonee Airport, Canada
Occupants4
Passengers2
Crew2
Fatalities4
Survivors0

On May 31, 2013, a Sikorsky S-76A helicopter crashed resulting in the deaths of two Ornge pilots, Capt. Don Filliter and first officer Jacques Dupuy, and two Ornge paramedics, Dustin Dagenais and Chris Snowball. The crash occurred one kilometre from the Moosonee Airport, shortly after a night-time take-off.[84]

TSB report

[edit]

The Transportation Safety Board of Canada investigated the accident. The report noted: "The causes of this accident went well beyond the actions of this flight crew."[85] The pilots had not received sufficient training. The company lacked standard operating procedures to deal with night operations. The company lacked resources and key personnel were inexperienced. Crew pairing was deemed "sub-optimal" for that flight. Some pilots were given inadequate time to prepare for training; the training did not meet company SOPs and was not operationally realistic.[85] It was noted that in 2012, Ornge eliminated the pilot manager positions at each base, switching to a centralized scheduling system. Knowledge of local conditions and familiarity with crews was therefore lost.[85]

Ornge was understaffed at the time of the accident. The Operations Manager and the Chief Pilot were new to the management of Emergency Medical Services operations. Key positions, such as Manager of Rotor Wing Flight Safety, Manager of Rotor Wing Flight Training and Standards, his assistant, and an aviation clerk (who was to track records) were vacant.[85]

Transport Canada was aware that Ornge was struggling to meet regulations and company requirements. There were clear indications of Ornge's problems months before the accident.[85]

TSB chair Kathy Fox said "[Ornge's] willingness to operate safely and within regulatory requirements exceeded its capacity to do so."[86]

Canadian Labour Code charges

[edit]

On 29 May 2014 Ornge was charged with 17 offences under the Canadian Labour Code. Court documents disclosed that the charges included permitting pilots to fly the S-76A helicopter "without adequate training in the operation of that specific aircraft," failure to provide the pilots with "a means to enable them to maintain visual reference while operating at night", that the aircraft captain, Donald Mark Filliter had "insufficient experience in night operations", that his pilot proficiency check in the helicopter was incomplete, plus the two pilots did not meet experience requirements to be flying as a crew. The organization was also charged with failure to ensure employee safety resulting in the death of the two pilots and also failure to ensure that the organization's supervisors and managers had sufficient knowledge of the Canada Labour Code. In October 2013, company officials had been warned by the Moosonee base safety officer that inexperienced pilots and night operations in combination was a high risk for a fatal accident.[87]

The trial began at Brampton court in April 2017.[88]

In court testimony, a check pilot noted he felt Captain Filliter "didn't have the necessary technical knowledge to serve as a crew captain".[89]

In November 2017, the court found Ornge not guilty of negligence. The judge noted that while night-vision goggles and ground proximity alarms were available, they were not required under 2013 rules.[90]

Civil lawsuit

[edit]

In a 2016 lawsuit, Christopher Snowball's family is seeking $3.7 million from Ornge, Transport Canada and two unnamed Transport Canada inspectors.[91]

Helipad dedication

[edit]

In 2014, the helipad at Health Sciences North in Greater Sudbury was dedicated to the crash victims.[92]

Follow on effects

[edit]

After the accident, Ornge suspended night operations at 58 remote helipads (73 locations by another source). These locations are marked by reflective cones rather than lighting. Service was expected to resume as pilots were trained for un-lit sites or helipads had lighting upgrades.[93][94] However, in early 2015, there were reports that Ornge was still unable to land at some sites, despite helipad upgrades.[95] Ornge now has a "currency" requirement for night landings, that one of the two pilots must have landed at the helipad during the previous six months. It appears that Ornge might not have communicated this with local authorities.[96]

Aircraft fleet

[edit]

The initial fleet of helicopters had a base white with yellow-black (Bandage 1) trim, followed by the orange with blue markings in the 1990s and finally the current orange with white markings. In 2020 and 2021, Ornge began to repaint their rotor aircraft in an orange and dark blue livery with a white stripe separating the colours, in a near hybrid of their first livery. One of the first aircraft to be painted was an AW-139 with the registration C-GYNL.

Ornge AgustaWestland AW139 helicopter, with the new livery, recently departed from the Sunnybrook Helipad.
Ornge AgustaWestland AW139 helicopter landing at Billy Bishop Toronto City Airport
An Ornge Sikorsky S-76A (in old livery) preparing to receive a patient at Toronto/Buttonville Municipal Airport
An Ornge Sikorsky S-76A lifting off at Toronto/Buttonville Municipal Airport
AgustaWestland AW139 at the Peterborough Regional Health Centre in Peterborough, Ontario.

On 28 August 2008 Ornge announced the purchase of ten new AgustaWestland AW139 helicopters to replace their fleet of Sikorsky S-76 helicopters,[97] to be delivered over a period of two years beginning in late 2010.[98] The S-76 helicopters were previously owned and operated by Canadian Helicopters, but are now owned by Ornge and operated by Canadian Helicopters.[99] The S-76 helicopters will be serviced by Canadian Helicopters until April 2012.[99]

Helicopters

[edit]

The helicopter fleet operate as Nav Canada airline designator LF, and telephony LIFEFLIGHT.[100]

AgustaWestland AW139 located at:

From the first long weekend of the summer to Labour Day, one Toronto crew was relocated and based out of Muskoka Airport for the increased number of trauma calls in cottage country during this period.[101] This practice stopped after the summer of 2010.

Fixed-wing aircraft

[edit]

As of the end of 2009, Ornge has begun operating its own fleet of Pilatus PC-12NG fixed-wing aircraft from its bases in:

As of February 2023, Ornge has eight Pilatus PC-12/47E (PC-12NG) registered with Transport Canada and operate as ICAO airline designator PUL, and telephony PULSE.[105][106]

Land critical care ambulance

[edit]

ORNGE operates three land transfer bases and 18 Crestline Coach Type III ambulances in Ontario

  • Markham Base (Shields Court just north of Toronto and south of Buttovillle Airport)[107] - both Critical Care and the Ted Rogers Pediatric Transport teams
  • Ottawa Base (2094 Alert Rd, Ottawa International Airport)[108]
  • Peterborough Base[109]
  • Chatham-Kent Base[110]

Standing agreement aircraft

[edit]

Additional aircraft are available under the Standing Agreement (as and when required) contract with other operators:

