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How Does A Gust of Wind Incapacitate Indian Hospital?

Cheryl Clark, for HealthLeaders Media, June 17, 2009

Hickory Starr has been working for the Indian Health Service for 28 years, for 14 years as a hospital CEO. And he's used to dealing with very big problems in providing good care.

But when a gust of wind 10 days ago tore down the power lines and incapacitated his Indian Hospital in Lawton, a 28-bed critical access facility in Southwestern Oklahoma, he says, "I just wanted to scream."

He characterized the cascade of system breakdowns that ensued as like a "Trail of Tears," all of which he says were caused by preventable human errors, not because the 40-year-old hospital is "run down."

"Lots of human errors," he repeated. "Lots of human errors."

Here's how the system failed to work, he explains.

About 8:30 p.m. Sunday June 7, a 60 to 70 mile per hour wind storm caused power lines to cross, which caused a short in the electrical lines to the hospital and power was lost. That activated a surge protector and an emergency power generator, just as expected.

But the surge protector only had enough battery power to last two hours. And unbeknownst to Starr, areas of the hospital that provide essential medical services weren't attached to the backup generator, he says. Those portions of the hospital all shut down as well until power lines were fixed the next day.

"When the computer system powered down, it caused some damage (to the computers) and it took until 7:30 p.m. Monday before it was back on line," Starr says.

"We became incapacitated. What if something had happened—a patient brought here because of a car wreck?" he asks. "We would not have been able to take care of them. And that puts everyone at risk."

The computer system wasn't the only thing that wouldn't work. The radiology equipment shut down so patients could not get X-rays or ultrasound tests. The freezers and refrigerators lost power so the kitchen had to be closed. All the food and some supplies of medicine had to be thrown away.

The coil for the $200,000 air conditioner "chiller" system was damaged, leaving the hospital without air conditioning, and the phone system powered off and couldn't be reset until someone who knew how to do it came in the next day.

Luckily, there were only two patients admitted at the time and neither was reportedly harmed by the outage. But for patients awaiting care in the emergency department, which sees about from 100 to 120 on a weekend day, and for about 300 who came to the outpatient clinic on Monday, care slowed almost to a halt, Starr says. "It messed up our outpatient center big time. We couldn't do prescription refills or pull up a patient's chart."

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