Surgery is never without some risk, but bursting into flames during a routine procedure is not something most patients worry about. Maybe they should.
While these terrifying flash fires are still considered rare in the tens of millions of surgeries performed each year, several cases of OR flash fires are in court right now, raising serious questions.
Joe DiMaria was never seriously burned in 33 years as a Chicago firefighter. Then, in September 2012, he was in an operating room having a catheter implanted in his chest when he claims flames erupted.
"My whole face was black, and I didn't realize how bad I was burned across here," said DiMaria. "I was very depressed, literally prayed to God to just let me die."
DiMaria filed a lawsuit against Presence Resurrection Medical Center in Chicago and the surgical team. Among the allegations were claims the hospital didn't have appropriate procedures or policies to reduce risks of surgical fire.
In court records, the hospital denies these allegations and that there even was a fire.
Now consider Dahlia Ramirez. After a premature birth, the little girl was having heart surgery when something went horribly wrong.
"They told us she was burnt 37% of her body and it was 2-3 degree burns," said Evilyn Ramirez, mother.
Ramirez lost her thumbs, finger tips and part of her nose in the 2009 surgical fire. Settlements were reached with the doctors, who did not admit fault. A lawsuit against Rush Copley in Aurora remains. In court documents, the hospital denies any negligence and the Ramirez' claim that there was no fire safety training for doctors.
A training video demonstrates how quickly these flash fires can erupt. Most surgical fires start in an oxygen enriched environment created when extra oxygen given to a patient leaks out. Electrosurgical tools can then ignite materials that may not normally burn in regular room air.
Mark Bruley is a nationally known researcher and expert on surgical fires who says operating room staff should be required to go through a fire risk checklist before starting surgery.
"If it's on a checklist then it tends to be dealt with on each and every surgical case. . . and that helps increase awareness," said Mark Bruley, V.P. Accident/Forensic Investigation, ECRI.
Some metro Chicago hospitals we surveyed don't have a pre-op fire safety check, and there is no required reporting of OR fires nationally or to the Joint Commission, an Oak Brook-based organization that accredits U.S. hospitals. The Joint Commission asks hospitals to voluntarily report OR fires.
"It's doesn't affect their accreditation and I would encourage them to call us and work with us in helping them to reduce a future event," said Ana McKee, Exec. VP & Chief Med. Officer, Joint Commission.
"There is an inconsistent habit in medicine where all guidelines and everything is written as recommendations. Nothing is ever written as law," said William A. Cirignani, Ramirez family attorney.
Finally, consider 82-year-old Mary Evens of Kankakee who was having a mole removed from her forehead. Evens' family says a fire erupted on her face while a cauterizing tool was being used.
"She actually put her hand up and said my face is on fire," said Adria Mossing, attorney.
She survived a year, but died last May due to her injuries, according to a lawsuit against the surgical team and Riverside Medical Center in Kankakee.
Due to the lawsuit, Riverside declined comment on the Mary Evans case. A 2012 report estimates operating room fires are declining from about 600 to 240 a year nationwide, so fire prevention programs may be helping. Still, before surgery patients should ask about OR fire procedures and whether the staff has had surgical fire training.
Read the lawsuits:
Resurrection answer to DiMaria
Rush answer to Ramirez
Evans complaint (Riverside hospital has not answered Evans; filed for extension to respond.)
Anesthesia Patient Safety Foundation
Joint Commission: Accreditation, Health Care, Certification
Preventing Surgical Fires - Food and Drug Administration
Preventing Surgical Fires Initiative - Food and Drug Administration