North Carolina EMS uses Pivotal BlackFly eVTOL for rapid first response missions
Quinn Reece, a paramedic with Hyde County Emergency Medical Services (EMS) in North Carolina, is not your average first responder. Recently, Reece responded to a 911 call about 20 minutes faster than an ambulance. The seemingly impossible feat was enabled by a unique aircraft that lifts off vertically like a helicopter but tilts forward to fly on fixed wings. Pivotal's BlackFly , a prototype of the company's planned Helix, is a Part 103 eVTOL (electric vertical takeoff and landing) ultralight that several private owners and the U.S. Air Force have already flown . The BlackFly and Helix are single-seat models marketed primarily for recreational use. But the California-based manufacturer may have found another application—"saving lives," CEO Ken Karklin told FLYING . "We've been very focused on finding the best utility for this craft," Karklin said. "And one mission that consistently rose to the top was that of taking advantage of the simplified flight controls—cross-training paramedics, technicians, emergency physicians, EMS chiefs." The BlackFly's pilot controls—comrpising a joystick, digital displays, and fly-by-wire system—are designed to be simple enough that a new pilot could master them within weeks or days. Pivotal said Hyde County paramedics completed more than 300 training and proficiency flights before Reece used the BlackFly to respond to real emergency calls under public aircraft operations (PAO). The partners believe Hyde County is first in the nation to deploy eVTOL aircraft for real-world EMS. Officials dispatched the BlackFly for two calls, allowing Reece to begin advanced life support (ALS) while she and the caller waited for an ambulance. Pivotal said it believes helicopters will remain indispensable for patient transport. But eVTOL aircraft could keep patients stable while they await one. Karklin said the partners took a "very conservative approach" and deferred a "long list of potential 911 dispatches" to ambulances, opting for safety over scale. But he added that the initial deployment gives Pivotal a "playbook" to "clone" or "stress-test" the operation in other North Carolina towns that have different terrain or higher call volumes. Months of Preparation Brook Cox, chief of Hyde County EMS, grew up in the Chapel Hill area of western North Carolina, which has a robust hospital system. Cox said that shortly after becoming chief, she requested a helicopter that took hours to arrive and was unable to land once it did. Pivotal described Hyde County as "one of North Carolina's largest and most geographically challenging EMS response areas." "I thought to myself, why is it that the eastern part of North Carolina can't get the same options that we did [in Chapel Hill]?" she said. The experience prompted Cox to explore more "creative ways" of improving response times. Deploying eVTOL aircraft was "one of the projects that I chose to fight on first," she said. Pivotal and Hyde County EMS announced their partnership in March, and the partners quickly got to work. Even among eVTOLs, the BlackFly is unique. While many models incorporate tilting rotors, the entire BlackFly airframe tilts when transitioning from vertical to forward flight. Karklin said the training that Pivotal provides in California "falls considerably short" of what an EMS pilot would need. That required Hyde County paramedics to complete hundreds of preparational flights during "near daily operation." The trainees familiarized themselves with the aircraft's range and endurance (about 20 miles or 20 minutes) as well as its limitations in wind and rain. They learned how to judge ideal landing spots from the air and catalogued potential sites. The eVTOL paramedics even studied old 911 calls, using them to reproduce real flights and landing areas. Personnel had to get into the mindset of being aviators in the air and first responders after landing. EMS helicopter pilots typically do not also provide care at the scene. "Patient care comes after you land," Karklin said. Hyde County EMS paramedic Quinn Reece gives a thumbs-up from the seat of a Pivotal BlackFly. [Credit: Pivotal] The Pivotal chief said the BlackFly is "cloud connected," which allowed personnel to examine flight data after each sortie. Across months of training, teams studied different BlackFly placements to find an optimal dispatch location that would get the most out of the aircraft. Cox credited the program's partners, Code Blue Resources and Akute Networks, with helping it "run like a well-oiled machine." Code Blue recruited pilots while Akute served as aviation program manager, developing an operational framework and flight rules. Akute provided services under direct contract with Hyde County on a fractional basis, a model Karklin said could easily be replicated elsewhere. Getting county leaders and the FAA on board was another obstacle. Hyde County had to establish a safety management system, go and no-go criteria, maintenance routines, and an understanding of when versus when not to deploy aircraft. The county Sheriff's office delegated those responsibilities to Cox, who brought stakeholders together for dinners to build a sense of community. "It was a little bit of educating and then reeducating of what the job roles were, responsibilities," she said. Karklin said the process entailed a "lot of back and forth" with the FAA, which had "more than a few issues" with permitting the Hyde County Sheriff's Office proposed PAO. It also required negotiation with officials at the local Flight Standards District Office (FSDO), whom he said "went from skeptics to complete fans." Karklin said rural, non-cooperative air traffic managers in the region "were not that excited about this, and they let the FSDO know." "You've got to win some hearts and souls," he said. "That took some real time, and it didn't necessarily start out in the most collaborative way." New Kind of First Response Karklin said Pivotal and Hyde County began with four pilots in training, but Reece flew both operational missions. "In the end, we are hopeful we provided a tool that our EMS first responders can take advantage of to get better outcomes," he said. Reece piloted the BlackFly directly to GPS coordinates near each scene. She was the sole EMS provider aboard the aircraft and carried with her a cardiac monitor, airway supplies, and primary response bag. One of the two missions saw Reece land directly in the caller's yard. The BlackFly is designed to land on grass, asphalt, and "other suitable surfaces" according to Pivotal, including water when the aircraft is equipped with floats. It is also quieter and produces less downwash than a helicopter, per the company. On one occasion, Reece used her aerial vantage point to guide an ambulance to a caller's address after it got lost. Cox said the EMS department relies on a computer-aided dispatch system that produced inaccurate pings. "She guided and even advised the telecommunicators of the right location, because it was not pinging where it was supposed to be pinging," Cox said. Cox said the time that it took to negotiate with the FAA and FSDO "ate into the proof of concept," which was planned to include more real-world flights. But she said the BlackFly "gave us that extra edge" to bring the department's response time closer to the national average. What's Next? From a crawl-walk-run perspective, Karklin said Pivotal is "maybe out of the crawl phase…we're almost ready to graduate to walking, but not yet." For example, he said the FAA required it to demonstrate an equivalent level of safety to other aircraft. To comply, the company assigned half of the BlackFly's energy margin to reserves, which limited its range and ability to fight through wind. Karklin added that there is a "silver lining" to the exercise—Pivotal has not yet validated a supported engineering configuration for the EMS BlackFly. He said the company plans to certify the model under Part 91, which would permit more weight and enable th