Surgical Fires in Ontario: What’s the Risk?

Undergoing surgery always involves risks. Before a surgeon can operate on a patient, he or she must first inform the patient of the material risks involved in the procedure, and obtain the patient’s consent in light of those risks. But one risk that many people — including medical professionals — are often unaware of is the risk of a surgical fire or burn during an operation.

A surgical fire is a fire on or in a surgery patient. Although not especially common, such fires are frequent and traumatic enough that the Canadian Medical Protective Association (CMPA) — a mutual-defence organisation for medical professionals facing malpractice claims — recently released a brief report warning doctors of the risks and providing advice on how to avoid them.

In light of the CMPA’s report and subsequent media coverage, we thought it would be helpful to provide an overview of surgical fires and burns, and what legal remedies may be available for patients injured in such incidents.

How common are surgical fires?

Fortunately, surgical fires are relatively rare, but they are not unheard of. The CMPA’s report was based on its analysis of 54 closed surgical-burn cases from 2012 to 2016. That figure does not represent all instances of surgical burns during that timeframe, however. In fact, even some of the 54 cases that were analyzed by the CMPA involved inadequate record-keeping.

Of the 54 cases, only about one-third involved an actual surgical fire. For reference, according to one source cited by the U.S. Food and Drug Administration (FDA), between 550 and 650 surgical fires occur in the United States every year.

Nonetheless, for victims, a surgical fire is a traumatic experience, and often one that causes long-lasting physical or emotional scars.

Causes of Surgical Fires and Burns

Unfortunately, there are many potential causes of surgical fires and burns in the average operating room. Identifying the cause of a fire generally involves looking for three elements, described below, but burns can result from a single independent cause.

Understanding the Fire Triangle in the Operating Room

The fire triangle is a concept that captures the three elements of a fire: an ignition source, a fuel source, and an oxidizer. When all three elements are present, a fire can occur.

All three elements can be present in multiple ways in an operating room. For example:

Ignition sources can include lasers, fiber-optic light sources, and electrosurgery units.
Fuel sources can include surgical drapes, alcohol-based skin preparations, and hair.
Oxidizers can include concentrated oxygen, nitrous oxide, and even the air in the operating room.

Further complicating matters, each element might be under the control of a different person, meaning that inadequate communication among a surgical team can increase the chances of a fire occurring.

For instance, an anesthesiologist could be in charge of the oxidizer (oxygen or nitrous oxide in the anesthesia), whereas a nurse is in charge of prep with an alcohol-based agent, and a surgeon operates a laser. In such instances, miscommunication or lack of communication between the people involved could result in any one of them unwittingly causing a fire.

Other Causes of Burns During Surgery

Sadly, surgical fires are not the only causes of burns during surgery. Other causes can include lights, medical equipment, and chemicals used before, during, or after surgery.

For example, at one hospital in the U.S. during 2013, staff forgot to install filters on halogen lamps used during surgery. As a result, more than 2,000 patients were exposed to unfiltered UV light, which caused burns to at least 10 of them.

In addition, many types of medical equipment become hot by design, such as cauterizers and lasers. Inattentive medical personnel or malfunctions can cause such equipment to come into contact with a patient or remain in contact with a patient for too long and cause a burn.

Finally, many chemicals used in the operating room can also cause burns. These include sterilizing chemicals that may reside on patients’ gowns and chemical prepping agents that are left on a patient’s skin too long.

Legal Remedies for Surgical Fires and Burns

The Canadian Patient Safety Institute in a 2015 report highlighted surgical fires and burns as one of 15 types of “never events,” which are “patient safety events that result in serious patient harm or death, and that can be prevented by using organizational checks and balances.”

When a preventable injury like this occurs to a patient, that patient may have a claim for medical malpractice. Medical malpractice occurs when a physician fails to comply with a reasonable standard of care, thereby causing injury to his or her patient. Although such cases can be difficult to prove in Ontario — not least of all because medical professionals can rely on the vast resources of the CMPA to defend them — successful plaintiffs may be able to recover for:

Expenses for further medical care and rehabilitation;
Lost wages resulting from the injury;
Disfigurement; and
Pain and suffering.

How a Lawyer Can Help You Recover After a Surgical Fire or Burn

Rare though they may be, surgical fires and burns can cause dramatic physical injuries and serious mental and emotional trauma to their victims. Hospitals are supposed to be places we go to get well, but when injured by preventable burns, fires, or other hazards, our sense of safety and security can be shattered in addition to the physical harm we suffer. In such cases, Ontario law entitles us to recover our damages, but not easily.

If you’ve been injured by medical malpractice in Ontario, including surgical fires or burns, you need to contact one of the medical malpractice lawyers of Preszler Injury Lawyers to help you recover what you deserve. We help our clients collect the evidence they need to build the strongest case possible against those responsible for their injuries, helping provide financial stability, peace of mind, and closure following acts of medical negligence.