Aircraft inventory

[edit]
Aircraft Country of Manufacture Type In Service[115] Notes
AgustaWestland AW139 Italy multi-purpose medium-size commercial helicopter 10 owned and operated by Ornge; 2 sold off from the initial 12 purchased[116]
Pilatus PC-12 NG Switzerland single engine turboprop 8 owned and operated by Ornge; used in Northern Ontario

February 2015 sale

[edit]

In February 2015 reports surfaced that Ornge may look to sell its AW139 fleet due to maintenance costs and their unsuitability for ambulance work. Two PC12 are considered surplus to requirements and are for sale. "[The AW139] burns a lot of fuel. It's a big airplane. It is costly to maintain because of the complexity of the machine, more costly than say a simpler machine ... the AW139s are more suited to flying to offshore oil platforms and that few other agencies use them in an air ambulance role," according to CEO Dr. Andrew McCallum. Two of the AW139 units purchased were equipped with 12 seats and were unsuitable for ambulance use. These units were sold in 2013.[34]

Historical fleet

[edit]

Accidents and incidents

[edit]
  • On 8 February 2008 a Sikorsky S-76 helicopter crashed while attempting to land at a remote helipad at night near Snake Lake, Ontario near Temagami, about an hour north of North Bay, Ontario. The 2 pilots and 2 paramedics aboard suffered injuries requiring hospitalization.[120]
  • On 31 May 2013 a Sikorsky S-76 helicopter crashed after departure from Moosonee, Ontario. Two pilots and two paramedics were on board. There were no survivors.[121]
  • On 22 December 2013 the rotor blades on an S-76 struck trees. Snow raised during a hover caused a white-out. No injuries occurred, but the helicopter was out of service for some time.[122]

References

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Ornge

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Ornge is a Canadian not-for-profit charitable organization designated by the province of Ontario to deliver air ambulance services and critical care medical transports for patients who are seriously ill or injured, operating across a territory spanning over one million square kilometres and serving more than 14 million residents. Established in 2006 as the successor to the provincial air ambulance system, Ornge coordinates a fleet that includes helicopters, fixed-wing aircraft, and critical care land ambulances stationed at 12 bases, enabling approximately 21,000 patient transports annually through a combination of emergency scene responses and inter-facility transfers. The organization employs over 700 staff, including pilots, flight paramedics, and critical care professionals, and maintains contracts with independent providers to supplement its operations, positioning it as Canada's largest air and critical care land transport provider. Key achievements include the expansion of its critical care land program, which marked its 10th anniversary in , and ongoing investments in fleet modernization and base infrastructure to enhance response times and capacity amid rising demand, with patient transports increasing by five percent in 2023 alone. Ornge also emphasizes education and training for its personnel, adapting programs during challenges like the to sustain high standards in patient care. Ornge has faced significant scrutiny over its and financial practices, particularly in the early when a 2012 provincial auditor general's report highlighted excessive , opaque related-party transactions, and inefficient use of public funds, prompting legislative hearings, board dismissals, and a police investigation that concluded without charges in 2018. These issues stemmed from the organization's corporate structure, which included for-profit subsidiaries, leading to public and political concerns about accountability despite its charitable status and reliance on government funding. Under subsequent leadership, Ornge has implemented reforms focused on transparency, strategic planning, and performance metrics, as detailed in its annual reports, to rebuild trust and prioritize operational efficiency.

Overview

Mission and Scope

Ornge's mission is to overcome time and distance when it matters most, facilitating timely access to life-saving medical interventions for patients in critical condition. This directive underscores the organization's commitment to bridging geographical barriers inherent in Ontario's vast terrain, prioritizing rapid response and transport to mitigate delays that could exacerbate health outcomes. As the province's designated air ambulance provider, Ornge's scope centers on delivering high-quality air ambulance services and medical transport tailored to critically ill or injured individuals, integrating advanced paramedical care during transit. Its core operations involve timely patient transportation via air and land modalities, encompassing scene responses, interfacility transfers, and specialized critical care services, with an emphasis on evidence-based protocols to optimize rates. Operationally, Ornge extends its reach across Ontario's approximately 1 million square kilometers, serving a population of 14.5 million residents, including those in remote northern and underserved communities where ground-based emergency services face significant logistical challenges. This broad mandate ensures equitable health access, supported by strategically positioned bases and a fleet capable of addressing diverse scenarios, from trauma incidents to inter-hospital relocations, while aligning with provincial healthcare integration goals.

Organizational Governance

Ornge operates as a not-for-profit under the oversight of the Ministry of Health, with structured around a volunteer responsible for strategic direction, financial accountability, and ensuring compliance with provincial performance agreements. The Board, composed of dedicated leaders from 's health, business, and public sectors, holds ultimate authority over approval, , and executive appointments, guided by principles of transparency and ethical conduct. Key policies include a Whistleblower to protect reporting of and a to mitigate potential biases in decision-making. As of the 2024/2025 fiscal year, the Board is chaired by Ian W. Delaney and includes directors Charles A. Harnick, Patricia Lang, Maneesh Mehta, David Murray, Dr. Andrew Smith, Patricia (Trish) Volker, and Dr. Annelind Wakegijig. In October 2025, Tracey MacArthur, President and CEO of Hamilton Health Sciences, was appointed as an additional director, bringing expertise in hospital administration and health system integration. The Board maintains specialized committees, such as the Quality of Care Committee, which incorporates advisors to review service standards and outcomes. Executive leadership reports to the Board and is led by President and Dr. Homer Tien, appointed following reforms, alongside a senior team including Dr. Bruce Sawadsky, Wade Durham, and Percy Gyara. Provincial oversight is formalized through a performance agreement ratified in March 2012 and amended in 2015, which mandates regular reporting on operations, finances, and service metrics to the Ministry's Air Ambulance Oversight Unit, enabling audits and corrective actions. These structures emerged from 2012 reforms prompted by findings of inadequate transparency and misuse of funds via for-profit subsidiaries, which led to a reconstituted Board, changes, and enhanced reporting requirements to prevent recurrence of fiscal opacity. Ornge holds Accreditation with Exemplary Standing from Accreditation Canada as of 2023, reflecting adherence to governance functioning standards assessed via tools like the Governance Functioning Tool.

