Why Do So Many Hospitals Lose Power During a Weather Crisis?

Among the casualties of superstorm Sandy’s massive destruction was the security people feel about the safety of being hospitalized. As described by public interest advocate ProPublica, “It is a hospital’s nightmare: The power goes out and backup generators don’t kick in, leaving critically ill patients without the mechanical help they need to breathe.”

Hospital generators failed again during Sandy, most notably at New York University Langone Medical Center, which had to evacuate all 215 of its patients. Patients at New York’s Bellevue Hospital and New Jersey’s Palisades Medical Center also were evacuated when generators failed.

The ProPublica story invokes the horrors of Hurricane Katrina, when medical personnel were reported to have hastened terminal patients’ deaths when New Orleans was deprived of electricity and water. It recalled how generators at two hospitals failed last year during a blackout in San Diego, and how a Connecticut hospital had to be evacuated when its generator failed during Hurricane Irene.

As pointed out on PopTort, a sassy blog produced by the Center for Justice & Democracy at New York Law School, “Thanks to the almost super-human heroic efforts of doctors and nurses, no NYU-Langone patient died during this experience, but the doctors and nurses were no less heroic during Katrina. It was just sheer luck that the ambulances could make their way down city streets.”

Perhaps most troubling is that these failures and their dire consequences weren’t exactly a surprise. Dr. Arthur Kellermann, formerly of Emory University’s emergency department and now a policy analyst at the RAND Corporation think tank, tweeted during the NYU evacuation: “Hospital preparedness and well-functioning backup systems are a costly distraction from daily business, until they are needed. Like now.”

Later, he told ProPublica, “What I find most remarkable about this story is that [more than seven] years after Hurricane Katrina, major hospitals still have critical backup systems like generators in basements that are prone to flooding.”

Newly constructed hospitals are supposed to site generators and fuel in close proximity, above flood level. Older hospitals are not subject to this common sense policy, and many don’t redesign their facilities to do so because it’s too expensive.

Pop Tort referred to a story on Bloomberg News that said 1 in 20 hospitals is unprepared for power disruptions.

In New York, the tale of failure is long and, apparently, never-ending. Bellevue Hospital lost all power during the New York City blackout of 1977. In 1987, a 22-minute power failure led to the death of a 40-day-old baby. In 2003, when the city lost power again, according to an official report: “Despite prior testing according to applicable State and accreditation standards, [some] generators malfunctioned, experiencing, for example, problems with switches and overheating. …In a few cases hospitals reported that fuel supplies for generators fell to dangerously low levels, in part because of transportation difficulties encountered by fuel delivery trucks.”

And after Sandy blew through town late last month, a trustee at NYU publicly acknowledged that the facility’s infrastructure was outdated and vulnerable.

Hospitals are required by the Joint Commission, an independent body that accredits them (see our post about hospital accreditation) to have back-up power capabilities and to “load test” them monthly.

Kellermann told ProPublica that despite their failures, New York City’s hospitals and health department “have taken preparedness more seriously than nearly everyone else in the country, particularly since 9/11/01.” A recent RAND test of disaster drills at different city hospitals went well.

That highlights the need to do more than simply what the rules require. Dr. Dan Hanfling, a disaster planning expert, said that evacuating patients might be “the new normal,” and that hospitals should be prepared with an evacuation plan.

During Sandy, NYU, hospital chairman Kenneth Langone was battling pneumonia in his own facility, and was one of the patients evacuated. As reported on Pop Tort, Langone said, “So last night God decides to give us a test and our machines failed. …Machines fail, airplanes take off in great shape and they have malfunctions. Why do we always need to blame somebody for something that could just have happened? Why not write a story about what people did because things happened? Let’s be a little positive once in a while.”

That’s a nice sentiment, but it doesn’t always keep you from harm.

If you or a loved one is scheduled to spend time in a hospital, ask its patient advocate about the facility’s disaster plan. Find out about its capacity for generating electricity, and where its generators are located. If you’re given the brush-off or admonished for unnecessary worry, remind these folks about what happened in New York during Sandy.

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