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Operating room fires hurt hundreds each year

Lauren Wargo’s surgery was supposed to be a simple procedure – just a quick operation to remove a mole from her face. But the operation went terribly wrong when the surgeon’s electro-cautery device sparked a fire that flashed over the 20-year-old woman, leaving her with second degree burns on her face and much of her neck. Wargo woke up from the surgery in searing pain.“I kind of heard the
/ Source: TODAY contributor

Lauren Wargo’s surgery was supposed to be a simple procedure – just a quick operation to remove a mole from her face. But the operation went terribly wrong when the surgeon’s electro-cautery device sparked a fire that flashed over the 20-year-old woman, leaving her with second degree burns on her face and much of her neck.

Wargo woke up from the surgery in searing pain.

“I kind of heard the doctor telling my dad there had been an accident,” Wargo, now 24, told NBC chief medical editor Dr. Nancy Snyderman. “I couldn’t see anything.”

“Surgeons rarely realize that something like this could happen to them,” Snyderman told TODAY’s Matt Lauer. “But an increase in the rate of surgical fires has led the [Food and Drug Administration] to create a new surgical fire safety initiative.”

Experts estimate that each year 650 fires flare up in operating rooms around the country. Some patients, like Wargo, recover with scars and emotional damage. Others aren’t so lucky.

Dr. Nancy Perrier remembers her horrifying introduction to the problem.

Perrier was in the OR working on a patient when suddenly the room was ablaze. “The flames were at least 6 to 8 feet high,” she told Snyderman, clearly still shaken by the incident. “And the correct actions were unknown to everyone in the operating room. The patient survived the operation, but died about 30 days later from complications of a significant pulmonary injury.”

In October the FDA launched a new initiative to prevent surgical fires, noting that though these are rare events, they are also highly preventable. The agency convened a special workshop to look for ways to stop fires from ever happening and to give medical personnel the tools and knowledge needed to deal with a fire if one occurs.

That’s an approach that makes sense to Dr. David Cowles, an anesthesiologist who knows all too well the dangers of not being prepared to deal with a flash fire.

“I worked as firefighter and paramedic for 14 years,” Cowles told Snyderman. “As a firefighter you’re concerned about what’s going to be the safest way to do a dangerous job and that’s not unlike what it is in the operating room, where every day we perform procedures that could be dangerous and we need to explore the safest way to do that.”

Related story: On fire in the OR

It shouldn’t be a surprise that surgical fires might be on the rise, since more and more operations involve the use of electro-cautery devices and lasers.

Those devices are part of what Cowles calls the “trifecta” of elements – oxygen, alcohol prep and an ignition source - that lead to flash fires in the OR. “There’s a basic simple chemistry and physics principle that when three elements are combined then a fire occurs,” Cowles explained to Snyderman. “Likewise, if you remove any one of those elements it makes it impossible for a fire to occur.”

Cowles has dedicated himself to educating surgical staff about fire risks in the operating room and tells fellow doctors that while you may not be able to avoid every fire, deaths should be 100 percent preventable.

Snyderman suggests that patients about to undergo surgery discuss the risk of fire with their doctors before an operation.

As for Lauren Wargo, the scars from her burns will be a permanent reminder of why doctors need to be on guard.

Over time Wargo’s facial scars have diminished some, and with artful use of make-up they’re barely visible, but she will continue to have eye problems and emotional issues for the rest of her life.

“It’s easy to tell someone else that looks don’t matter,” Wargo told Snyderman. “But when you’re walking around with an open wound on your eye and scars on your face it’s hard to say that looks don’t matter because it gets into your self-esteem.”

Linda Carroll is a health and science writer living in New Jersey. Her work has appeared in The New York Times, Newsday, Health magazine and SmartMoney. She is co-author of "The Concussion Crisis: Anatomy of a Silent Epidemic."