Historical Development

Founding and Early Years

Ontario's air ambulance program, the precursor to Ornge, was formally established by the Ministry of Health in 1977, becoming the first dedicated air ambulance service of its kind in . Operations launched in early 1977 with a single twin-engine named "Bandage One," based at Toronto's Buttonville Airport. The initial focus was on inter-facility transfers between hospitals and supporting ground ambulances in remote or hard-to-reach areas, addressing Ontario's geographic challenges spanning over one million square kilometers. Services were delivered through contracts with private carriers, which provided the aircraft, pilots, and often paramedics, under Ministry oversight. In the ensuing years through the 1980s and 1990s, the program expanded incrementally by adding more helicopters and fixed-wing aircraft, establishing additional bases to improve response times and coverage in northern and rural regions. This period saw the service evolve from a single-helicopter operation to a networked system reliant on multiple private operators, though coordination challenges persisted due to the decentralized model. By 2005, amid efforts to enhance efficiency and accountability, the Ministry created the Ontario Air Ambulance Corporation as a not-for-profit entity to consolidate operations previously fragmented across private providers, laying the groundwork for the modern Ornge structure established in 2006.

Expansion Phase (2000s)

In 2005, the government established the Ontario Air Ambulance Program as a not-for-profit to integrate and coordinate air ambulance services previously managed by the Ministry of Health and Long-Term Care in partnership with . This reorganization aimed to enhance and expand critical care transport capabilities across the province. The new entity, initially known as the Ontario Air Ambulance Corporation, assumed responsibility for both air and emerging land-based critical care services, marking a shift toward a unified provincial model. By 2008, the corporation had expanded its footprint with the opening of critical care land ambulance bases in Ottawa, Peterborough, and the Greater Toronto Area, including specialized facilities like the Ted Rogers Paediatric Emergency Department at the Hospital for Sick Children. These additions complemented existing air bases and improved response times for inter-facility transfers and neonatal transports in densely populated regions. Concurrently, the service initiated procurement of advanced rotorcraft to modernize its fleet. A pivotal development occurred on August 28, 2008, when the corporation announced the acquisition of ten twin-engine helicopters to replace the aging fleet, enhancing speed, range, and all-weather capabilities for time-sensitive missions. Deliveries commenced shortly thereafter, with the AW139s featuring medically equipped interiors for . This fleet upgrade, valued at significant investment, supported broader service demands amid growing call volumes in Ontario's vast geography. In 2009, the organization rebranded to Ornge, reflecting its evolving role beyond traditional air ambulance operations.

Reforms Following 2012 Investigations

In response to the Auditor General's March 2012 special report highlighting financial irregularities, including excessive and opaque related-party transactions totaling over $100 million in public funds routed through for-profit subsidiaries, the Ministry of Health and Long-Term Care intervened decisively. On January 11, 2012, the Ministry dismissed Ornge's and president/CEO Chris Mazza, whose annual compensation exceeded $1.4 million, appointing an interim CEO and initiating a to restore . The government ordered the dissolution of Ornge's complex network of for-profit subsidiaries, which had been established with ministerial approval but lacked sufficient transparency, redirecting operations to a simplified not-for-profit structure under direct provincial oversight. An amended performance agreement signed on March 19, 2012, mandated Ministry approval for all borrowing, debt incurrence, and major financial decisions, while requiring detailed reporting on consulting contracts and eliminating provisions that had previously insulated Ornge from full Auditor General scrutiny. Legislative reforms followed through Bill 50, the Ambulance Amendment Act (Air Ambulances), 2012, which empowered the Lieutenant Governor in Council to designate Ornge as a "designated air ambulance service provider" and granted the Ministry authority to appoint investigators, supervisors, or receivers in the , akin to powers over land ambulance services. These changes addressed prior gaps in the Ambulance Act that had limited oversight of air operations, enabling proactive intervention to prevent recurrence of governance lapses. Subsequent enhancements included strengthened internal controls, improved protocols for investigations and safety reviews—such as those initiated by the Ministry of Natural Resources for rotary-wing operations—and routine performance metrics tied to funding, resulting in a more streamlined organization by late 2012. The Ontario Provincial Police's criminal probe, launched in 2012, yielded no charges by 2018 due to insufficient evidence, but the reforms prioritized structural safeguards over punitive measures.

Operations

Air Ambulance and Critical Care Services

Ornge delivers air ambulance services across Ontario, utilizing rotary-wing helicopters and fixed-wing aircraft to transport critically ill or injured patients to appropriate medical facilities. The service operates from 12 bases province-wide, enabling rapid response to scene incidents such as trauma or cardiac arrests, as well as inter-facility transfers for patients requiring specialized care unavailable locally. Critical care services encompass during transport, staffed by flight paramedics trained in intensive care procedures, including , hemodynamic monitoring, and administration of vasoactive medications. Eligibility for air transport typically involves high-acuity cases classified as emergent or urgent, where patients depend on ongoing interventions like blood products or specialized equipment. Non-urgent inter-facility transfers qualify if they exceed 240 kilometers one-way. Complementing aerial operations, Ornge maintains a fleet of land critical care ambulances for ground-based transports, particularly in or when weather precludes flying. These vehicles, such as the 13 Crestline Commander units, mirror airborne capabilities with dual-paramedic crews providing equivalent critical interventions. The Operations Control Centre in coordinates all modalities 24/7, optimizing logistics for over 14 million residents spanning one million square kilometers. Rotary-wing assets, primarily 12 Leonardo AW139 helicopters, facilitate short- to medium-range missions, including hoist operations in inaccessible terrains, while fixed-wing aircraft handle long-haul transfers to tertiary centers. Fleet renewal initiatives, including additions of jets by 2030, aim to enhance speed and capacity for northern and rural coverage.

Fleet and Infrastructure

Ornge operates a fleet consisting of rotor-wing, fixed-wing, and land-based vehicles dedicated to critical care transport across . The rotor-wing component includes 12 Leonardo AW139 twin-engine helicopters, configured for with advanced critical care capabilities, including dual-pilot operations and certification for all-weather response. The fixed-wing fleet comprises 8 NG turboprops, selected for their short takeoff and landing performance suitable for remote airstrips, with ongoing provincial funding to replace these with 12 next-generation PC-12 variants delivered between 2026 and 2030, alongside the addition of 2 jets for enhanced northern coverage. Land assets include 13 Crestline Commander critical care ambulances, integrated for inter-facility transfers and base support.
Aircraft TypeQuantityRole
Leonardo AW13912Rotor-wing air ambulance
Pilatus PC-12 NG8 (to be renewed)Fixed-wing air ambulance
(incoming)2Fixed-wing air ambulance
Ornge maintains 14 operational bases province-wide, comprising 9 air bases for and fixed-wing deployments and 5 land bases for coordination, enabling coverage over 1 million square kilometers. Known bases include , , , Sudbury, , , and , each equipped for rapid response with AW139 helicopters. Infrastructure supports fleet maintenance and operations through specialized facilities, including headquarters at 5310 Explorer Drive in for dispatch and oversight. Recent expansions feature a new 35,000-square-foot "superbase" at Airport, acquired in November 2024 to house mixed fixed- and rotor-wing assets plus land , alongside a planned at Regional Airport in for enhanced central operations. These upgrades, funded by provincial investments exceeding $200 million since 2023, address fleet renewal and regional access amid growing demand.

