Aging ventilation equipment that has spewed tiny bits of grit near surgical tables at the Northport VA Medical Center has forced the closing of all five of the operating rooms at Long Island’s only veterans hospital.
The closure, which dates back to Feb. 17 except for a brief failed reopening in early spring, has forced the 502-bed facility in Northport to send surgical patients to facilities as far away as Manhattan and the Bronx.
Phillip C. Moschitta, the center’s director, said he hoped to have the surgical suite operational again by early June, after engineers install temporary air filters in each of the operating rooms.
But he acknowledged that the filters had to be designed and built to order, and that he could not say for sure when doctors will resume surgeries there.
“The first obvious concern is our patients,” Moschitta said.
“The air quality has been monitored from day one, and we have shared that information with our staff,” Moschitta said. “We have been transparent.”
Since the February closing, patients urgently in need of surgeries have been sent elsewhere, such as Stony Brook University Hospital, a 40-minute drive east, or to VA facilities at the James J. Peters Medical Center in the Bronx or the New York Harbor Healthcare System in Manhattan. Some patients have been advised to use the VA’s Choice Card program, which pays for private medical care when VA facilities are unavailable.
The problems at Northport come as the VA health system has encountered criticism for its handling of maintenance at facilities nationwide. A 2014 audit of the VA’s Non-Recurring Maintenance Program, which this year funneled $2.4 million to pay for repairs at the Long Island facility, said the VA faced a “nearly $10.7 billion identified facility maintenance backlog,” and that the giant agency “inadequately assessed risks to patient safety and underestimated repair costs by $12.3 billion.”
The audit said 74 of 150 maintenance construction projects it reviewed at VA facilities were a year or more behind their scheduled completion date, and that the VA did not have a system to adequately track nonrecurring maintenance expenses.
The 2014 audit looked at eight VA facilities; Northport was not among them.
Moschitta said the particle contamination emanated from rusting parts and crumbling concrete in a dedicated ventilation system that serves the surgical suite in the center’s 44-year old main medical facility, Moschitta said.
Engineers determined that the contaminants were coming from a component within the air ducts responsible for reducing the noise produced by the air system’s mechanical equipment.
Hospital officials had begun noticing black specks the size of grains of sand in the Number Four operating room. Testing by an outside contractor showed the contaminants to be mostly oxides of zinc, aluminum and iron, as well as tiny bits of concrete.
The sampling also discovered traces of cladosporium, a ubiquitous species of mold that is typically harmless, but “has been known to cause several different types of infections, including skin, eye, sinus, and brain infections,” according to a Centers for Disease Control website.
The hospital’s chief of staff, Dr. Mark Kaufman, did not express concern for the cladosporium, saying that “ambient air” typically contains concentrations of the fungus 300 times that of what was discovered in the operating room ductwork.
Hospital officials first tried to solve the problem by having the ducts cleaned. But after briefly resuming surgeries in three of the operating rooms, new specks appeared.
On April 12, operations were again halted, and the operating suite has remained shuttered since then.
The medical center’s chief engineer, Ronald V Brattain, said temporary filters that are expected to allow the operating rooms to open in June will cost about $32,000, and that a more permanent fix to the noise quieting equipment will take longer, and cost in the neighborhood of $600,000 to $700,000.
Northport officials said the operating rooms each year handle about 1,200 to 1,500 of the types of surgical procedures that the closure has halted. Since February, 117 veterans have had to reschedule surgeries, Kaufman said. Of them, 69 were treated at other facilities, and 48 chose to postpone surgery until Northport becomes available again.
Long Island’s primary medical facility for veterans, the center handles more than 32,000 individual patients each year.
But the facility, which dates back to 1928, is showing its age.
Some of the buildings on the sprawling campus are fenced off and surrounded by unmown weeds. Peeling paint flakes from the woodwork. Several occupied buildings have diesel powered or other temporary service equipment set up outside their walls.
Last year, an improper concentration of a fungicide treatment caused the cooling towers to fail at Building 200, the medical center’s main hospital building built in 1972 which houses the now-shuttered surgical suite. The lost cooling towers have forced hospital officials to rent temporary air conditioning trailers, at a cost of $30,000 for each of the four needed in the warm months.
A replacement of the air conditioning system scheduled for completion next March will cost $18 million, although the VA will recoup at least some of that expenditure through an energy savings program, Moschitta said.
Moschitta said the now-closed surgical suite will eventually be completely renovated, at an expected cost of $8 million.
But he said when that will happen remains to be determined.