19 May Decaying Long Island V.A. Hospital Closes Operating Rooms
Usually, there are 10 operations a week scheduled at the Northport Veterans Affairs Medical Center on Long Island. But since mid-February, the hospital’s five operating rooms have stood empty and unused, shut down after sand-size black particles began falling from air ducts.
The ducts are part of the hospital’s HVAC system. Providing heating, ventilation and air-conditioning, the system is integral to improving the hospital’s air quality and mitigating the airborne transmission of germs that could lead to infections.
Patients in need of surgical treatment have been sent to other facilities, such as Stony Brook University Hospital a half-hour away, or to sister facilities like the James J. Peters V.A. Medical Center in the Bronx or the Manhattan campus of the V.A.’s New York Harbor Healthcare System, said Philip Moschitta, Northport’s director. Others are being referred to the V.A.’s Choice Card program, which allows some veterans to obtain taxpayer-funded care from private doctors, though it has been troubled by delays.
The Veterans Affairs medical system, the nation’s largest integrated health care organization, has been under scrutiny since 2014, when the department confirmed that numerous patients had died awaiting treatment at a V.A. hospital in Phoenix, where officials had tried to cover up long waiting times for 1,700 veterans seeking medical care. A study released by the Government Accountability Office last month indicated that the system has yet to fix its scheduling problems.
Northport is a 502-bed teaching hospital that serves about 18,000 patients per year. Doctors there perform 633 inpatient and 1,822 outpatient surgeries a year. Some procedures that do not require a sterile room, such as colonoscopies or cataract surgeries, are currently taking place in other parts of the hospital, Mr. Moschitta said.
“Cutting into the body, those types of procedures are not being done in those rooms at this time,” he said.
Two or three of the operating rooms were reopened for a few weeks in April, but they were again shuttered and sealed off with yellow caution tape because contamination returned.
An environmental analysis of the air quality at the Northport hospital by Environmental Analysis Associates, a San Diego firm that specializes in the identification of indoor air-quality problems associated with dust contamination, found that the particulates came from oxidizing metal and crumbling concrete in the building’s duct system, which was built in the early 1970s.
The report, which was obtained by The New York Times, linked the operating room contaminants to Northport’s decaying building. The kinds of particles deposited in the operating rooms were “typically associated with galvanized duct corrosion and metal piping/fittings,” the report said. It also mentioned that “low concentrations of fiberglass fibers” — irritants to the skin, eyes and upper respiratory tract — were detected.
Mr. Moschitta said the problems stemmed from rusted sound attenuators in the ducts, which reduce mechanical equipment noise. “As the forced air goes through the ducts, little fragments break off,” he said.
“When you have a 45-year-old facility, things rust,” he added.
The report also noted the presence of spores of cladosporium, a common mold that can grow indoors on surfaces when moisture is present and can cause allergic reactions and respiratory problems.
Ronald Brattain, the chief of the hospital’s engineering service, said that the operating room air-supply ducts have been wet and regularly exposed to high humidity because they pull air from the outside, as is common in older V.A. hospitals. “The humidity that is in the air is drawn through the air handler, and so that by itself creates a moist environment,” he said.
The entire V.A. system has been plagued with crumbling buildings and deferred maintenance. According to the V.A., roughly 60 percent of its medical facilities are more than 50 years old. The department’s inspector general issued an audit report in 2014 warning that there was a $10 billion to $12 billion backlog in maintenance throughout the system, jeopardizing patient safety at a time when aging baby boomers and newly enrolled veterans of Iraq and Afghanistan increasingly sought care at V.A. hospitals.
Mr. Moschitta said that one backup plan under discussion at Northport was to bring in mobile surgical units that would be parked outside the emergency room on the lawn, but those units rent for $70,000 to $85,000 per month.
Mr. Moschitta said he is confident the problem will be solved with the installation of high efficiency particulate air filters in each of the vents in the operating rooms, and that at least one of the surgical suites will be up and running in the near future. “Barring any mishap, we’re ready to go on June 1,” he said. “A lot of these facilities are vintage.”
It is not only the operating rooms that have been affected at Northport. In the basement of Building 200, one floor down from the operating rooms, the air-conditioning broke down in March 2015, and since then particulates have accumulated in five ultrasound rooms and an M.R.I. area. Mr. Brattain said the problem was a rupture of the cooling tower on the roof. Since then, air-conditioning has been provided by temporary air-cooled chillers, which cost $30,000 a month each to rent, Mr. Brattain said, and two more will be brought in for the summer months. A new system is supposed to be installed in the spring of 2017.
An internal email from an engineer and safety officer at the hospital, obtained by The Times, details staff complaints about the particulates. “The dust is depositing on HVAC registers, ceilings, walls, and on medical equipment,” the email said. “Maintenance continues to clean the surfaces but, as the staff has observed, the dust reappears within a short time. At least three staff members have indicated their concern that this environment has affected them. They have been to employee health and to their individual physicians.” The email was sent in April to administrators at the hospital.
In a statement, Mr. Moschitta said that he took “very seriously concerns about the air quality” in the M.R.I. area and the ultrasound rooms, and that he had asked for “air sampling to be conducted to ensure the safety of our patients and employees.”