Performance Metrics and Coverage

Ornge provides air and critical care transport services across the entire province of , encompassing an area exceeding one million square kilometres, including remote and northern communities. This geographic scope supports access to specialized care for patients in underserved regions, with operations coordinated through bases in major cities such as , , , and , as well as forward operating locations for rapid deployment. Regional data is tracked by former Local Health Integration Networks (LHINs), now Ontario Health regions, highlighting transport volumes varying by area, with higher demand in urban-hospital interfacility transfers and scene responses in rural zones. In fiscal year 2023-2024, Ornge completed approximately 18,612 patient transports, though typical annual volumes reach around 21,000 patient-related missions utilizing helicopters, fixed-wing aircraft, and ground critical care vehicles. Performance targets include a 15-minute benchmark from pilot acceptance of a dispatch to air traffic control clearance, alongside 90th percentile response times measured from initial call (T0) to scene or facility arrival, aimed at minimizing delays in critical scenarios. Actual adherence to these metrics is monitored via quality improvement plans submitted to the Ontario Ministry of Health, with ongoing efforts to optimize routing through mathematical programming models to enhance efficiency in high-demand periods. Patient satisfaction metrics, derived from annual third-party surveys by NRC Picker involving roughly 4,000 recipients, show response rates of 28.4% in 2023 and 2024, reflecting feedback on care quality, communication, and overall during transports. dashboards in Ornge's Stats Centre provide sortable insights into daily and regional transport patterns, asset utilization (e.g., rotor-wing vs. fixed-wing), and response types, enabling stakeholders to assess operational reliability without disclosing sensitive details. These indicators underscore Ornge's role in bridging geographic barriers, though performance can fluctuate due to weather, crew availability, and provincial demand surges.

Achievements and Societal Impact

Service Delivery Outcomes

In the 2023/2024 , Ornge transported 22,420 patients, a 4.5% increase from 21,450 the prior year, with transports distributed across (4,231), fixed wing (3,165 Ornge-operated), (6,249 Ornge-operated), and other carriers. Interfacility transfers dominated, totaling 10,477 fixed-wing legs averaging 1,780 km each and 2,818 legs averaging 402 km. For the 2024/2025 , Ornge reported 19,550 individual patients served across 23,725 transport legs, up 4.8% in patient volume from the preceding period, with fixed-wing legs at 11,310 and at 4,439. Response times for scene trauma calls via rotor wing held steady at a median of 11 minutes from dispatch completion to departure. Interfacility emergent priority one (life-or-limb) responses averaged medians of 36 minutes for rotor wing and 81 minutes for fixed wing in 2023/2024, improving to 32 minutes and 62 minutes respectively in 2024/2025. Specialized services included 823 transports (up 26% year-over-year), 682 bariatric cases, and 403 of 484 organ retrieval requests for Gift of Life Network, achieving 93% fulfillment for living donor transports. Third-party patient satisfaction surveys, conducted annually on approximately 4,000 recipients with response rates of 28.4% in 2023/2024, yielded overall satisfaction rates of 99.7% for 2023 transports, up marginally from 99.6% the prior year. These metrics reflect Ornge's role in a hub-and-spoke model covering over one million square kilometers, including remote communities, though clinical outcomes like survival rates remain undocumented in public performance data.

Accreditations and Innovations

Ornge achieved Accreditation with Exemplary Standing, the highest designation under Accreditation Canada's Qmentum program, in December 2018 following an on-site survey from October 29 to November 2, 2018, marking it as the first air ambulance service to receive this status. The evaluation covered 453 criteria across governance, leadership, infection prevention, clinical services, and safety, with Ornge meeting 98.2% (445 criteria) and identifying opportunities for improvement in areas such as governance feedback mechanisms and equipment validation processes. This standing was retained in January 2023, affirming ongoing compliance with national standards for quality improvement and patient-centered care. Ornge's Critical Care program holds accreditation from the Canadian Medical Association, the only such program in , emphasizing advanced pre-hospital training. Certifications extend to operational compliance under Ontario's operator standards, including regular inspections by the Ministry of Health for vehicle, equipment, and service delivery protocols. In innovations, Ornge has advanced simulation training through partnerships, such as with CAE Healthcare, integrating high-fidelity simulators for scenario-based education in transport medicine, including procedures under adverse conditions like blizzards and zero-visibility . This includes specialized sessions like first-of-its-kind trauma care simulations in and underwater recovery training using cockpit-matched simulators. Technological advancements include the June 2020 launch of the Ornge 360° Experience, enabling immersive simulations of and pilot operations for and . Ornge employs modular support systems like the MOVES® SLC™, allowing rapid conversion of standard aircraft into critical care transports with integrated capabilities. Its 2024-2029 strategic plan prioritizes process flow innovations to enhance response times and interfacility transfers for high-acuity s.

Economic and Regional Contributions

Ornge employs over 700 personnel province-wide, encompassing roles such as 235 paramedics, 86 rotor-wing pilots, 46 fixed-wing pilots, and 55 aircraft maintenance engineers, thereby generating sustained employment in specialized , medical transport, and support services across urban and remote locations. These positions, funded primarily through provincial allocations exceeding annually from the Ministry of Health, circulate economic value via salaries, training, and procurement of fuel, parts, and equipment from local suppliers. Government investments have amplified Ornge's economic footprint, including a $93 million allocation in December 2024 to acquire two high-speed , construct a new hangar at Lake Simcoe Regional in , and hire 102 frontline staff—comprising paramedics, pilots, and engineers—directly stimulating job growth and infrastructure development in . Similarly, a $108 million infusion in November 2023 supported northern expansions, such as relocating to a larger facility at with $10 million dedicated to base enhancements, fostering aviation-related economic activity in underserved areas. Regionally, Ornge's network of bases in northern and rural hubs—including Sudbury, , , and planned 24/7 operations in Sudbury by 2026—bolsters local economies by maintaining year-round operational presence that demands regional labor, maintenance, and logistics support. These facilities enable rapid patient transports, with approximately 98% of fixed-wing missions serving northern and rural populations, thereby sustaining healthcare-dependent communities through timely access to distant specialized treatments and reducing long-term economic burdens from untreated emergencies. In fiscal 2023/2024, Ornge transported over 19,000 patients, many from remote Indigenous and rural locales, indirectly supporting regional stability by facilitating medical repatriation and continuity of care.

