by Charles Ornstein, 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.
It happened in New Orleans after Hurricane Katrina, when hospital staff were on their own when electricity and water cut out. Some died.
It happened last year in San Diego, when generators at two hospitals failed during a blackout.
And it happened last year in Connecticut, when a hospital had to be evacuated during Hurricane Irene when its generator failed.
As Hurricane Sandy headed toward the East Coast, New York City Mayor Mike Bloomberg said Sunday, he was assured that hospitals were ready. “The teams from the City Health Department are at these facilities making sure that the emergency generators are working and that they have back-up fuel supplies,” he said at a news conference before the storm.
In spite of this confidence, the generators at some hospitals did not work as expected. In the most high-profile case, New York University Langone Medical Center had to evacuate all 215 of its patients when its power went out and both of its backup systems didn’t work. Staff had to hand pump oxygen to critically ill patients until patients could be taken by ambulance to another hospital.
In New Jersey, patients at Palisades Medical Center had to likewise be evacuated in recent days after two generators failed. A hospital spokesman said today that officials were working to bring the “plant up to speed” and could not immediately answer questions about the generators.
And this afternoon, Bellevue Hospital in New York City said it is evacuating hundreds of patients because of failing power and deteriorating conditions. “It’s Katrina-esque in there,” one nurse told ABC News.
Experts say such failures are troubling but not entirely surprising. Dr. Arthur Kellermann founded the emergency department at Emory University and headed it from 1999 to 2007. Now, he’s Paul O’Neill-Alcoa Chair in Policy Analysis at RAND Corporation think tank.
The other night, as the NYU evacuation was unfolding, he tweeted, “Hospital preparedness and well-functioning backup systems are a costly distraction from daily business, until they are needed. Like now.”
In an email interview with ProPublica, Kellermann elaborated: “I have no doubt when the hospital assured the Mayor that their backup systems were ready, they believed they were. They were wrong. 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.”
Bruce Altevogt, a senior program officer at the Institute of Medicine who has studied crisis standards of care, lauded NYU for safely evacuating patients. But he said the incident should prompt a new discussion about where hospitals place generators and how to ensure they work when they’re needed.
Newly constructed hospitals are supposed to place their generators and fuel in adjacent locations above flood level. But the location requirements do not apply to already-built hospitals.
“These older facilities, it’s just an economic issue,” Altevogt said. “They don’t have the resources, or they haven’t devoted the resources to moving the equipment to locations that would be less prone to disasters or flooding in these cases.”
An NYU spokeswoman told Modern Healthcare magazine Tuesday that “part of the generator is on the roof and part in the basement, which she said took on 8 feet of water. The reason for the failure, she said, is being investigated.”
New York hospitals have had experiences with generator failures before and have seen the consequences firsthand.
