Operating Room Fires Are Rare, But Avoidable

When you go in for a surgery, you have some basic expectations. The doctors and nurses will take good care of you while you’re at your most vulnerable, right?

Staff makes sure all tools and operating equipment are sanitary, and surgeons perform basic safety checks such as confirming a patient’s name and what procedure they’re having done. These presurgical routines are second nature to workers in the operating room (OR), but is your medical team ready to deal with something more unexpected?

Fires in the OR, while indeed rare, are not totally outside the realm of possibility. In fact, fire in the OR has been documented in medical journals as far back as 1930, and about 650 fires continue to occur in ORs across the U.S. annually. As far back as 2010, The Surgeon called surgical fires “a clear and present danger,” yet the numbers have not diminished in the last 13 years.

Yet, despite the scary stats, fires in the OR are considered to be “never events” since they are highly preventable and should never even happen in the first place.

So what causes fires in the operating room?

The three elements of any fire event are fuel, air, and heat. Together, they are known as the “fire triangle.”

In a medical setting, fuel can be anything from flammable surgical drapes and personal protective equipment, or PPE, to solutions such as alcohol or petroleum; “air” can be either oxygen or nitrous oxide, and the heat could be a laser or a high-power drill that acts as the fire starter.

NOTE: In order to prevent fires, personnel must always monitor the oxygen content at the surgical site. Even with careful monitoring to keep the site’s oxygen content well below the 30% limit, a fire may be caused by something as simple as a piece of defective equipment.

Today’s surgeons skip the scalpel, preferring to use more modern electrosurgical tools, cauterizers, and the like. These electrosurgical units (or ESUs) rely on an electric current – a spark, essentially – that cuts and coagulates tissues during surgical procedures.

But these advanced technologies come with a documented risk of catastrophic events. Surgical fires are most frequently associated with electrosurgical equipment (68%), followed by lasers (13%). And in almost 3/4 of those cases (74%), the patient was receiving supplemental oxygen as well. Anesthesia is also commonly involved in surgical fire events, which is why fire safety guidelines were established for anesthesiologists.

In some cases, the causes of a surgical fire are never fully known.

What are the most common anatomical locations where surgical fires occur?

According to the Ochsner Journal, surgical fires most often occur in, at, or on the patient’s head, face, neck, and chest, including the airways. The majority involve the upper body (85%), near where the oxygen source is generally positioned. But burns from fires can also occur at the arms and legs during certain procedures involving ESUs.

Each year, approximately 20 to 30 surgical fires cause serious injury or disfiguration. Of those annual fires, about one or two result in fatality, mostly attributable to fires in the victim’s airway.

Some injuries a person might sustain from an OR fire include coagulative necrosis, which the Ochsner Journal describes as the sustained death of the skin or deeper tissues. Depending on the extent of the necrosis, the skin and tissues may or may not be salvageable — and sepsis is not out of the question either.

In addition to these localized injuries, the victim may also suffer from damage to the cardiovascular, respiratory, metabolic, and immunological systems. So-called inflammatory mediators as well as cytokines (small, defensive proteins the body releases) come to the scene to help the body’s immune system.

But other significant, systemic injuries are still a possibility, too. Patients are at risk of systemic hypotension, end organ hypoperfusion, splanchnic hypoperfusion, bronchoconstriction, and, in severe burn cases, adult respiratory distress syndrome.

Not surprisingly, victims may also experience sustained psychological trauma after a fire event in the OR.

Can you sue a Mississippi hospital for injuries from an OR fire?

Depending on the circumstances, yes, you may have an eligible case for a lawsuit. In the state of Mississippi, anyone from a doctor, nurse, EMT — even the facility itself — may be held liable for medical malpractice.

Merkel & Cocke can assess your situation and determine if, in the eyes of the law, any individual has either been negligent in or breached their professional duties. You may have even suffered an injury as a result of someone’s actions (or inaction) and had to pay out-of-pocket for unexpected medical expenses.

Any economic losses or expenses resulting from the OR fire event are classed as actual damages, and the offending party may be held responsible. In addition, intangible “general” damages include things like psychological trauma, chronic mental distress, and a reduced quality of life due to your suffering. In rare cases, we may pursue additional punitive damages.

Depending how the fire occurred, the surgeon and/or the facility may not be the only ones accountable for your injuries. Manufacturers may also be at fault if their equipment is proven to have a serious design flaw or a manufacturing defect that caused their product to malfunction in the operating room.

Do you believe you have a medical malpractice case against someone in the state of Mississippi? The attorneys at Merkel & Cocke, PA knows that being the victim of a surgical fire can be an extremely traumatizing event. But we are here to answer your questions and guide you through, every step of the way.

Fill out our contact form to schedule your free personal consultation with an expert member of our team: Together, we have nearly 200 years of experience in fighting for Mississippians just like you. Our four convenient office locations include Jackson, Clarksdale, Greenville, and Oxford.