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Medical Malpractice Newsletter

Flash Fires During Surgery Lead to Injuries, Death

A surgical patient likely never considers the risk of being injured in a fire during an operation. Failure by nurses, doctors, or anesthesiologists to follow the recommended safety protocol to avoid fire ignition could result in serious injury or even death to a patient in the event of a fire during surgery.

Surgical fires can occur when heat, air, and fuel are simultaneously present during a surgery. These three elements combine to provide an environment in which a fire can ignite. Heat, air, and fuel are present in most operating rooms in some of the following forms:

  • Common sources of heat include electrical surgical tools, defibrillators, drills and burs, heated probes, or surgical lasers.
  • A common source of air is oxygen, which is used as part of the mix for anesthesia.
  • Common sources of fuel include hair on the face, body, or scalp; GI tract gases; aerosol adhesives; alcohol (used as a prepping agent); gowns, hoods and caps; mattresses, pillows, blankets, and drapery; surgical sponges; gauze; and ointments.

In the past, surgical fires were thought to occur 50 to 100 times a year; a relatively low number given that 50 million surgeries are performed annually in the United States. However, a 2007 study by the Pennsylvania Patient Safety Reporting System shows the incidence of surgical flash fires to be much higher than originally thought. Research shows that of all 2007 Pennsylvania surgeries, one out every 87,646 operations involved a surgical fire. These figures reflect that Pennsylvania alone had 28 surgical fires in 2007. Thus, in extrapolating the data, the research indicates that between 550 and 650 surgical patients are affected every year by a surgical fire. In addition, out of that group, as much as 20 or 30 of those individuals may face serious burns, with a handful even dying from injuries sustained in the fire.

Another area of concern is that the figures regarding the number of surgical fires in a year are not exact because there is no national mandate for health officials to report surgical fires. The 2007 Pennsylvania study was made possible because Pennsylvania requires the reporting of such incidents. As quoted by HealthNewsDigest.com, Dr. Jan Ehrenwerth, professor at the Yale University School of Medicine and a member of the American Society of Anesthesiologists (ASA), stated that “We think there is a lot of underreporting and a lot of near misses.” The Food and Drug Administration does maintain data on circumstances where equipment failure is suspected as the cause of a surgical fire. These numbers are often low because device failure is typically not the cause for such fires. Thus, surgical fires could be even more prevalent than the data from the Pennsylvania study suggests.

When patients are injured by a surgical fire, typically 65 percent of them face injury to their upper body or to the inside of their airways. Another 25 percent of patients are typically injured on their body. The remaining 10 percent of patients endure injuries to the inside of their body.

Preventing Surgical Fires

Hospitals can take steps to reduce the risk of a fire occurring during surgery. One available precaution is to ensure that all surgical staff, including nurses, doctors, and anesthesiologists are trained in the proper actions to take in preventing fire. Hospitals might also engage in regular fire drills to establish and maintain preparedness for such an emergency. The ASA also released guidelines for dealing with surgical fires. Regular drills are included among their recommendations. The ASA also recommends various preventative measures, such as avoiding use of ignition sources in an oxygen rich environment, stopping the use of nitrous oxide, or allowing sufficient drying time for flammable skin prepping agents (such as alcohol).

When a surgical team fails to follow the recommended precautions or when a fire results despite a team taking precautions, the resulting surgical fire can cause great harm to the patient. In one instance in Maryland, Msnbc.com reports that a 74 year old woman was injured when a topical cleaner that had not been allowed to completely dry was ignited by a cauterizing tool. The woman suffered 2nd and 3rd degree burns to her face. As a result of this surgical fire and the resulting burns, the woman faced terrible pain, as well as infections and kidney failure. Two years later, the woman died having never fully recovered from her injuries. The patient’s estate sued the hospital and received a confidential settlement.

In two other incidents, USNews.com reports surgical fires involving children. In one operation in North Carolina, a newborn was burned during surgery. In California, an 8 year- old boy was injured during a tonsillectomy when his breathing tube ignited. The boy suffered injuries to his mouth, throat, and lungs.

These examples highlight the possibility that surgical fires can occur, even during routine surgeries, and that they do pose a real risk of which patients may not be aware. If you think that you or a loved one may have suffered an injury from a surgical fire, it is recommended that you contact knowledgeable legal counsel as soon as possible to preserve any rights that you or your loved one may have.

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