Hospital Evacuation in N.Y. Exposes Outdated Power Backup

Patient Evacuation Shows Risk of Outdated Hospital Power Backup
Hospital workers evacuate a patient from NYU's Langone Medical Center during Hurricane Sandy the evening of October 29, 2012 in New York City. Photographer: Michael Heiman/Getty Images

New York University Langone Medical Center, the 705-bed hospital in lower Manhattan that assured city officials it was ready for Hurricane Sandy, stood dark and empty a day after the storm rolled through.

As wind and rain from the largest-ever Atlantic storm pounded New York on Oct. 29, electricity at NYU-Langone went out. Then a backup generator failed. In the middle of the night, medical staff had no choice but to carry patients down dark stairwells and relocate them to other facilities.

The patient evacuation is prompting questions from trustees and the city’s mayor about how prepared the medical center was for the storm. Blame is being placed on the building’s outdated backup power system, which has raised concern that aging infrastructure at U.S. hospitals has created a risk for similar outages that jeopardize patient care.

“Hospitals are careful to get the latest and greatest medical equipment, but then they don’t spend on the infrastructure,” Michael Orlowicz, a principal at consulting company Lawrence Associates LLC, said in an interview. “It surprises me what happened in New York.”

One in 20 hospitals are unprepared for power disruptions, and an incident may result in more than $1 million in lost revenue and other costs, according to Bridgewater, New Jersey-based Lawrence Associates, which focuses on economic justification for technology spending. Coney Island Hospital and Bellevue Hospital Center in New York also were forced to evacuate patients because of power failures.

Hospital Preparation

Kenneth Langone, the billionaire chairman of New York University Hospital, was a patient at the time of the power failure and evacuation. He said the hospital expected its backup generators to work and was surprised by the power of the storm.

“We believed we had the machines, we believed the machines would work, and we believed everything we were told about the scope and size of the storm,” Langone, now home, said in an interview. “Do you think they’d have kept me in there if they thought I was going to be unsafe?”

The board knew the facilities’ generators were outdated and at risk, Gary Cohn, a trustee who is also president of Goldman Sachs Group Inc., said yesterday in an interview on Bloomberg Television.

“The infrastructure at NYU is somewhat old,” Cohn said in a television interview. The backup generators “are not state of the art and not in the most state-of-the-art location.”

Raising Money

Cohn said an effort to raise $3 billion for hospital upgrades is under way. The hospital had raised $1 billion by June 2011, according to a statement.

The evacuation drew the ire of Mayor Michael Bloomberg, who said he had been assured the hospital had tested its equipment.

“The one thing we had not counted on, New York University’s hospital backup power, in spite of them assuring us that it’s been tested, stopped working, and we’re working with them to help move people out,” Bloomberg said Oct. 29 at a press conference. The mayor is the founder and majority owner of Bloomberg LP, the parent company of Bloomberg News.

New York City weathered a 16-hour power failure in 2003 that affected 120 hospitals, with one forced into bankruptcy and 10 others suffering significant revenue loss, according to the 2010 study by Lawrence Associates.

Katrina Deaths

Electricity failures at hospitals in Louisiana during Hurricane Katrina led to lawsuits. Tenet Healthcare Corp., the third-largest publicly traded U.S. hospital chain, agreed to settle a class-action lawsuit over patient deaths brought by families who blamed the actions of officials at the company’s Memorial Medical Center in New Orleans. At least 34 patients died at the hospital after the hurricane knocked out power.

Backup generators need to be tested regularly and gas or diesel fuel replaced, Orlowicz said. They also need to be kept on floors that are above any potential flooding, he said.

The evacuation at NYU-Langone began after flooding at the building, with more than 20 ambulances lined up outside in the night, said Ilyssa Goodman, a pediatrician who was off-duty in her apartment across the street and went to help. Patients were carried down the stairs on stretchers because elevators weren’t working, she said.

“The side where the ICU is was completely dark, and the stairwells were lit by medical students with flashlights,” Goodman said in an interview. “It was very calm. Medical students and residents came in to help.”

Redirecting Patients

The hospital is part of a complex of NYU medical facilities along First Avenue in Manhattan near the East River. Attempts to contact NYU-Langone personnel yesterday for comment were met with busy telephone signals and unreturned messages. Goodman said the computer system was down and e-mail wasn’t working.

By yesterday afternoon, the hospital was closed with security blocking the door and all patients had been evacuated. Residents seeking care were directed to other hospitals.

Mount Sinai Medical Center in East Harlem said it took in patients from NYU-Langone, as well as from Bellevue Hospital Center and Coney Island Hospital.

Sandy, a storm with winds stretching 1,100 miles (1,770 kilometers) from end to end, tested the preparedness of hospitals across the Northeast and Mid-Atlantic regions. The storm hit New York, New Jersey and Connecticut hardest, toppling trees, knocking down power lines and swamping electrical systems with record tides.

Bellevue Conditions

At Bellevue, staff were evacuating 500 patients today after sustaining worse-than-expected damage to the basement, which took on 17 million gallons of water, the mayor said in a news conference. The hospital is trying to find facilities for those patients. It previously evacuated critical patients dependent on a ventilator.

Bellevue lost power during the storm and doctors had been working mostly in the dark since the night of Oct. 29 with limited power from generators. The lobby was dark yesterday and telephones were down although some walk-in emergency patients were being admitted.

The North Shore-LIJ Health System, the largest on New York’s Long Island, said its Staten Island University Hospital started flooding Oct 29, shutting down the computers and electronic medical records and forcing workers to use paper records, according to its website.

Prior to the storm, dozens of critically ill patients dependent on ventilators and other devices were evacuated from Staten Island University Hospital and Southside Hospital in Bay Shore, the health system said Oct. 28 in a statement.

North Shore LIJ ambulances evacuated 26 patients from Eastern Long Island Hospital, according to a statement.

Staying Open

The health system, which has 16 hospitals and three long-term care centers in New York, said all its hospitals, emergency departments and long-term care facilities are open.

AtlantiCare Regional Medical Center, based in Galloway, New Jersey, remained fully staffed and had personnel stay overnight in casinos and hotels, Jennifer Tornetta, a spokeswoman, said Oct. 29 in an interview. Most cared for patients who were too ill to be discharged rather than injuries related to the hurricane, she said.

Meridian Health Hospitals, based in Neptune, New Jersey, suspended visitation for patients Oct. 29 and discouraged visitors through the height of the hurricane for safety and security reasons, according to a press release. They also canceled many elective and non-urgent procedures.

Washington ERs

Hospitals in Washington reported mostly quiet conditions. At George Washington University Hospital, which has 371 beds, there were 150 doctors, nurses, and support staff who slept on cots on the sixth floor and 100 additional staff members who stayed overnight in local hotels. Medstar Washington Hospital Center, the largest private hospital in the city with 926 beds, reopened outpatient clinics yesterday after closing them before the storm, So Young Pak, a spokeswoman, said in an interview.

Some hospitals that turned to backup power fared well. Saint Barnabas Medical Center, a 597-bed hospital in Livingston, New Jersey, operated yesterday on auxiliary power.

“We made sure our generator worked,” Sally Malech, a spokeswoman, said in an interview. “We’re fully staffed, patients are safe, and the ER is open.”

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