The airplane was destroyed when it impacted terrain at approximately 0015 Central time. A post-crash fire ensued. Dark night visual conditions prevailed. The emergency medical services flight was operating on an IFR flight plan under FAR Part 135. The airline transport pilot, two flight nurses, the patient and a passenger were fatally injured. Witnesses observed the airplane flying low and reported they saw lights on the airplane; nothing appeared to be abnormal other than the low altitude. One witness said the airplane appeared to descend and then a fireball was observed shortly thereafter. All of the witnesses interviewed remarked that it was very dark and the skies were overcast at the time of the accident.