Staff shortages, delayed responses to save money, poorly designed interiors in brand-new helicopters and a money trail that disappeared in a complex web of for-profit spinoffs were among the litany of problems the legislative committee tried to unravel.
Few witnesses were able to provide answers. Former executives pointed the finger at each other, saying they were just following orders. Senior health bureaucrats shrugged their shoulders when asked how Ornge went off the rails under their watch, even as the red flags piled up.
Health Minister Deb Matthews, under fire for months about another health agency mired in controversy, insisted she was kept in the dark by Ornge until late last year, when the scandal had already hit the front pages.
There was one consistent refrain from the parade of witnesses who testified: Dr. Chris Mazza, Ornge's mercurial mastermind, was at the centre of it all.
But the ousted CEO didn't shed much light on what went wrong during an emotional appearance before the committee after months of silence.
Mazza couldn't answer some key questions about Ornge's business dealings, citing gaps in his memory. He refuted allegations that he masterminded a kickback scheme, said he was handed $1.4 million in compensation from the board and that he would have replied "Yes, ma'am" if the minister had asked him to change course.
The committee heard Ornge "encouraged" the hiring of family members, including the chairman's daughter and Mazza's girlfriend — who rose to the rank of junior executive. Even the daughter of Rhoda Beecher, Ornge's head of human resources, landed a job, but Beecher insisted that all three women underwent a rigorous hiring process.
But the most shocking testimony came this week from former chairman Rainer Beltzner, who said he saw documents showing Ornge paid millions in unnecessary fees to an Italian company that sold it a fleet of new helicopters for $144 million. Shortly after, AgustaWestland signed two contracts with Ornge totalling $6.7 million.
Where that money went is still a mystery.
Provincial police probing "financial irregularities" at Ornge may be able to shed some light. AgustaWestland has vehemently denied any wrongdoing.
The province's auditor general has already detailed Ornge's questionable business dealings and slammed the government for failing to oversee an organization that received $730 million over five years and borrowed $300 million more.
What started as a plan to consolidate Ontario's patchwork air ambulance service under one roof and generate revenue to help support it fell far short of its goals, said Conservative Frank Klees. And the man the government handpicked to do the job left behind a mess that's still being cleaned up.
"A vision turned into a nightmare," Klees said.
The Ornge debacle is a major embarrassment for the minority Liberals, who are gearing up for two potentially game-changing byelections this fall that could hand them a majority.
The storm swirling around Ornge has even drawn in individuals connected to Canada's most powerful political players.
Prime Minister Stephen Harper's former chief of staff Guy Giorno, former president of the federal Liberal party Alfred Apps and Lynne Golding, who is married to cabinet minister Tony Clement, were among the team of lawyers who provided advice to Ornge.
The work included advising Ornge on setting up the web of for-profit subsidiaries, compensation for its executives and whether the organization needed to disclose Mazza's sky-high compensation package — all of which have come under fire by the auditor. The firm collected almost $11 million over nine years.
Questions have swirled about unregistered lobbying on Ornge's behalf. Ontario's integrity commissioner said Apps engaged in it, but he insists he didn't.
The hearings have flushed out some details about how Ornge operated, said NDP health critic France Gelinas.
"We did get a lot of answers. Did we get them all? No," she said.
"We're starting to get a pretty clear picture of the mess that happened there."
What's not yet clear is whether the committee will get an opportunity to ask those remaining questions. There's a possibility of more hearings when the committee re-forms in the fall, but that won't be decided until the legislative session resumes.
Klees — who wants a public inquiry — has accused the Liberals of trying to shut down the hearings and proceed to writing a report in an effort to avoid further embarrassment. That would also prevent Premier Dalton McGuinty, who is on the witness list, to testify.
"Again I think if we have done anything, we've demonstrated that we are just as eager as the opposition to gain a full understanding of what it is that has happened," McGuinty said Thursday.
The Liberals have asked Ornge for more documents about its deal with Agusta and Mazza's pay.
Beltzner suggested Mazza may have collected more than $1.4 million last year, citing payments he didn't know existed until the day after government auditors started combing through Ornge's books. Top executives went along with it, he said.
"Clearly this may only be the tip of the iceberg so to speak," Beltzner wrote in an email to the head of the auditing team on Dec. 24, 2011.
"This is most disturbing."