Here is my understanding of what happened.
There were two helicopters that initially responded to the call. One was an experienced Oregon National Guard Blackhawk crew. The second an Air-force reserve Pave-hawk. The Guard helicopter was a much more experienced crew and hoisted the first 2 patients. I was told that the second helicopter was going to wait for the first one to return from the hospital in Portland and not attempt the hoist. Now this is all here say, because the military does not post their accident investigations like the NTSB.
The second helicopter went in to perform the hoist anyway. He was too heavily loaded at the time with fuel and crew. Had he done a proper performance calculation it would have shone the aircraft was too heavy for the altitude and temps. Its a bit of a trap when you are used to flying a very high performance helicopter a lower elevations. These aircraft are used to having tons of power reserve and you don't worry much performance calculations at lower altitudes.
So into the hover they go. Everything is looking good. The Torque meter (shows how much power is going to the transmission) is not close to the redline. Problem is they are now engine limited and the engines are right at their max power output, which at that altitude is much less horse power than at sea level. Still they are able to hover (for now). Well the winds are a little shifty and here comes a little down draft. The Pilot pulls in a little more collective to maintain his hover hight. The engines need to produce more power to maintain rotor RPM. They are maxed so rotor RPM starts to decay. You can see this in the video as the rotor blade angle begins to cone upward. Now here comes the real problem, the main rotor and tail rotor are mechanically driven together. A 3% drop in main rotor RPM equals a good 10% or more drop in tail rotor RPM. In an american helicopter the tail rotor pushes the nose left to counter act the torque of the engines and main rotor system.The pilot pushes the left pedal to the stop to arrest the right turn. The increase in pitch in the tail rotor blades requires more power(which is not available) and the rotor RPM further decreases. At this point the aircraft begins to settle into its own down wash and the bottom falls out. The pilot pulls back on the cyclic to get away from the mountain and the people on the ground. The crew man in the back severs the cable. The only way out is airspeed. Helicopter pilots are trained to get forward airspeed to recover. Well the mountain is now in front of the nose. You could fly out of it backwards but you can't see and crater rock is some where behind you. Its just not something most helicopter pilots have done before.
For the question on rolling the throttle off. That is a way to get out of settling with power but its not recommended. In the mount hood crash it would stop the right turn. But the increase in decent rate required would just make the impact that much sooner.
One thing I find interesting is there is a place to land a Blackhawk just 500 ft below where the accident happened. The patient could have been lowered down the snow slope to there and placed inside the helicopter while it was on the ground. Helicopters can do amazing things, but the more amazing the greater the risk of an accident.
Here is another good one where a pilot did not take high altitude in to account. This guy probably does these return to target runs all day long at lower elevation. Things take a little longer to pull out of at high elevation.
[youtube]Cqrh8WYnvaA[youtube]
http://www.youtube.com/watch?v=Cqrh8WYnvaA