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Fire in the OR: a lesser known medical risk for patients

The surprising incidence of surgical fires is a reminder to patients of the complexity of risks associated with medical procedures, Toronto personal injury lawyer David Derfel tells AdvocateDaily.com.

Canadian Medical Protective Association (CMPA) review of 54 medical-legal cases involving fires and burns to patients found a number of people were left with “scarring, disfigurement and psychological trauma” by the incidents, the National Post reports.

Although the story notes that surgical fires are rare — the 54 cases occurred between 2012 and 2016 — it also includes a claim from safety advocates that the total number of cases across Canada could be more than 10 times higher in the same period, since only a fraction of incidents tend to result in litigation at the CMPA.

“Surgery is complex and there are many components involved in any procedure. Many people think that the only risks are a botched procedure or post-surgical complications such as infection or delayed healing," says Derfel, founder and principal of Derfel Injury Lawyers

“This article highlights another risk that people might never think is a possibility — you might catch fire during surgery,” he says.

According to the Post, one woman spent three weeks in intensive care after a procedure to shrink a tumour in her trachea went wrong. The surgeon’s laser struck an inflatable cuff around a breathing tube containing anesthetic gases and 100-per-cent oxygen, causing a burst of flames in her windpipe when the released gases caught fire.

The review found a lower concentration of oxygen may have prevented the fire in this case. Similar problems played a role in about half the fires studied.  

“It’s shocking to think about something like that happening, but it makes sense when you consider that all the ingredients necessary for a fire to occur may, depending on the procedure, exist in the operating room: heat, fuel and oxygen,” Derfel says.    

The CMPA review found a third of its cases concerned actual fires in the operating room, with further incidents involving burns from equipment and chemicals employed during the operation.

The use of alcohol-based cleaning agents, which often remain flammable until completely dry, increases the risk of fire in surgery, the article says.

The review also blamed some burns on equipment issues, including malfunctions and the use of improper power levels, while communication errors between members of the surgical team also played a part in many cases.

Derfel says patients must advocate for themselves when a primary-care physician refers them for surgery or other procedures.

“No one plans for something bad to happen during a medical procedure,” he says. “But you can reduce your risk. Make sure you research the person you’re being referred to, find out their qualifications and ask questions of the referring doctor.”

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