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Katrina Death Trial May Raise Stakes for Hospital Emergency Planning

 |  By swallask@hcpro.com  
   January 12, 2010

CEOs, emergency planners, and facility directors should be monitoring the upcoming results of a trial in New Orleans, which has the potential to alter the way hospitals plan for disasters.

The family of deceased patient Althea LaCoste is suing Pendleton Methodist Hospital, LLC, in New Orleans, saying that LaCoste died in the aftermath of Hurricane Katrina because the facility allegedly failed to design its emergency power infrastructure to withstand flood waters and allegedly failed to have an adequate plan in place to transfer patients, according to prior court documents available online.

The hospital suffered terrible damage from flood waters and never reopened. LaCoste required a mechanical ventilator when she was admitted to Pendleton Methodist on August 28, 2005. During Katrina's rising waters, the hospital lost regular and emergency generator power, which caused various medical equipment to shut down, according to court records.

The hospital had two generators: one near the ground floor and one on the roof of the building. LaCoste's family argues that if the hospital had invested in a $10,000 submersible fuel pump, the roof generator might have kept operating, according to a January 4 article in The Times-Picayune of New Orleans.

Hospital lawyers said in court documents that Katrina's aftermath was unforeseeable, that the facility was not negligent, and that the emergency power system met or exceeded electrical codes, The Times-Picayune reported.

Generally, medical facilities put emergency generators in the basement because it's easier to install and they don't take up valuable, income-earning space on patient care floors.

Any outcry to retroactively move generators to higher floors to avoid flooding is a complicated edict. Such steps involve rewiring entire buildings and changing power distribution networks.

There are other options to protect basement-level equipment, such as installing flood doors to protect a low-lying building's perimeter.

Joint Commission warnings to heed
In September 2006, The Joint Commission published a Sentinel Event Alert that put additional focus on emergency generator performance.

The main messages of the Sentinel Event Alert, which remains in effect today, include the following:

  • All hospitals must have an emergency power testing program that includes generator load testing and emergency power supply system maintenance
  • Healthcare facilities should strive to exceed minimum National Fire Protection Association requirements for emergency power
  • Hospitals must conduct thorough hazard vulnerability analyses of their utility systems

The alert recommends that facilities ensure “engineering staff communicate the capabilities and limitations of the emergency power supply system to the organization's management and clinical leaders.”

That aspect proved burdensome at Indian Hospital in Lawton, OK, according to an article featured in HealthLeaders Media in June 2009.

A wind storm knocked out power to the hospital that month, which activated a surge protector and generator. But the surge protector only had enough battery power to last two hours.

Additionally, areas of the hospital that provide essential medical services weren't attached to the generator, which the CEO didn't know about. Engineers at the hospital had allegedly assured the CEO in the past that the generator had enough capacity to handle the facility's needs.

There have been other post-disaster critiques that have pointed to infrastructure flaws and incomplete staff member education as potential risks in future emergencies.

For example, following a severe ice storm in December 2008, Heywood Hospital in Gardner, MA, stayed on generator power for 48 hours. Hospital managers noted that some ICU areas had no power to bathrooms or vending machines, yet the Christmas lights remained on, according to HCPro's Briefings on Hospital Safety.

That irony indicated a lack of understanding about which electrical outlets emergency power will supply.

Scott Wallask is senior managing editor for the Hospital Safety Center. He can be reached at swallask@hcpro.com.

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