I read with interest the recent article by Jones et al. titled “Operating Room Fires.”1  As someone who has a longstanding interest in this subject, I was pleased to see the publication of this excellent review. However, I would like to clarify a couple of statements published in the article.

At the beginning of the article, the authors state that operating room fires occur at least 650 times annually. The reference for this is an article on the U.S. Food and Drug Administration website. However, careful analysis of this reference shows that the U.S. Food and Drug Administration (Silver Spring, Maryland) is citing a study from the Emergency Care Research Institute (Plymouth Meeting, Pennsylvania) published in 2009. This data is now 10 yr old. Currently, the Emergency Care Research Institute estimates that in 2012 there were 200 to 240 operating room fires, and in 2018, that number had decreased to 90 to 100 (personal verbal communication, June 2019, with Scott Lucas, Ph.D., P.E., director, Accident and Forensic Investigation, Emergency Care Research Institute). Similarly, in figure 1 the authors show an increasing incidence of fires between 2006 and 2016. Again, this is not consistent with current data. In 2018, the Pennsylvania Patient Safety Authority (Harrisburg, Pennsylvania) published a report that stated there has been “a statistically significant (P < 0.001) reduction in the patient risk of surgical fires of 71% since 2004.”2 

On page 492 under the heading of Oxidizer, the authors state, “When ignited, oxygen combines with a fuel source to produce heat, gas, and light.” A casual reading of that sentence might lead one to conclude that oxygen can be ignited, i.e., that it is a combustible gas. While oxygen supports combustion, it is not a combustible gas like hydrogen or methane.

Finally, reference 15 is incorrectly cited. The correct citation is: Ehrenwerth J: Electrical and Fire Safety. Chapter 5. In Clinical Anesthesia, edited by Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, Ortega R, Sharar SR, and Holt NF. 8th edition, Philadelphia, Wolters Kluwer, 2017.

The author declares no competing interests.

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Operating room fires.
Surgical Fires: Decreasing Incidence Relies on Continued Prevention Efforts
PA Patient Saf Advis