Narrative:

On a lifeguard flight from ZZZ to ZZZ1; I got a cabin altitude warning light passing through 10000 ft. I leveled at 12000 ft and notified the medical crew of the situation. Because the critical condition of the patient; and the fact that in spite of the oxygen he was receiving; his pulse/oxygen reading was dropping. The flight nurse told me to return to ZZZ. I notified ATC of the problem. He cleared me to return direct at 12000 ft. I told him I needed lower and started a descending turn; and told him I could proceed VFR. (Fortunately; there was good moonlight to illuminate the high terrain.) descending through 10500 ft; ATC asked me to check my altitude; and I repeated my VFR intentions. He then cleared me direct VFR to ZZZ. This was a particularly crappy flight for me. The aircraft had a substantial fuel leak which maintenance chose to ignore. The propeller controls are grossly misaligned; and the antiquated LORAN had all the letters and symbols worn off the control buttons. While climbing out; I was cleared direct to ZZZ VOR at 17000 ft. Because I was struggling to figure out the LORAN operation; I didn't notice the cabin altitude problem until the warning lights came on. I should have caught the pressurization sooner. I usually carry my own GPS with terrain avoidance function to back up the crappy avionics; but it wouldn't work because the cigarette lighter which I plugged it into was also crapped up. I turned in my resignation to this company the following day. In a 24-hour period; we nearly killed 2 different patients because of our crappy equipment.

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Original NASA ASRS Text

Title: UNFAMILIAR WITH NAV EQUIPMENT ABOARD HIS PA31; AIR AMBULANCE PLT IS LATE IN RECOGNIZING PRESSURIZATION FAILURE AND RETURNS TO DEP ARPT.

Narrative: ON A LIFEGUARD FLT FROM ZZZ TO ZZZ1; I GOT A CABIN ALT WARNING LIGHT PASSING THROUGH 10000 FT. I LEVELED AT 12000 FT AND NOTIFIED THE MEDICAL CREW OF THE SITUATION. BECAUSE THE CRITICAL CONDITION OF THE PATIENT; AND THE FACT THAT IN SPITE OF THE OXYGEN HE WAS RECEIVING; HIS PULSE/OXYGEN READING WAS DROPPING. THE FLT NURSE TOLD ME TO RETURN TO ZZZ. I NOTIFIED ATC OF THE PROB. HE CLRED ME TO RETURN DIRECT AT 12000 FT. I TOLD HIM I NEEDED LOWER AND STARTED A DSNDING TURN; AND TOLD HIM I COULD PROCEED VFR. (FORTUNATELY; THERE WAS GOOD MOONLIGHT TO ILLUMINATE THE HIGH TERRAIN.) DSNDING THROUGH 10500 FT; ATC ASKED ME TO CHK MY ALT; AND I REPEATED MY VFR INTENTIONS. HE THEN CLRED ME DIRECT VFR TO ZZZ. THIS WAS A PARTICULARLY CRAPPY FLT FOR ME. THE ACFT HAD A SUBSTANTIAL FUEL LEAK WHICH MAINT CHOSE TO IGNORE. THE PROP CTLS ARE GROSSLY MISALIGNED; AND THE ANTIQUATED LORAN HAD ALL THE LETTERS AND SYMBOLS WORN OFF THE CTL BUTTONS. WHILE CLBING OUT; I WAS CLRED DIRECT TO ZZZ VOR AT 17000 FT. BECAUSE I WAS STRUGGLING TO FIGURE OUT THE LORAN OP; I DIDN'T NOTICE THE CABIN ALT PROB UNTIL THE WARNING LIGHTS CAME ON. I SHOULD HAVE CAUGHT THE PRESSURIZATION SOONER. I USUALLY CARRY MY OWN GPS WITH TERRAIN AVOIDANCE FUNCTION TO BACK UP THE CRAPPY AVIONICS; BUT IT WOULDN'T WORK BECAUSE THE CIGARETTE LIGHTER WHICH I PLUGGED IT INTO WAS ALSO CRAPPED UP. I TURNED IN MY RESIGNATION TO THIS COMPANY THE FOLLOWING DAY. IN A 24-HR PERIOD; WE NEARLY KILLED 2 DIFFERENT PATIENTS BECAUSE OF OUR CRAPPY EQUIP.

Data retrieved from NASA's ASRS site as of May 2009 and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.