Controversies

Executive Compensation and Governance Issues

In 2011, Ornge's president and CEO Chris Mazza received total compensation of approximately $1.4 million annually, making him the highest-paid public official in Ontario at the time, amid revelations that the organization had ceased disclosing his salary after 2007. Ornge acknowledged that withholding this information was a mistake, as the non-profit entity, heavily reliant on provincial funding exceeding $700 million over five years, operated with limited transparency on executive remuneration. Mazza defended the package as aligned with the demands of leading a complex air medical transport system, though critics, including opposition leaders, labeled it excessive for a publicly funded service. Over the period from 2007 to 2011, Mazza's total earnings reached $9.3 million, while executives across Ornge and its affiliated for-profit subsidiaries collected $52.8 million collectively. Board compensation also drew scrutiny, with directors receiving nearly $2 million in payments during the same timeframe, including $232,757 to former chairman Rainer Beltzner in 2011 alone. The Ornge board later admitted ignorance of certain components of Mazza's pay, which included unauthorized elements lacking proper documentation or approval, highlighting internal oversight lapses. These disclosures fueled public and political backlash, contributing to Mazza's ouster in June 2012 and the replacement of the entire board amid ongoing probes into financial practices. Governance concerns centered on inadequate provincial monitoring, as detailed in the 2012 Ontario auditor general's report, which criticized the for failing to enforce transparency or curb Ornge's expansion into for-profit subsidiaries without ministerial approval, despite annual public around $150 million. This structure allegedly enabled conflicts of interest and diverted resources from core air operations, prompting reforms including a new performance agreement in March 2012 that mandated ministerial veto on corporate changes and enhanced conflict-of-interest rules. The auditor general noted that such autonomy, absent robust accountability, risked taxpayer funds without commensurate service improvements.

Corporate Affiliations and Financial Flows

Ornge, a federally incorporated not-for-profit under the Not-for-profit Corporations Act, maintains a that includes wholly owned subsidiaries such as the for-profit Ornge Global Air Inc., incorporated under the Business Corporations Act to provide air transport services, and 7506406 Inc., a holding entity owned by Ornge Global Air Inc. Ornge also incorporates Ornge Issuer Trust for financing purposes, with all controlled for-profit and not-for-profit entities consolidated in its . In January 2011, Ornge formed additional for-profit entities under the Ornge Global umbrella, including Ornge Global Air Inc., Ornge Global Corporate Services Inc., and Ornge U.S. Inc., aimed at international service expansion and owned by Ornge and board members rather than the parent organization. These subsidiaries provided , administrative, and billing services to Ornge, charging at cost, but raised concerns over limited government access to their records due to their private status. Financial flows to Ornge are dominated by provincial funding through a performance agreement with the Ministry of Health, which accounted for $287.2 million of its $317.2 million total revenue for the ended March 31, 2024, with the remainder from ancillary sources like critical care land programs ($17.4 million) and other ($12.2 million). Historically, transfers comprised over 93% of Ornge's inflows, enabling debt issuance such as a $275 million bond in 2009 for acquisitions and . Controversial aspects include transfers of public funds to for-profit subsidiaries, exemplified by a 2011 arrangement where Ornge Global Real Estate Inc. purchased Ornge's headquarters building for $15 million using $24 million in financing, with the $9 million excess intended to flow to a related for-profit entity controlled by executives. Ornge's lease-back payments for the property exceeded by approximately $2 million over five years, and similar structures allowed subsidiary profits from taxpayer-supported operations without direct ministry oversight. By early 2012, Ornge had loaned $5.6 million to these entities, amid findings that ministry funding—rising 30% from $111 million in 2006/07 to $150 million in 2010/11—subsidized non-core activities despite stagnant transport volumes. In March 2012, Ontario's released a special report on Ornge, identifying significant deficiencies, including inadequate provincial oversight of the $730 million in provided over five years, opaque financial structures involving for-profit subsidiaries, and excessive without proper board approval processes. The report criticized Ornge for lacking transparency in related-party transactions and failing to ensure value for money in operations, prompting the Ministry of Health and to impose stricter reporting requirements and restructure mechanisms. Following media reports and the Auditor General's findings, the launched a in 2012 into Ornge's financial practices, focusing on potential , breach of trust, and misappropriation of funds related to procurements and fund flows to entities linked to former CEO Chris Mazza. The probe revealed that Ornge overpaid $4.77 million for Italian , with funds subsequently directed to a Mazza-controlled private company, but in February 2018, the OPP concluded there was insufficient evidence to lay charges. In May 2014, Ornge faced 17 charges under the Canada Labour Code, stemming from alleged violations related to workplace safety and employment standards, though specific outcomes of these proceedings remain limited in public records. Separately, following a 2013 helicopter crash near Timmins that killed four people, Ornge was charged with 17 counts under aviation and occupational health regulations; fourteen counts were withdrawn prior to or during trial, and in November 2017, the organization was acquitted on the remaining three, with the court ruling no negligence attributable to Ornge. The Office of the Chief Coroner conducted an expert panel review starting in 2012 into operational aspects of Ornge air ambulance cases, identifying issues in select incidents but recommending systemic improvements rather than pursuing legal sanctions. Overall, while investigations exposed accountability gaps, they resulted in no convictions or financial penalties against Ornge executives, leading instead to internal reforms and enhanced government supervision.

