A man pushing his bike along the road falls over and breaks his wrist, exposing bones. That's what we know now.
But at the time, rescue workers on their way to the scene - who were told the man was hit by a car - request a medical helicopter, which lands next to the highway to fly the man to a hospital.
Even in hindsight, hospital and rescue officials say the flight was justified.
The scenario played out the night of July 26 on Highway 701 in the New Hope community, south of Whiteville.
The first person to dial 911, just after 10 p.m., thought a man had been hit by a car and told dispatchers a bone was sticking out of the man's arm, according to a Columbus County Emergency Services report. That's what dispatchers told first responders.
Later, though, based on eyewitness accounts and a survey of the scene, Highway Patrol troopers determined the man was not struck by a car and instead fell over while pushing his bike, according to Trooper K.K. Conner.
Firefighters who arrived on scene told dispatch it was "10-18 traffic," or an emergency situation, according to the call log.
Still on their way on the scene, Tabor City rescue workers asked dispatch to request a medical helicopter.
In a field next to the highway, emergency crews used traffic cones with flashing lights on top to mark the boundaries of a landing zone. Less than 30 minutes later, a New Hanover Regional Medical Center (NHRMC) helicopter touched down to transport the man.
Beverly Benton, the Tabor City EMS worker who requested the helicopter, is adamant AirLink was justified. She said the nature of the original call – a pedestrian struck – was enough to warrant the helicopter.
Plus, she said the man's injury – an open compound fracture of the wrist – required care at a high-level trauma center. The closest one was NHRMC in Wilmington.
NHRMC has helicopters stationed in Onslow and Columbus counties. Hospital spokeswoman Erin Balzatti was unable to confirm which helicopter responded to the call on Highway 701, saying she couldn't discuss specific cases.
She explained that officials conduct a utilization review of every flight to ensure the call was warranted.
Balzatti said it had been a long time since a review determined that a flight was unjustified, but she wasn't able to provide a date. Utilization reviews are not public record, she said.
From October 2013 through June 2014, NHRMC helicopters responded to 636 calls. In 129 cases, the helicopters landed on a scene rather than a hospital, according to Balzatti.
Balzatti said each county sets its own protocols for dispatching air medical units.
Columbus County's air transport policy states, in part: "Air transport should be utilized whenever patient care can be improved by decreasing transport time or by giving advanced care not available from ground EMS services…"
While the AirLink helicopters are emblazoned with NHRMC logos, they are owned and managed by a company called Air Methods, which also handles the billing.
Christina Brodsly, a company spokeswoman, said she couldn't provide information about the July 26 or even how much an average flight costs.
She explained a number of factors make up the cost of an air medical transport, including a lift-off fee, per-mile fee, equipment, fuel, insurance, and salaries. Each flight has three crew members: a pilot, nurse and paramedic.
Air Methods "will make every effort to maximize the amount the patient's insurance pays to minimize the patient's out-of-pocket," Brodsly wrote. "For those who can demonstrate the inability to pay, we have a Charity Care Program to bring the costs down to reduce the patient's obligation."
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