On July 14, 2004, approximately 1220 mountain daylight time, a Bell 222U helicopter, N277LF, was substantially damaged while maneuvering during departure from Louie Lake, Idaho. The helicopter was registered to PNC Leasing LLC of Pittsburgh, Pennsylvania, and operated by CJ Systems Aviation Group, Inc., of West Mifflin, Pennsylvania. The commercial pilot, flight nurse, paramedic, and patient who was being transported were not injured. Visual meteorological conditions prevailed for the 14 CFR Part 135 medical evacuation flight, and a flight plan was not filed. The flight was originating at the time of the accident. In a written statement provided to the NTSB investigator-in-charge (IIC), the pilot reported that upon arrival at the designated landing zone (LZ), located 6,500 feet above mean sea level (MSL), "I told the crew we were going to perform an out-of-ground-effect (OGE) hover to verify the aircraft performance. The power check was good and we had a positive rate of climb OGE." The pilot reported that after landing and deplaning the crew, he decided to depart the LZ to locate another one which would be closer to the patient/crew pickup point. The pilot further reported locating an LZ about 3/8 of a mile closer to the pickup point at 6,600 feet MSL. The pilot stated that while waiting for the crew to load the patient he determined the passenger's weight, computed the [aircraft's] weight and balance, and checked his performance charts. The pilot reported, "Everything checked out fine and the patient was loaded. The crew checklist was completed and I performed [an] IGE (in-ground-effect) power check. All systems looked good and we departed at approximately 1220 hours." The pilot stated the aircraft performed well during the vertical climbout and he could see the helicopter would clear the 100 foot tree line as it began to transition forward. "As the rotor system cleared the tree line and forward progress was started, I felt the aircraft lose all lift and begin to settle back toward the approaching trees. I applied the remaining power that I had left." The pilot reported the audible RPM warning sounded, accompanied by a slight yaw. The pilot stated, "I reduced collective, realized I was descending into my obstacles, and essentially performed a quick stop, applied right pedal and attempted to return to the original point of departure." The pilot further stated that the rotor RPM had still not completely recovered at this point. "I attempted to cushion the impact with collective and we touched down in the confined area with zero ground speed." The pilot reported the left skid impacted a boulder, the RPM fully recovered, and the aircraft "jumped" back into the air. The pilot further reported, "We rotated 180 degrees [and] I responded by rolling the throttles off and performed a hover autorotation. [After landing] I performed the emergency shutdown and we evacuated the patient." The pilot further stated that there were several boulders where the helicopter impacted the terrain, and that the left skid tube between the crosstubes was broken. The pilot also reported that during the 180 degree rotation the tail rotor contacted a tree branch and damaged a tail rotor blade. The pilot stated that at the departure point the wind was calm and was shielded with tall tress. The pilot related, "It is my feeling that as I cleared the tree tops I entered a downwind condition. I did not anticipate this downwind condition and did not have enough of a power margin to overcome this loss of lift. The pilot did not assert that any mechanical malfunctions precipitated the accident. According to a Federal Aviation Administration (FAA) inspector, who conducted a post accident examination of the tail rotor, the helicopter had sustained an approximately 8 inch chordwise gash to one of the tail rotor blades as a result of the impact with the tree branch. According to the Pilot/Operator Aircraft Accident Report provided to the IIC, weather conditions at the accident site were reported to be wind from the southeast at 10 knots with gusts to 10 knots, ceiling and visibility unlimited, temperature 70 degrees Fahrenheit, and an altimeter setting of 29.91 inches of Mercury. At 1250, the McCall Municipal Airport (MYL) Automatic Surface Observing System (ASOS), located 7 nautical miles west-northwest of the accident site elevation 5,021 feet MSL, reported wind variable at 3 knots, visibility 10 statute miles, sky clear, temperature 84 degrees Fahrenheit, dew point 48 degrees Fahrenheit, and an altimeter setting of 30.08 inches of Mercury. Density altitude at the accident site was calculated to be 8,898 feet.