Safety Record and Incidents

Major Accidents and Investigations

On May 31, 2013, an Ornge-operated Sikorsky S-76A helicopter (registration C-GIMW) crashed shortly after takeoff from Airport in , killing all four occupants: pilots Captain Don Filliter and First Officer Jacques Dupuy, and flight paramedics Chris Snowball and Dustin Dagenais. The aircraft was en route to to transport a when it departed at approximately 00:12 EDT in complete darkness, without night vision goggles or terrain awareness warning systems equipped, and impacted trees and about 1.3 nautical miles from the . No mechanical failures were identified as contributing factors. The (TSB) investigation (A13H0001), finalized in June 2016, attributed the crash to systemic deficiencies rather than individual errors, including inadequate crew training for operations, insufficient risk assessment by Ornge for dispatching the flight without aids, and regulatory shortcomings by in oversight of air ambulance operations. The report highlighted that the pilots, though experienced, lacked specific recurrent training for low-visibility , and Ornge's safety management system failed to mitigate known risks in remote northern operations. In response, the TSB issued 14 recommendations, targeting improvements in goggle usage, awareness systems, enhanced training protocols, and better regulatory enforcement for commercial helicopter operations. Subsequent legal proceedings included a $3.7 million wrongful lawsuit filed by Snowball's family in 2016, alleging in and ; however, in November 2017, a judge ruled Ornge not liable, finding no evidence of operational directly causing the crash. Ornge retired its S-76A fleet and implemented safety enhancements, including mandatory night vision goggles and advanced , as noted in TSB follow-up assessments. Earlier incidents include a February 2008 Sikorsky S-76A crash on Snake Island near Temagami, where four Ornge crew members survived a hard landing during frigid conditions, attributed to pilot disorientation and weather factors per TSB findings (A08O0050, though non-fatal, it prompted reviews of cold-weather operations). No other fatal Ornge accidents have been documented as of 2025, underscoring the 2013 event as the organization's most significant aviation mishap.

Safety Protocols and Improvements

Ornge implements stringent landing zone safety protocols to protect patients, crews, first responders, and the public during helicopter operations. These require a minimum clear radius of 150 feet from the aircraft, free of vehicles and personnel, with approach vehicles positioned perpendicular at each end to restrict access. Preparation involves hosing down dusty surfaces, packing fresh snow, and removing loose debris such as pillows, tarps, or paper to mitigate rotor downwash hazards. Personnel must approach only under Ornge crew escort, maintaining eye contact with the pilot, from the front or downhill side on uneven terrain, and remain clear for three minutes prior to arrival or until signaled safe by the pilot; back approaches are prohibited, and cover must be taken during landing and departure, with vehicle doors and windows closed. Communication occurs via local dispatch centers like Central Ambulance Communications Centres (CACC). Dispatch protocols emphasize selecting the closest, most appropriate aircraft equipped for the required care level, a policy formalized following early 2010s incidents to optimize resource allocation and reduce unnecessary risks. Ornge has deployed a computer-aided dispatch system to enhance decision-making in identifying suitable resources for transports. In response to equipment limitations identified in operations, interim interiors were installed in AW139 helicopters by February 2013, enabling paramedics to perform CPR on patients at any time during flight, including takeoff and landing; these modifications also minimize entanglement risks for lines and tubes during loading/unloading, while improving access for IV insertions and retrieval of medical bags and supplies. Developed with input from Ornge paramedics, pilots, and staff in collaboration with Aerolite, these interiors served as a temporary measure pending permanent redesigns. Ornge fosters a where responsibility is shared across all staff, supported by ongoing training, innovation, and verification processes through its Quality Management Committee. Between 2020 and 2022, a disclosure training program was rolled out to address incidents, equipping crews with skills for transparent communication under medical oversight from transport physicians. Annual Plans outline frameworks for enhancing clinical and staff , targeting reductions in and musculoskeletal incidents via standardized checklists aiming for 85% usage by fiscal year-end. Post-pandemic adaptations include specialized protocols for transporting proned patients and managing infectious diseases, with hazard controls for contact, droplet, or airborne precautions applied to approximately 13.7% of critical care transports. Ornge hosts the annual Air Critical Care and Transport (ACAT) to promote industry-wide advancements.00262-6/fulltext)

Recent Developments

Fleet Modernization and Expansion

Ornge's fleet modernization initiatives have primarily targeted its fixed-wing component to improve transport capabilities for long-distance patient transfers across 's remote regions. In November 2023, the Ontario government committed over $108 million to procure twelve new NGX single-engine turboprops, with deliveries planned from 2026 through 2030; these will replace the operator's current eight aging PC-12 aircraft, enhancing reliability, fuel efficiency, and capacity for critical care missions. This upgrade supports the addition of two fully staffed, round-the-clock air ambulance crews, addressing increased demand from northern and rural communities. Building on this, in December 2024, an additional $93 million provincial investment facilitated the acquisition of two twin-engine jets, expanding the fixed-wing fleet toward a total of fourteen aircraft by 2030. The PC-24s offer superior speed, range, and short-field performance compared to turboprops, enabling faster evacuations in adverse weather or from unpaved airstrips. Concurrent infrastructure developments include constructing a new hangar in to house the expanded fleet and acquiring an existing hangar at Airport in November 2024, designated as a "superbase" for integrated fixed-wing, rotor-wing, and land operations. Rotor-wing assets, comprising twelve Leonardo AW139 twin-engine helicopters introduced in the early as replacements for prior models, have seen no major expansions since 2020 but continue to underpin short-haul and urban interfacility transfers. Ornge's 2024-2025 underscores these fixed-wing advancements as key to sustaining service growth amid rising patient volumes.

Strategic Planning and Future Outlook

In 2024, Ornge unveiled its five-year Strategic Plan titled "We Respond," spanning 2024 to 2029, which outlines priorities for enhancing critical care transport services across Ontario's 1 million square kilometers serving 14.5 million residents. The plan emphasizes operational excellence, patient-centered care, and targeted improvements in access for underserved populations, including remote and Indigenous communities, through four core pillars. Its vision is " in Motion," with a mission to "overcome time and distance when it matters most," guided by values of , , , and . The first pillar focuses on improved timeliness via , aiming to optimize personnel, assets, and response protocols. Key initiatives include increasing front-line staff by more than 50% by 2029, renewing the fixed-wing fleet to 12 aircraft operating from four bases by 2026, and deploying specialized teams by 2026 to address psychiatric transport needs. Dispatch enhancements and data-driven performance metrics are targeted for implementation by 2027 to reduce delays. Under the second pillar, Ornge plans to establish the Ornge Academy for by advancing , , and , with goals to form a Provincial Health Equity Alliance by 2026 and develop virtual training curricula and fellowships by 2029. This includes expanding First Response Teams for rapid intervention in remote areas, prioritizing geographic and demographic disparities in service delivery. The third pillar promotes through "One Team, One Mission," involving a values-based framework by 2026, policy reviews for consistency, and program expansions like Blood on Board for in-flight transfusions to bolster patient outcomes. The fourth pillar stresses accountability and partnerships, including integration with CritiCall Ontario's dispatch system by 2025, deepened ties with First Nations communities, and adoption of environmental, social, and governance (ESG) priorities encompassing patient health, workforce well-being, and sustainable operations such as fuel-efficient aircraft. Looking ahead, the plan commits to long-term service scalability, with fleet growth projected beyond and routine reporting on timeliness and equity metrics to ensure transparency. Supported by provincial funding, including over $108 million for four additional announced in 2024, Ornge aims to sustain financial viability amid rising demand while advocating for infrastructure upgrades. These efforts build on 2024-2025 annual progress in capacity expansion and cultural alignment, positioning Ornge for resilient adaptation to evolving healthcare needs.

