Disaster Recovery Journal - Summer 2003 Issue- 1603-13 -Off Site, Off The Hook?

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CASE HISTORY

Off Site, Off The Hook?

By THOMAS J. HUSER, MS, CHSP

How do you define a facility as being “off site?” Do you use the campus approach? If you are located off of the campus, you are off site. Do you use the mileage approach? If you are X miles or more from the campus, you are off site.
Or does your facility use an approach similar to ours? If you cannot hear the hospital fire alarm bells, you are off site.
We have used this approach for several years on our campus where there are two medical office buildings directly attached to the main hospital (one is four stories with a two-story underground garage and the other is nine stories). The attached buildings are owned by the hospital, and hospital departments occupy the majority of one of the buildings. However, since they are operated by an independent management firm, there has always been a “hands off” approach taken by the hospital including the safety and emergency preparedness committees. Fire drills were conducted on a suite-by-suite basis since the hospital did not occupy 100 percent of the buildings.
Many of the tenants, myself included, had no idea as to what the fire alarm sounded like when activated. The hospital also left it to the management company to prepare for emergency response in the buildings. There were generic plans for the hospital-based tenants, however, all other tenants were directed to the building’s management company for planning and response programs.

The Event
The date was Feb. 16, 2000, and the State Department of Health was on site for their annual inspection. With a few minor exceptions the survey had been going quite well. That morning, at approximately 9:13 a.m., I heard an announcement I had not heard in the two years I had been in the building.
I heard a gong ring three times followed by the announcement, “Prepare to evacuate.” This continued as I located the building manager and inquired as to the announcement. He said the fire alarm had activated and was uncertain as to the location of the fire.
Reports of the smell of smoke began to come into the building management office as security and facility services personnel responded from the hospital. Several personnel began searching for the origin of the smoke.
The fire department soon arrived and also began searching the building for the origin of the smoke. Soon a report was received that water was running down the stairs in the northwest stair tower. The waterfall was traced to an activated sprinkler head in the ninth floor mechanical room.
A wastebasket had been ignited, the fire spread to a desk, which activated the sprinkler. For the safety of the tenants the entire building was evacuated. Several hundred people either went into an adjoining parking garage or into the hospital cafeteria.
It soon became apparent that a chain of command was needed. As the building was still being evacuated a director took it upon himself to announce that everyone could return to the building.
Confusion reigned as the fire department, which had control of the building, ran head on into the people returning to the building. There was also confusion in the hospital as there was no way of communicating with the people who were at that location.
There were further problems with some tenants refusing to leave until threatened with arrest. Also patients were arriving for appointments and could not enter the building and persons could not leave as the only exit from the parking garage was via the front of the building, which was blocked by fire apparatus.
After ensuring the fire was completely extinguished, and that the carbon monoxide levels were within a safe range, the tenants were allowed to return to their offices.
Within one hour of people being allowed to return to the building an ambulance was called for a “sick person.” Soon more calls for the same symptoms were made – nausea, headache, upset stomach.
As the reports of people becoming ill grew, a meeting was called with the fire marshal, the building manager and myself. We determined the best course of action was to close the building for the rest of the day.
This time the evacuation was announced in person to the occupants of each suite. They were informed they would have 30 minutes to leave the building at which time the building would be secured and no one would be allowed entry until the next morning.
The next morning there was a meeting and air samples were taken from throughout the building. Only after it was determined that the building was safe were the tenants allowed in to resume business.

Post Incident Critique Findings
As with any post-incident critique, there were numerous opportunities for improvement found. Listed in the accompanying graphic are the findings and the corrective actions taken to reduce risk to the tenants and the responders in future events.
The cause of the fire was determined to have been accidental. Improperly discarded smoking materials and/or improperly discarded oily rags were determined to have been the cause.
There were no injuries and no permanent damage was caused to the building. We were given an opportunity to learn from these mistakes and have done so.
There have been some false alarms since this event. However, there have been no actual fires. Annual fire drills continue, as does the cooperation established between the hospital and the building management.
Yes, they are off site. However they are still very much a part of the hospital.

Thomas J. Huser, MS, CHSP, is the manager of health and safety risk management for St. Vincent Hospitals and Healthcare Centers in Indianapolis, Ind. Huser’s responsibilities include the St. Vincent Carmel Hospital and approximately 77 off-site locations along with consultation for seven hospitals that are members of the Central Indiana Health System.

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