The case of the neighbors opposing Overlook Hospital's helipad application began Monday night when Dr. Bryan Bledsoe, a clinical professor of Emergency Medicine at the University of Nevada School of Medicine, testified as an expert on emergency medicine and medical helicopter use.

But before Bledsoe could testify, Overlook's attorney Bart Sheehan attempted to impeach Bledsoe's character by asking him about a time when he had his medical license suspended due to an abuse of prescription drugs Bledsoe admitted he had wrongfully self-prescribed.

Bledsoe responded that in 1999 he had a near-fatal accident and was given his last rites in the Catholic Church. But after surviving the accident Bledsoe said he experienced chronic pain and began self-prescribing Vicodin.

Bledsoe said he self-reported his abuse and had his medical license suspended but subsequently reinstated early, essentially for good behavior.

Despite this, the zoning board excepted Bledsoe as an expert witness and he began his testimony. Bledsoe said over the last decade there has been a significant increase in medical helicopter use since the Medicare reimbursement for helicopter use has increased. This move created an opening for private sector, for-profit helicopter companies to emerge instead of hospitals providing their own service.

But with an increase in use comes an increase in crashes, Bledsoe said.

Bledsoe testified before the National Transportation Safety Board after a rash of crashes in 2008 took the lives of 30 people.

"What we're seeing is a lot of patient transports that could have gone by ground," Bledsoe said. "We have to balance as physicians the risks and benefits. We've seen situations where patients were brought in that didn't need to be brought in and ended up with $15,000 bills. No one of us are against helicopter EMS. It's not being reasonably used."

Bledsoe also said it is uncommon to see a hospital construct a helipad for just inter-facility transfers.

"This is the first I've ever heard of even the concept," he said, to which Overlook Planning Consult Michael Tobia seemed to disagree, as he squirmed in his seat and shook his head.

Bledsoe also raised questions about the need to transfer patients by air from referring hospitals within 45 miles of Summit.

"I agree with all the monikers," he said. "Time is brain; but the definition of time seems to have chancged over the last 10 years. "

Tobia could be heard whispering "This is outrageous."

With stroke patients, Bledsoe said, if an interventional window exists and air transport will deliver a patient to the hospital within the interventional window when ground transport would not, that is when he would support the use of medical helicopter EMS for interfacility transfers.

Both Sheehan and Planning Board member Ann Berman questioned whether 45 miles took the same amount of travel time in Nevada that it does in New Jersey.

"It can take an hour and a half to go 45 miles," Berman said of travel time here in New Jersey.

But Bledsoe also said he sees a tendency of hospitals building helipads not for medical need but for financial needs and when a helipad is built the number of flights to and from the hospital increases.

"It's all part of the survival of hospitals in the millennium," he said.

The Planning board will finish the public questions for Planning Consultant Michael Tobia April 5 but the opposition case will continue March 15.

The zoning board will also meet March 9 to hear residential cases.

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