New York, NYHot on the heels of a report by the Centers for Disease Control and Prevention that suggests medical errors are the third leading cause of death in the United States after heart attacks and cancer, comes a heavily redacted report about an operating room fire at NYU Langone Medical Center that occurred in late 2014.
According to a report in the New York Post (5/1/16), fires in the OR occur with alarming frequency.
The flashpoint often occurs when pure oxygen interacts with heat or a spark from a medical instrument. It is for this reason that hospitals routinely perform a checklist of instruments and implements intended for use during surgery, in association with the intended environment that usually includes oxygen fed to the patient.
According to the Post report, the event took place in December 2014. The newspaper had obtained a redacted report by the New York State Department of Health following the blaze, information that was accessed with a request through the Freedom of Information Law.
The report outlined a “communications failure between the surgeon and the anesthesiologist,” the latter unaware that a certain instrument would be used “in the presence of oxygen.”
Oxygen was being delivered to the patient from an opening in the wall; through a tube connected to a face mask. According to the redacted report, when the surgeon began using the instrument, a spark reacted with the oxygen and a fire ensued. There was no indication from the report whether or not the patient was injured in the blaze and if so, how badly. There is what appears to be a reference to injury, but no details: “The patient sustained [redacted].”
It is also not known if an operating room fire lawsuit originated with the incident.
The report notes that OR staff told investigators they had conducted a fire risk assessment prior to surgery. And yet, the investigators noted in their report that “[OR staff] gave no details of any strategies they discussed or actions they would implement to prevent the occurrence of an actual fire.”
The report notes that the hospital took steps to implement new safety procedures within an hour of the occurrence. The hospital, it has been reported, undertook additional staff training following the OR fire.
That did not placate investigators, who found that NYU Langone was “not in substantial compliance” with federal regulations governing surgery and anesthesia. “It was evident that the hospital failed to provide surgical services that conformed to current standards of practice,” the report said.
“There was no evidence of an immediate plan to prevent the recurrence of fire injury to patients undergoing surgery.”
According to the US Food and Drug Administration (FDA), which is well aware of the risk for fire in the OR, most blazes occur when the required concentration for oxygen is greater than that of room air, and when the oxygen is given to the patient by way of a mask or nasal tube.
How often do fires occur in the OR? Between 550 and 650 times each year in the United States, according to the Post report. Plaintiffs in operating room fire lawsuits allege hospitals are not taking sufficient care and caution on a consistent basis to ward against an operating room fire, and fail to plan for immediate strategy should an OR fire occur.
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