Surgical fires are a “never event” meaning they should never happen. Nonetheless, experts estimate that approximately 700 surgical airway fires occur every year, with even more “near misses.” Airway fire is most common in surgeries involving the head and neck - ENT surgeries including tracheostomy and tonsillectomy - as well as surgeries involving skin on the neck and eye surgeries. An airway fire during surgery can result in serious injuries, including loss of the ability to breathe without assistance, scarring, disfigurement, severe emotional trauma, and a loss of the ability to participate in pre-accident activities.
Causes of Airway Fires During Surgery
Airway fires during surgery occur when the three elements necessary for a fire - oxygen, fuel, and heat - are present in just the right amount. These elements are present in the right combination during many head and neck surgeries performed by ENTs, including tonsillectomies and adenoid surgery, and any surgery that involves a tracheostomy.
A fire needs three things - oxygen, fuel, and heat. All three are present during airway surgeries.
Oxygen is present in higher-than-normal quantities during airway surgery as patients are intubated and receiving breathing assistance.
Fuel is supplied in the form of PVC tubes and other surgical materials which can ignite in oxygen-rich environments.
Heat is introduced through lasers and other cauterizing devices that are commonly used to close minor bleeds.
The anesthesiologist controls the flow of oxygen and nitrogen to the patient during surgery. The gas may leak into the oral cavity and trachea, creating a flammable environment. To reduce the risk of fire, the anesthesiologist should reduce the amount of oxygen flowing to the patient or consider using a mixture of room air and oxygen rather than pure oxygen.
Nurses are often responsible for the fuel - the sponges, preparation solutions, drapes, masks, and tubes. If materials are placed so that oxygen can accumulate underneath them, or if dry pads are used instead of wet ones, fire is more likely to occur.
Heat is introduced when a surgeon uses lasers and other cauterizing tools to stop a minor bleed.
A fire during surgery is a “never event.” If a fire does occur, it is almost surely because someone committed malpractice. Common causes of surgical fires include:
Alcohol pooling under the patient
Using 100% oxygen during surgery
Sparks from cauterizing tools
Ignition of pads or sponges around an incision
Poor communication among members of the surgical team
Surgical Fire Is Almost Always Caused by Malpractice
Surgical fires are so rare that they are called “never events” meaning that they should never happen. If a surgical fire does occur, it is almost always a complete surprise to the surgical team and is almost surely the result of malpractice. Surgical fires are preventable, and surgical staff must understand how to reduce the likelihood of surgical fire.
Although airway fire is a risk of any surgery involving the head and neck, and specifically the trachea, it is not often listed among the possible complications. In fact, many surgeons do not fully appreciate its potential and fail to advise patients of the risk.
Injuries Due to Surgical Fire
Airway fire during surgery is an uncommon but serious risk for surgical patients. When a surgical fire does occur, it can cause severe, debilitating, and permanent injuries that can result in serious post-surgical complications and even death.
Injuries after a trachea fire during surgery are often permanent and can include losing the ability to speak, inability to breathe without assistance, and an inability to participate in many daily activities that a patient did before the botched surgery. Surgical fires can also cause scarring, disfigurement, and severe emotional trauma.
Holding People Accountable for Injuries Caused by an Airway Fire
ENT surgeons, anesthesiologists, members of the surgical team, the facility where the surgery was performed, and medical device manufacturers can all be held responsible for injuries caused by a an airway fire during surgery.
At Robenalt Law, our medical malpractice lawyers fight for people who have been injured as a result of airway fires during surgery. If you were injured because of an airway fire during surgery, you may be entitled to compensation including:
Tom Robenalt started his litigation career representing doctors and hospitals at a large firm in Cleveland. For the past 25 years, he has used that experience to help victims and the families of those injured by negligent health care providers.
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