Surgery fires Fry Patients, spark action by medical group in US
Pastor Dale Morgan
Surgery fires Fry Patients, spark action by medical group in US*
27.07.2007 Source: AP ©
Just a simple procedure to remove two moles from the face turned a real
nightmare for Kathleen Osberger. She was laying sedated on a Chicago
operating room table when flames engulfed her face.
Now, seven years and 18 corrective surgeries later, the 54-year-old
clinical social worker is still on disability leave because of the
severe burns to her upper lip, nose and nasal passages.
She says doctors have never told her what they think went wrong, but she
believes oxygen collected under the surgical drapes and fed a fire
sparked by surgical tools. She sued and settled with the hospital, which
denied negligence.
"I believe they walked into the operating room trying to help me.
However, something massively went wrong," she said.
Surgery fires are rare but serious enough that the American Society of
Anesthesiologists plans this fall to issue its first guidelines aimed at
preventing them. Health officials are not required to report surgery
fires, but the medical group believes they have increased over the past
two decades with the use of lasers and tools that use electric current.
"We think there is a lot of underreporting and a lot of near misses,"
said Dr. Jan Ehrenwerth, a professor at the Yale University School of
Medicine and a member of the society's task force on the issue.
ECRI Institute, a nonprofit health research agency, estimates that there
are 50 to 100 fires out of the more than 50 million surgeries performed
in the United States each year. Such fires kill one to two people
annually, and 20 percent of patients suffer serious, disfiguring
injuries, according to ECRI, which investigates medical procedures and
devices.
Most fires are caused when oxygen builds up under surgical drapes during
the use of electric surgical tools that cut or remove tissue or control
bleeding, the institute says.
ECRI's Mark Bruley said too many anesthesiologists are using 100 percent
oxygen instead of only what the patient needs.
The proposed guidelines include lowering the concentration of oxygen
given to patients during surgery by diluting it with room air when
surgical tools that could ignite a fire are in use. Other suggestions
are to reconfigure drapes to minimize oxygen buildup and use suction
devices to remove excess oxygen from surgery sites.
Ehrenwerth disputes suggestions that anesthesiologists are unnecessarily
giving high concentrations of oxygen.
"We have to look at the patient and see what's safe for the patient," he
said. "We don't want them to have decreased oxygen to their heart or
their brain."
Dr. Richard Greco, a plastic surgeon in Savannah, Georgia, had a patient
catch fire in 1991. While cauterizing an area during an eyelid
procedure, excess oxygen fueled flames that burned his patient's nose.
"I was absolutely astonished that the fire occurred while I was doing
everything I was trained to do," he said. "There was obviously a flaw in
the system. People weren't considering the risk of fire."
He said patients can be kept stable with an oxygen levels of 30 or 40
percent during the use of electrosurgery tools.
Medical researchers and doctors say concern about surgery fires waned in
the 1970s when safer anesthetics replaced ether and other flammable
agents used to sedate patients. Today more electrosurgery devices are
used and cloth drapes have been replaced with paper drapes, which are
more flammable.
Osberger, who lives in Chicago, settled a malpractice lawsuit in 2003
against Weiss Memorial Hospital for $6 million (EUR4.37 million). She
has had to wear special masks, had stents inserted into her nasal
passages and still has trouble breathing or smiling.
The hospital said in a statement Thursday that it has changed its
procedures and follows the recommendations of a hospital accrediting
group to prevent surgical fires. Those changes include how patients are
prepped before surgery and how oxygen is administered. The surgical
staff is also trained to prevent fires and how to respond to them, the
hospital said.
Osberger believes one of the ways to decrease surgery fires is to
require mandatory reporting of them.
"With the high level of skill you have in the operating room, this is
preventable," she said.