April 2011 Archives

April 28, 2011

Overlooked Fire Hazards in the Home Can Be Deadly

Here are two stories from this past week that should provide lessons about paying close attention to anything around the home that can cause a fire, or which can make your escape from a fire more difficult

First: On April 20, the Consumer Product Safety Commission ordered the recall of more than 7 million candles because of concerns the plastic cup that holds the candle could melt or catch fire.

The "tea lights" were sold under the brand names of Chesapeake Bay Candle and Modern Light. They were sold at stores such as Home Goods, Target, Wegmans and others nationwide between July 2009 and February 2011.

The CPSC says the candles have a clear plastic cup that can melt or ignite, posing a fire and burn hazard. In fact, the importer of the candles, Pacific Trade International Inc., has received at least one report of the plastic cup melting while being used. No burn injuries or property damage have been reported so far. Consumers can call the company at 800-331-8339 for more information, or visit www.chesapeakebaycandle.com.

Or, if you have had a problem with these types of candles or any other product that has caused a burn injury, you can contact Mineola-NY based personal-injury lawyers Kramer & Pollack LLP to find out if the maker of the product is liable for causing that injury.

Remember: Along with cigarettes, candles are one of the most common causes of fires in the home. It is very easy for children and even adults to knock over a candle--and remember, even if it does not start a fire, the candle's hot melted wax can land on someone's skin (and stick to it!), causing a second-degree burn or even a third-degree burn.

The second story is a sad one. A few days ago, a father, mother, and oldest child of three were killed in a fast-moving fire in their living quarters in New York City. Notice that I did not say "apartment"--the reason for this is because this family was living in an apartment building that had been illegally converted into many very small, one- and two-room apartments. This is illegal because it creates overcrowding in the building and it also affects the fire safety of everyone living there.

In this case, a fire began in one unit and spread so quickly that the three victims could not get through the maze of doorways fast enough to survive. And according to the New York Daily News, NYC Mayor Michael Bloomberg has now ordered top aides to crack down on such illegal apartments all around the city.

Conceding the city has not done enough, Bloomberg said he told the fire and buildings commissioners to "develop some new strategies for going after building owners that we suspect are most egregiously responsible for dangerous illegal conversions citywide."

He said the spread of illegal apartments "has been a problem for many, many years," and acknowledged the city's efforts have fallen short. The concession came as Bloomberg confirmed that the burned-down apartment house at 2321 Prospect Ave. had been converted into many illegal apartments.

"The real disgrace here is building owners who put profits ahead of people's lives ... and allow extremely dangerous conditions to persist," Bloomberg said.

The city received five complaints of illegal apartments with faulty wiring and blocked exits in the burned-down building. Building inspectors visited the site 10 times but, following department policy, took no further action after they failed to get in after two tries.

The FDNY vacated one floor of the building but never got back into the building to see if tenants had returned, Bloomberg acknowledged.

Meanwhile, City Council Speaker Christine Quinn (D-Manhattan) joined the growing chorus of outrage by scheduling a June hearing on how the city deals with suspected illegal apartments. She told the Daily News that Bloomberg has opposed pending Council legislation that would give inspectors more flexibility. A mayoral spokesman said Bloomberg believes the proposed legislation "will not stand up in court," but said he "will continue to work with the Council to find a solution."

Bloomberg opposes a bill sponsored by City Councilman Peter Vallone (D-Queens) that would let inspectors cite a property owner for an illegal apartment based on circumstantial evidence like a large number of mailboxes or doorbells. Bloomberg also is against a bill sponsored by Councilman Oliver Koppell (D-Bronx) that would strengthen city inspectors' ability to obtain court-issued access warrants based on affidavits from inspectors.

"This is an outrageous system that will lead to more deaths, but the administration is happy to let that exist," Vallone said. "If they have better legislation, [let them] propose it."

The Buildings Department gets about 20,000 complaints of illegal conversions a year, but is able to get in to inspect only about half of them, Bloomberg said.

The mayor said the city obtained twice as many warrants demanding property owners grant inspectors access in the past 28 months than it did in the six years before that.

April 26, 2011

Burn Survivor Stories: Children Getting Another Chance at Life

This month, a young Iraqi boy disfigured by a car bomb in Iraq came to Long Island, NY for surgery that could give him a chance at a normal life. Zeenabdeen Hadi, now four years old, was barely a year old when the blast burned part of his face down to the bone.

The Global Medical Relief Fund helped bring the boy and his uncle to the United States. The two are staying at Ronald McDonald House in New Hyde Park, NY and are expected to be there for several months. In addition to reconstructive surgery, doctors want to close a wound in Zeenabdeen's forehead that could lead to a brain infection.

This is not the first time that young victims of severe burns in Iraq have been brought to the U.S. for life-altering and even life-saving treatment of injuries resulting from third-degree burns. In 2007, a six-year-old Iraqi boy, who was horribly scarred after he was set on fire by insurgents outside Baghdad, underwent surgery in Los Angeles to repair his badly burned face. The boy, known only as Youssif, will need almost a year and several more surgeries to recover. The American public responded generously to his needs, donating $300,000.

