Infectious Diseases Expert Comments on Forced Air Warming System Risks

    Hospital Acquired InfectionThis case involves a popular brand of surgical warming devices that circulate warm air through a detachable plastic blanket to regulate patients’ body temperature during surgical procedures. As a consequence of the way the device operates, air within the operating room is disturbed, causing a convection current that can disrupt the downward laminar flow of air in the room. This convection current can pick up bacteria from the floor, which can then be deposited deep within surgical incisions, leading to serious deep-tissue infections. In addition, it has also been argued the device’s pump and heating unit provide inadequate filtration for air that is moved to the blanket, creating an additional vector for bacterial exposure.

    Question(s) For Expert Witness

    • 1. Please briefly describe your experience with hospital-acquired surgical site infections.
    • 2. After a review of the facts and medical records, can you opine as to the association of the use of the device and an increase in the risk of SSI?

    Expert Witness Response E-055125

    I have directed a large healthcare system’s infection prevention initiative since 2008, including prevention of surgical site infections. Like all infectious disease specialists, I focus on inpatient/outpatient care, but I have considerable experience performing infection prevention research in operating suites. I am actively familiar with the device in question here – it is commonly used for active rewarming in an effort to prevent hypothermia-related infections, so I am curious to review the details of the case to see how it may have contributed to surgical infections. I have served as an expert witness before for a plaintiff whose spouse died of clostridium difficile colitis following bilateral knee replacement, who I believe did not receive standard of care. I also served as an expert on behalf of a former patient who had hip replacement surgery and suffered a surgical site infection that was mismanaged. I was deposed for both cases and testified in front of the jury for both.

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