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NYU Hospital’s Backup System Undone by Key Part in Flooded Basement

Hospital
official explains how move to rooftop generators failed to prevent failure of
backup power during Hurricane Sandy

.

A Con Edison worker walks through the flood waters on the corner of 33th Street and 1st Street in front of NYU Langone Medical Center during Hurricane Sandy on Oct. 29, in New York City. (Michael Heiman/Getty Images)

After Hurricane Irene, officials at NYU Langone Medical Center spent several million dollars protecting its backup power system from flooding, according to Richard Cohen, vice president of facilities operations.

The hospital removed a fuel tank and a set of emergency generators at street level and chose to depend on what Cohen termed an “extremely modern, extremely reliable” system of rooftop generators.

The hospital also built a new, flood-resistant house for pumps that draw fuel from the hospital’s sealed underground tank and feed it to the generators that make electricity when New York City’s power fails.

One vulnerability remained, and it proved to be the system’s Achilles Heel. A portion of the hospital’s power distribution circuits, which direct the generated electricity out into various areas of the hospital, were located in the hospital’s basement.

“It’s like what happens when you have a flood in your basement and the electrical panel is in your basement,” Cohen said.

The predicted storm surge heights feet from Sandy did not worry NYU officials. “We had Hurricane Irene last year,” Cohen said. “We did not have any compromised or flooded areas in the hospital, so frankly we had no reason to think this would be any specific risk.”

However, the National Weather Service upgraded its predicted storm surge heights for lower Manhattan to as high as 11 feet as early as Sunday morning. That day, dozens of EMS units could be seen idling in front of NYU Langone Medical Center. EMTs said they were standing by to transfer patients. But the hospital leadership decided to keep the patients in place.

NYU’s Cohen stressed that the hospital’s system complied with building codes at the time it was constructed. Hospitals are generally not required to upgrade their systems to current code.

Even newly built hospitals in low-lying coastal zones are not necessary required to flood-proof their systems, according to George Mills, director of the engineering department at the Joint Commission, the organization that accredits most American hospitals.

Mills said his organization and the U.S. Centers for Medicare and Medicaid Services require hospitals to adhere to the 2000 edition of National Fire Protection Association life safety code. It calls for “careful consideration” to be given to protecting electrical components from “natural forces common to the area” such as storms, floods and earthquakes.

The 2012 version of the code upgrades that language, saying the systems “shall be designed” to protect against these hazards. However, CMS and the hospital accreditation agency have not yet adopted this edition.

“All of these systems are only as reliable as the weakest link,” Mills said.

During the storm, according to Cohen, the hospital also experienced a temporary loss of the system that pumps fuel to the generators. That occurred when a rapid, forceful rise in water breached the underground vault that holds the fuel tank. Sensors within the vault automatically shut off the fuel pumps.

“As soon as the staff was able to access that pump house, able to reset the pumps, they were able to feed fuel to those generators and those generators are running now.” Cohen estimated the loss lasted about an hour. During that period, he said, hospital leaders decided to evacuate.

After the pumps came back online, he said, areas of the hospital where backup power is distributed through a circuit panel located on a higher floor of the hospital regained electricity, including the intensive care units and labor and delivery.

Cohen said the hospital’s elevators were also powered through the upper level circuits and had safety features to keep them from running into the floodwater that had poured into their shafts.  The hospital decided not to use the elevators out of concern for safety. “There would have been a very good chance the elevators would have failed,” Cohen said. “We then would have had an elevator extraction in the middle of patient evacuation and that was a prospect that really nobody wanted to face.”

Cohen said the hospital is in the midst of constructing its own power cogeneration facility. When that is completed, the basement-level distribution circuits that proved the system’s downfall during Sandy will be relocated to an upper level. “We’ve purchased all the equipment,” Cohen said. “We currently expect to have it completed sometime around 2014.”

Assumption is the ...................... .

As I mentioned in the “companion” article, the real problem is that technology can’t be predicted.

What I mean is that you can get a general sense of how something will perform by testing it, and you can get a statistical sense over many units, but an emergency isn’t the test, and the test may wear out a part to the point that it’ll fail during the emergency.

It’s unfortunate, but there’s not much to be done other than (and I don’t mean this as a joke at all) backups for the backups.

Redundancy is a probability game.  If (for example) every system had a known failure rate, you pick the risk you’re willing to live with and “stack” the systems until the risk matches.  If, say, everything had a one-in-ten failure rate, five of them (use each in the event of the previous failure) would drive it to a one-in-hundred-thousand failure.

But you can’t convince the Board of Directors at a for-profit hospital to go for that kind of logic, when the backups cost more than insurance payouts.

FYI NYU is a nonprofit, it is not a for-profit hospital

My mistake, Kevin, but I think the point still mostly stands.  Executives even at non-profits need to watch the bottom line, otherwise there’s nothing to back up.

It would have been interesting to know who planned the move from the emergency equipment up from the basement. This wasn’t an issue of technology failing, or insufficient redundancy.  An integrated plan, prepared by a qualified electrical engineer would have looked at the whole system, and made sure all the pieces exposed to flooding risk would have been part of the move.  As the story was written above, it looks like there was an oversight in the planning phase.

NYU continues to deliver crappy services.  They are the only hospital to suffer this type of disaster.  No other hospital on the water had these issues.  This is typical of a hospital that has poor management (see 13 yo child they killed by not diagnosising a massive infection).  The hospital is over crowded, run by residents (who change every 40 days).  You never know who exactly did the surgery and when they screw up you never see the surgeon again.  To congratulate themselves for evacuating the hospital instead of originally taking care and not have the flooding happen is laughable.  It is a poorly run place stay away if you want to stay alive….

This was an incredible lack of vision for such a great institution. There is no way the distribution system should have been in the basement. Now that NYU has an engineering school, a program in medical facilities engineering (MEDFACE) should be introduced into the curriculum. This is exactly the type of problem CUSP should address in light of global warning challenges.

This article doesn’t mention the destruction to the neighboring NYU biol

Sorry about above. No mention of the damage done to the NYU biological sciences research building next door to the hospital. No back up generators: all the power down that kept the sub-zero freezers cold. Scientists lost lifetimes of work and research dollars: novel proteins, expensive reagents, etc. The research animals were housed in the basement, mostly transgenic mice representing years of work. All drowned in flooding. Has anyone reported on this incalculable loss?

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