References

  1. https://www.ornge.ca/home
  2. http://www.ontario.ca/page/emergency-health-services
  3. https://www.healthprocanada.com/article/member-spotlight-ornge
  4. https://www.ornge.ca/Media/Ornge/Images/Publications/Ornge-Annual-Report_101023-FINAL.pdf
  5. https://www.ornge.ca/Media/Ornge/Documents/Accreditation/Executive_Summary-January-2023.pdf
  6. https://www.airmedandrescue.com/latest/long-read/provider-profile-ornge
  7. https://www.ornge.ca/Media/Ornge/Images/Campaigns/Strategic%20Plan%202024/Annual-Report-v6.pdf
  8. https://www.ornge.ca/news-articles/2018/january-2018/ornge-celebrates-10-years-of-its-critical-care-land-ambulance-program-in-ontario
  9. https://www.auditor.on.ca/en/content/specialreports/specialreports/ornge_web_en.pdf
  10. https://globalnews.ca/news/4013922/ornge-air-ambulance-probe-opp/
  11. https://www.cbc.ca/news/canada/toronto/ornge-overspending-slammed-by-ontario-auditor-general-1.1150507
  12. https://www.ornge.ca/governance
  13. https://www.ornge.ca/stratplan2029
  14. https://www.ornge.ca/about-us/publications/strategic-plan/stratplanpublication2024
  15. https://www.ornge.ca/Media/Ornge/Documents/Publications/Annual%20Report/Annual-Report-2024-2025.pdf
  16. https://www.ornge.ca/news-articles/2025/october/ornge-welcomes-tracey-macarthur-to-board-of-directors
  17. https://www.facebook.com/teamOrnge/photos/d41d8cd9/1420007843308283/
  18. https://news.ontario.ca/en/release/20360/new-measures-to-strengthen-oversight-of-ornge
  19. https://www.auditor.on.ca/en/content/annualreports/arreports/en16/v2_202en16.pdf
  20. https://nationalpost.com/news/canada/government-oversight-of-ornge-woefully-inadequate-auditor-general-finds
  21. https://www.ornge.ca/Media/Ornge/Documents/Accreditation/Accreditation_Report-January-2023.pdf
  22. https://verticalmag.com/news/celebrating-legacy-bandage-1/
  23. https://www.ornge.ca/news-articles/2017/april-2017/celebrating-40-years-of-dedicated-air-ambulance-service-in-ontario
  24. https://www.ola.org/en/legislative-business/committees/public-accounts/parliament-41/reports/ornge-air-ambulance-related-services-summary-report
  25. https://www.helis.com/database/sqd/Ornge/
  26. https://news.ontario.ca/en/release/90215/mcguinty-government-improving-air-ambulance-services
  27. https://verticalmag.com/press-releases/ornge-purchases-new-fleet-of-high-performance-medically-equipped-helicopters-html/
  28. https://www.theglobeandmail.com/news/politics/ontario-removes-ceo-and-board-of-ornge-air-ambulance/article4179003/
  29. https://www.ornge.ca/Media/Ornge/Documents/Governance/Amended_Performance_Agreement_MOHLTC_Ornge_March_2012.pdf
  30. https://www.auditor.on.ca/en/content/annualreports/arreports/en16/v2_305en16.pdf
  31. https://globalnews.ca/news/214060/ousted-ornge-execs-let-government-taxpayers-front-line-workers-down-mcguinty/
  32. https://www.ola.org/en/legislative-business/bills/parliament-40/session-1/bill-50
  33. https://www.ola.org/sites/default/files/node-files/committee/report/pdf/2013/2013-06/report-2-EN-ORNGE%2520Air%2520Ambulance%2520English%2520Readable.pdf
  34. https://www.ornge.ca/healthcare/transporting-a-patient
  35. https://caep.ca/periodicals/Volume_20_Issue_2/Vol_20_Issue_2_Page_247_-_255_Tien.pdf
  36. https://www.ornge.ca/healthcare/operations-control-centre
  37. https://skiesmag.com/news/ornge-adding-two-pilatus-pc-24-jets-to-help-northern-and-rural-communities/
  38. https://news.ontario.ca/en/release/1005508/ontario-connecting-northern-and-rural-communities-to-critical-care
  39. https://www.facebook.com/teamOrnge/posts/ornge-owns-a-fleet-of-aircraft-and-land-ambulances-operating-out-of-14-bases-acr/1373350554640679/
  40. https://skiesmag.com/news/ontario-government-increases-ornge-fixed-wing-fleet-renewal-12-aircraft/
  41. https://www.facebook.com/teamOrnge/posts/ornge-operates-14-bases-across-ontario-nine-air-bases-and-five-land-bases-strate/1378948597414208/
  42. https://georgianbay.ca/boating/opp-liaison-and-emergency-response/ornge/
  43. https://www.ornge.ca/news-articles/2024/november/ornge-acquires-new-hangar-at-greater-sudbury-airport-to-support-fleet-renewal
  44. https://www.barrietoday.com/local-news/oro-medonte-airport-lands-93m-investment-for-ornge-air-expansion-9968708
  45. https://www.ornge.ca/Media/Ornge/Documents/Publications/Annual%2520Report/2020-2021-Annual-Report-September-29_1.pdf
  46. https://www.ornge.ca/stats-reports/data-statistics
  47. https://www.ornge.ca/Media/Ornge/Documents/Publications/Annual%2520Report/Annual-Report-2024-2025.pdf
  48. https://www.ornge.ca/Media/Ornge/Documents/Ornge-Quality-Improvement-Plan-FY-22-23.pdf
  49. https://www.ornge.ca/Media/Ornge/Documents/Publications/Quality%2520Improvement%2520Plans/Ornge-QIP.pdf
  50. https://www.ornge.ca/about-us/publications
  51. https://www.ornge.ca/stats-centre
  52. https://www.ornge.ca/Media/Ornge/Images/Campaigns/Strategic%2520Plan%25202024/Annual-Report-v6.pdf
  53. https://www.ornge.ca/Media/Ornge/Documents/Publications/Patient%2520Satisfaction%2520Survey/Patient-Satisfaction-Survey-2024-v2.pdf
  54. https://www.instagram.com/p/DGQcmWjRoX7/
  55. https://www.ornge.ca/Media/Ornge/Documents/Accreditation/Accreditation_Report-December-2018.pdf
