Virtua Health Reopens Operating Rooms in Marlton Hospital
MARLTON, NJ - May 9, 2000 - Following a satisfactory review by the
New Jersey State Department of Health, Virtua West Jersey Hospital Marlton
will reopen two operating rooms which had been closed following incidents on
March 13 and March 24 when nurses became ill during a procedure in an operating
room.
"After extensive testing by independent air quality consultants for
all possible causes for these events, it has been determined that the probable
cause of the nurses' symptoms was due to carbon dioxide buildup in the protective
helmets worn during orthopedic joint replacement procedures," said Richard
Miller, president and CEO of Virtua Health. "We have now replaced these protective
helmets with a newly developed state-of-the-art model that is designed to eliminate
this occurrence and insure a safe and continuous supply of fresh air to the
wearer."
Miller indicated that the new protective helmets were tested by an independent
consultant before a commitment was made to purchase them. "We are confident
that these devices will eliminate the problem." Similar protective helmets
are commonly used nationwide to insure a sterile environment for the patients
and to protect the surgical team from blood borne pathogens.
"We want to emphasize," said Miller, "that at no time were patients at risk
from exposure to any substance and that the ORs were and continue to be safe
for patients. Further, we have taken aggressive steps to insure that our employees
health will also be protected."
Immediately following the incidents, Virtua Health contracted with an independent
air quality consultant to perform extensive tests on air quality in
the operating rooms as well as the testing of the helmets. The testing was
performed in cooperation with and under the supervision of the New Jersey
State Department of Health and OSHA. Following is a summary of the results
of the testing:
- When the actual protective helmets were tested under simulated conditions,
an abnormally high amount of carbon dioxide was found in the helmets worn
by the nurses. Normal amounts of carbon dioxide in outside air ranges from
345 to 400 parts per million; recommendations for indoor air are a maximum
of 1,000 parts per million. According to OSHA, a maximum permissible exposure
of 5,000 parts per million is allowable. Under certain circumstances, the
protective helmets worn by the nurses were found to be in excess of that
amount.
- Tests for microbes determined that the air in the operating rooms was
well within safe limits for air quality. For example, at a time when the
outside air measured at 536 colony forming units of microbes per cubic
meter, the air in OR #4 measured 0. (A typical office environment measures
at about 250 colony forming units of microbes per cubic meter.)
- The laminar flow unit (an air delivery/filtration system used for some
types of orthopedic surgery) was tested for performance and was shown to
be providing 25 high purity room air changes per hour, well above the industry
standard of 15 per hour.
- During the testing of the anesthesia unit in the operating room, a minor
leak of nitrous oxide (an anesthetic gas also commonly used in dentists'
offices) was detected and the leak was corrected. However, the two people
closest to the anesthesia cart during the operation when nurses became
ill did not experience symptoms. The air quality consultants indicated
that the level of the gas leak was not a likely contributor to the incident.
- A thorough check of leaks for freon, natural gas, carbon monoxide from
the heating system and several volatile organic compounds showed that there
were no gases or vapors in the area that would have caused the nurses'
symptoms.
- Cleaning personnel were interviewed and cleaning compounds and procedures
reviewed to determine if there were any changes in the cleaning compounds
or procedures used previously and no changes were identified.
- Checks were made for changes in the use of chemicals by departments adjacent
to the operating rooms and for changes in activities in areas outside the
building (e.g. truck exhaust) and no changes in use or procedures were
found.
Following the testing, a number of steps were taken to ensure that the staff
and surgeons performing surgery in the operating rooms would be comfortable and
feel secure in their work environment.
- A new air handling system designed to provide air to the affected operating
rooms was installed to ensure consistent temperature, a cause of discomfort
by the operating rooms staffs.
- The air ducts were cleaned and sanitized and subsequent testing showed
them to be free of contamination.
- The laminar flow hood was dismantled, inspected and cleaned to ensure
efficient function.
"We are confident," said Miller, "that we have taken every precaution possible
to insure the safety and comfort of our patients, staff and physicians. Once
the operating rooms are opened, we will continue to monitor air quality, protective
helmet performance and the comfort and health of our operating room staff. We
will continue our normal maintenance and checks of all equipment to ensure that
everything is operating at its optimum level."
Used with permission - Virtua Health
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