Operating Room Fires Are a Clear and Constant Risk

When a patient undergoes surgery, either in a hospital or a surgical center, the surgeon may use electricity to cut through the tissue. Electrosurgery has a number of benefits, but one dangerous and significant drawback: the risk of an operating room fire.

Though OR fires are rare – there are about 650 a year, and the American College of Surgeons estimates about 15 million Americans undergo surgical procedures annually – the risk is constant, and the effects can be devastating. For example, a woman recently filed a lawsuit against an outpatient bariatric group which used electrosurgery to remove some tumors on her neck. According to the report:

She was placed on a nasal oxygen tube and the surgical staff used an electric cauterizing tool to close wounds left by excised tumors…. As doctors, nurses and assistants worked to cauterize the wounds, “there was a spark from the device that caused the oxygen to catch fire,” the suit states.

“While electrocautery was being used, there was a flash flame and the drapes surrounding the plaintiff caught fire.”

She suffered second and third-degree burns on her face and neck.

Why does electrosurgery cause operating room fires?

There are two common forms of electrosurgery: electrocautery, which applies the current directly to a patient’s skin, and fulguration, a process where surgeons “hold the probe over your skin to create a spark to generate enough heat to kill the targeted cells.” Fulguration is commonly used to remove tumors, so one might assume this was the process used on the woman who was burned.

Electrical sparks in and of themselves can cause a fire, of course, but surgical centers and ORs are especially dangerous. There is a lot which can catch fire: surgical drapes, gauze, the alcohol from sterilization wipes, a patient’s body hair, etc. They also tend to be oxygen-rich environments, and oxygen is an oxidizer, a substance which is ‘not necessarily combustible, but [it] can intensify combustion and increase the flammable range for chemicals so they ignite more readily”. So is nitrous oxide, which may be used as anesthesia. When you have a spark, fuel, and an oxidizer all in one place, referred to as the “fire triangle,” it can easily lead to a fire.

Which patients are at greatest risk of injury from an OR fire?

Virtually every surgical patient faces some risk of an OR fire, because electrosurgery is often used “to control bleeding and to rapidly dissect soft tissue” during the procedure. The patients at greatest risk of catastrophic injury, however, are those undergoing procedures closer to the oxygen source – AKA, anyone having surgery from the chest up. That can include patients who need:

• Pacemakers
• Shoulder surgeries
• Plastic surgery
• Abdominal surgeries (abdominal gasses can work as oxidizers, too)
• Eye surgery
• Tonsillectomy
• Dermatological procedures

Surgical patients are not the only ones at risk in an OR fire

Patients are often the ones who sustain these catastrophic burn injuries from the fire or from melting medical devices. Depending on the circumstances, it is possible that an electrical spark can cause an explosion, which means dust and debris like shattered glass and metal. Even if the patient manages not to suffer life-threatening burns, he or she can sustain immense physical trauma and develop infections.

However, an OR fire poses risk to everyone. These types of fires spread fast, and everyone in the room can be burned or otherwise injured. Older facilities may also allow smoke, ash, and debris to escape, posing a threat to other patients.

Warning about the PEAK PlasmaBalde

Plasma knives are electrosurgical tools used to cauterize wounds and stop bleeding. A little over a decade ago, Medtronic released the pulse-electron avalanche knife (PEAK) PlasmaBlade, a device which could both cut and cauterize. Some analysis showed that using this device in surgery “resulted in significantly better outcomes than traditional electrocautery (EC) as indicated by shorter time to wound healing, duration of post-operative hospital stay, pain-free swallowing, and length of time for which drains remained in place.”

Recent analysis from Baylor University Medical Center found that the PEAK PlasmaBlade is frequently cited in the US Food and Drug Administration’s (FDA’S) Manufacturer and User Facility Device Experience (MAUDE) as the root cause of adverse effects during surgery. Between 2010 and 2020, there were 424 adverse events linked to use of the PEAK PlasmaBlade. The device malfunctioned in 82.1% of cases, and 12.5% of the cases involved patient injury. (Operators were injured in 5.4% of all cited cases, too.)

Filing a medical malpractice lawsuit for OR fire injuries

An operating room fire is considered a “never event,” a term used to “signify adverse events that are unambiguous (clearly identifiable and measurable), serious (resulting in death or significant disability), and usually preventable.” These fires should be preventable if everyone is doing their job correctly and following all safety procedures to the letter. Patients who are injured can file a lawsuit for damages stemming from the incident. Those damages include:

• Medical expenses accrued as a result of the fire, including costs for longer hospital stays, additional surgeries, medications, and rehabilitation. Transportation costs associated with medical care are also included.
• Lost wages, as well as any loss of future earning potential if one’s injuries leave them unable to work.
• Pain and suffering, both physical and mental, associated with the event. This can include any mental trauma stemming from permanent scarring or disfigurement.
• Loss of enjoyment from life during the healing process, as well as once the patient is released.
• Loss of consortium/companionship with one’s spouse.
• Funeral and burial costs if the patient is killed or later succumbs to injuries.

Cases like these may also be candidates for punitive damages, which are designed to punish wrongdoers.

Who is liable for an OR fire leading to injuries?

Medical malpractice claims involving OR fires may have multiple liable parties. Typically, a lawsuit would name:

• The attending surgeon
• Any nurses or medical personnel tasked with operating or maintaining the device
• The hospital or medical facility itself

If the root cause of the OR fire is a defective unit or device, you may be able to file a product liability lawsuit against the manufacturer or other third-party.

Please contact Paulson & Nace, PLLC through this contact form or by calling our offices today.