Expect an onslaught of sharp questions for hospital chiefs on why backup generators for 705-bed NYU Langone Medical Center failed on Monday, necessitating a helter-skelter evacuation of fragile patients despite ample warnings of Hurricane Sandy barreling with colossal force toward the Northeast.
"You know, we were assured, we being the city, that the hospitals within Zone A had capacity to get patients on vents (ventilators) out before the storm, stop taking in anything that was not an emergency procedure, and that they had sufficient backup generators," New York City Council Speaker Christine Quinn told CNN's Piers Morgan during Tuesday night's broadcast. "That was the representation they made to the city."
"Why didn't that happen at [this] very significant institution?" she asked. "This is not a small neighborhood hospital...I think there are obviously enormous questions that NYU needs to answer."
Moments earlier, Morgan lobbed some of his own hard questions during a testy exchange with Andrew Rubin, NYU Langone's vice president of clinical affairs.
"How could a busy New York hospital have its backup generators fail when it's had a week at least to prepare for what everyone was saying was going to be a storm of huge magnitude?" Morgan asked.
Up for TJC accreditation
It seems that backup generator competence would be a priority for NYU Langone officials, especially since any day, they were expecting their three-year unannounced full survey from the Joint Commission to renew their accreditation.
In particular, such generators shouldn't be in the basement of any hospital at the water's edge, as some of them apparently are at NYU Langone, which is situated next to the East River in Lower Manhattan.
It's not like NYU Langone has no money to spend. Just in the last two months, the hospital has purchased expensive equipment—a Siemens new Somatom Definition Edge single-source CT system and a state-of-the-art PET/MRI Biograph mMr scanner.
I'm just asking: Do those new machines have the ability to save more lives than, say, having a competent electrical system to assure that power stays on in a storm?
It does seem odd, after all the disasters hospitals have endured across the country from sudden "acts of God," for which there may have been far less warning, that lessons haven't been heeded. They've certainly been learned.
'A dangerous situation'
Speaking to Rubin, Morgan conveyed more outrage with his signature dramatic flair. He characterized the NYU Langone evacuation as "a dangerous situation," with transport of hundreds of vulnerable patients amid strong winds and rain.
They were "being evacuated in the middle of the night...four newborns on respirators carried down nine flights of stairs as nurses manually squeezed the bags to get air to those babies...This is a very dangerous situation. My wife gave birth last year, and I can't imagine anything worse than in the middle of the night, your baby being rushed on a respirator..." Morgan said to Rubin.
In response, Rubin insisted that Langone has many generators and tests them "all the time." But, he said, "this was an unbelievable, powerful storm. Many, many things happened that were really beyond anyone's control...an unfortunate set of circumstances...we had 10 feet of water, 12 feet of water in our basement..."
But Morgan continued to push. "It does seem baffling, as I say, that a New York busy hospital like this could end up having to ferry newborn babies in the middle of a hurricane up and down Manhattan, simply because a hospital like yours, with all its facilities and resources, couldn't get a generator to work."
In full compliance
Rubin told Morgan that he didn't come on Morgan's show "to talk about generators." But he added that the systems "are tested all the time and in full compliance with all federal and state regulations...Our generators were working. This was an unprecedented storm."
"But they weren't working, were they?" Morgan shot back.
"They failed," Rubin said.
"If they failed, they're not working, are they?" Morgan retorted.
Something tells me that the dominant explanation so far, speculation that the hospital's infrastructure is "outdated" won't cut it with the Joint Commission or the City of New York, especially now.
Emergency power generator requirements
A spokeswoman for the Joint Commission said Wednesday that accredited hospitals have to identify potential emergencies and have management plans "that address command structures, backup communication systems, building evacuations, and coordination with other community health care organizations and emergency responders."
Specifically included "are requirements for utility systems to be designed and installed in such a manner as to ensure they are reliable during an emergency. Inspecting, testing, and maintaining critical components such as the emergency power generator is also required."
The agency published a Sentinel Event Alert in 2006, specifically addressing emergency electrical power system failures.
No one wants to beat up a hospital when they're down, of course, especially when the transfers have not resulted in obvious or apparent harm, even amid the chaos.
Other patient evacuations
And it's important to note that at least two other hospitals, Bellevue Hospital just next door to NYU Langone, and Long Beach Memorial Hospital, have evacuated patients to other hospitals due to similar infrastructure concerns, although under less hurried circumstances.
Hospital officials are well aware of quake destruction of Northridge Hospital in California, tornado damage to St. John's Hospital in Joplin, Missouri, and the deadly devastation from Hurricane Katrina to Memorial Medical Center in New Orleans.
Ironically, Kenneth Langone, the founder of Home Depot whose philanthropy in 2008 resulted in this large NYU medical facility changing its name to carry his, was being treated as a patient in the hospital at the time.
In an interview with Bloomberg News yesterday, Langone said: "We believed the machines would work, and we believed everything we were told about the scope and size of the storm. Do you think they’d have kept me in there if they thought I was going to be unsafe?"