  56. https://www.ornge.ca/news-articles/2023/january/ornge-retains-highest-possible-standing-from-accreditation-canada
  57. https://www.cae.com/media-centre/press-releases/cae-healthcare-partners-with-ornge-to-offer-transport-medicine-education-solutions/
  58. http://www.ontario.ca/page/certifications-and-inspections
  59. https://www.linkedin.com/posts/andrew-petrosoniak_this-week-we-ran-a-first-of-its-kind-in-ontario-activity-7326626893351317505-Rzkp
  60. https://www.facebook.com/teamOrnge/videos/ornges-new-internationally-trained-critical-care-paramedics-recently-participate/428374553275124/
  61. https://www.ornge.ca/news-articles/2020/june-2020/ornge-launches-virtual-reality-experience
  62. https://thornhillmedical.com/ornge-connecting-ontario-communities-with-critical-care/
  63. https://issuu.com/ornge/docs/52071-_ornge_strategic_magazine_v5_-_website_octob
  64. https://www.sootoday.com/local-news/ontario-spending-108m-to-boost-air-ambulance-presence-in-the-north-7796141
  65. https://www.thestar.com/news/canada/ornge-president-was-paid-1-4-million-per-year/article_e65ff61d-809b-5713-8797-23fcd1303772.html
  66. https://www.thestar.com/news/canada/ornge-admits-secrecy-surrounding-exec-s-salary-was-a-mistake/article_fbd45a4b-33d2-57d9-b3ad-940be18e570b.html
  67. https://www.ems1.com/air-medical-transport/articles/canadian-medevac-ex-ceo-unaware-service-was-off-course-EybdLARGTJNlPxEf/
  68. https://nationalpost.com/news/canada/former-ceo-chris-mazza-tells-gruelling-hearing-into-ornge-scandal-he-is-just-a-scapegoat
  69. https://www.cbc.ca/news/canada/toronto/chris-mazza-made-9-3m-in-6-years-at-ornge-minister-confirms-1.2460587
  70. https://www.theglobeandmail.com/news/national/ornge-board-in-the-dark-about-aspects-of-former-ceos-pay/article4457109/
  71. https://www.airmedandrescue.com/latest/news/entire-ornge-board-replaced
  72. https://globalnews.ca/news/1002986/hudak-call-ousted-ornge-ceos-nearly-10m-compensation-absolutely-incredible/
  73. https://www.longwoods.com/newsdetail/2609
  74. https://www.ornge.ca/Media/Ornge/Documents/Ornge-2024-Financial-Statements-English-Signed.pdf
  75. https://globalnews.ca/news/546070/ornge-for-profits-got-public-dollars-auditor/
  76. https://www.theglobeandmail.com/news/toronto/private-firms-got-public-money-ornge-audit-finds/article11801230/
  77. https://www.newswire.ca/news-releases/oversight-of-ornge-clearly-inadequate-auditor-general-509878201.html
  78. https://globalnews.ca/news/373856/year-before-charges-could-be-laid-at-orngeopp/
  79. https://www.thestar.com/news/canada/opp-says-ornge-millions-flowed-back-to-chris-mazza-company-but-no-charges-will-be/article_9ce9facb-b7e4-5645-907c-b082a1cd5da8.html
  80. https://www.newstalk1010.com/news/no-charges-in-ornge-air-ambulance-opp-investigation-1.3610442.html
  81. https://www.cbc.ca/news/canada/toronto/ornge-ontario-s-air-ambulance-service-faces-17-labour-code-charges-1.2659882
  82. https://stockwoods.ca/news/stockwoods-secures-acquittal-of-ornge-in-charges-arising-from-tragic-2013-helicopter-crash/
  83. https://news.ontario.ca/en/release/22726/update-on-office-of-the-chief-coroners-ornge-review
  84. https://www.ainonline.com/aviation-news/2012-07-02/ornge-stain-ontarios-air-ambulance-service-under-investigation
  85. https://www.tsb.gc.ca/eng/medias-media/communiques/aviation/2016/a13h0001-20160615.html
  86. https://www.cbc.ca/news/canada/sudbury/no-mechanical-problems-in-fatal-ornge-crash-investigators-1.1306536
  87. https://skiesmag.com/news/tsb-blames-organizational-regulatory-failings-for-2013-orng/
  88. https://www.cbc.ca/news/canada/sudbury/14-recommendations-ornge-helicopter-crash-1.3636221
  89. https://www.cbc.ca/news/canada/sudbury/ornge-snowball-lawsuit-1.3698157
  90. https://www.thestar.com/news/canada/ornge-cleared-of-negligence-in-ontario-air-ambulance-crash-that-killed-four/article_c023032d-bc4b-5a1f-8e4c-d1fe0cd3bc8d.html
  91. https://www.ems1.com/air-ambulance/articles/aeromedical-agency-responds-to-transportation-safety-board-of-canada-investigation-Hvr19sgI69ORZQK8/
  92. https://www.thestar.com/news/canada/ornge-helicopter-crash-kills-four-shortly-after-takeoff-in-northern-ontario/article_b5f48f45-9d9f-5a86-af3d-b8a1ae19c5bc.html
  93. https://www.tsb.gc.ca/eng/rapports-reports/aviation/index.html
  94. https://www.ornge.ca/aircraft-safety-protocols/landing-zone-safety
  95. https://news.ontario.ca/en/backgrounder/26374/improving-the-safety-of-air-ambulance-in-ontario
  96. https://verticalmag.com/press-releases/22680-ornge-improves-patient-safety-with-new-interim-interior-for-html/
  97. https://pmc.ncbi.nlm.nih.gov/articles/PMC7270485/
  98. https://www.ornge.ca/ACAT2023
  99. https://aviationweek.com/business-aviation/safety-ops-regulation/ornge-upgrade-pilatus-pc-12-fleet-order-12
  100. https://www.wingsmagazine.com/inside-ornge/
  101. https://barrie360.com/expand-ornge-air-ambulane/
  102. https://www.ornge.ca/Media/Ornge/Documents/Campaign%20Documents/Strategic%20Plan/Ornge-Strategic-Plan-2029-We-Respond.pdf
  103. http://www.ontario.ca/page/published-plans-and-annual-reports-2024-2025-ministry-health
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