One month before they were brought to Los Angeles, Youssif's desperate father approached a CNN television crew in Iraq and said, "Look what these monsters did to my boy." Donations poured into the Sherman Oaks-based Children's Burn Foundation. The foundation covered visas, plane tickets and medical costs.

Dr. Richard Grossman detailed the plan: First, some scar tissue was removed from the forehead and nose area and replaced with temporary grafts.Two skin expanders were inserted too. The following week, a full skin graft was performed with skin from Youssif's abdomen. Later, the expanded skin replaced the surrounding scar tissue.

The surgeries can never completely undo the disfigurement, but Youssif's spirits were very high about the idea of living a normal life.

Here's a similar story: In 2010, after a year in the U.S. where he underwent five surgeries to treat severe burns, an Iraqi boy landed at the Baghdad airport to reunite with his family. 13-year-old Mohammed wore a Detroit Tigers baseball cap and a T-shirt reading "Property of Michigan State" -- the university where his surgery was performed.

Caught in a house fire started by rebels when he was only two years old, Mohammed was severely scarred. Then three years ago, his father was gunned down by insurgents for working as translator for U.S. troops. When his uncle went to the morgue to claim the body, he too was killed by militants, who warned Mohammed's mother they would kill her and her children if she ever contacted the U.S. military.

Instead, Mohammed went on his own to an army checkpoint outside Ramadi in November 2008 and asked a Michigan Army National Guard physician assistant named Howell to save him and take him to America.

It took Howell six months to get permission, but he managed to get Mohammed to Michigan, find him a Muslim host family, and set up a foundation to pay for his operations.

Black, glossy hair now grows where only scar tissue was before. And Mohammed's left hand and wrist -- deformed in the fire -- now can field baseballs. He gained 26 pounds and grew 3.5 inches during his time in America -- and he now speaks English with an American accent.

Howell said they are hoping to find a way to someday get Mohammed back to the U.S. for college, hopefully at Michigan State.

April 21, 2011

Severe Burns and Smoke Inhalation From Sources You Can't Control

The CBS television station in Keller, Texas reported last week on this story of severe burns on one family's child and several other children, all of whom are in a special-needs class at their school:

Nicholas Chaney's parents trusted that he's taken care of at school just like he is at home. Nicholas, 18, has cerebral palsy. "I admire the teachers they do a very good job with them," says his mother Pauline Chaney.

But now that trust is shaken. "As I got closer, he smelled like burned hair and burned skin," says Nicholas' stepfather, Rudy Moreno. Moreno says that his stepson's special needs class at Keller High School went outside at the same time other students were using charcoal grills as part of a cooking class.

Moreno still doesn't know what exactly happened, but has pieced together that charcoal from the grills were gathered onto a cookie sheet. "There was a kettle placed on top of the charcoal. The kettle was removed, and I think the cookie sheet blew all the charcoal over," explains Moreno.

The grill was about 7 feet away from the special needs group. It was very windy day, and Moreno says the hot charcoal rained on some of the special needs students, including Nicholas, and burned them badly.

In pictures taken by Moreno there are buns on Nicholas's shirt, his hair singed and his scalped burned. Moreno rushed Nichols to the hospital. It was determined he suffered first and second degree burns from the charcoal.

But what bothers Nicholas' parents most is that no paramedics were called by the school, and they didn't even find out about what happened until 45 minutes later.

"I don't understand what they were thinking not calling a paramedic--they call the school nurses to take care of these children but the school nurses are not doctors," says Pauline Chaney.

In response the Keller School district released a statement reading: "We are aware of the situation that occurred at Keller High School on Wednesday. Two employees have been placed on administrative leave pending the outcome of an internal investigation."

Two other parents say their children are recovering at home with burns as well.

Another parent of a special needs child art the school wrote in an online forum the following: "To me, the issues are (1) why wasn't this [cooking] exercise postponed to a day with less wind; and (2) why were the special needs kids so close? These kids don't have the same reaction times and abilities to move away from hazards like blowing coals and embers. Looking at [the burns on] Nicholas' scalp, imagine what would have happened had he been turned the other way! Obviously wind is something that cannot be controlled, but when the event was held and the proximity of the kids could have been [controlled]."

And a neighbor of one of the burn victims write that there "is a third-degree burn on his back that will now require skin grafts. He has been on pain meds and running a fever since the incident. Negligence was allowing such an unsafe practice on such a windy day. Another negligence was not contacting paramedics immediately, especially considering none of the affected children could even speak for themselves to describe the extent of their pain!"

The second story I want to discuss, about the dangers of smoke inhalation, also comes from Texas: Nearly 1 million acres of land have burned in wildfires--and people with asthma, old people, young kids, and others all across the state are now more susceptible to breathing problems from inhaling smoke, soot and other particles from the fires.

The worst part is that these folks don't even have to be within 10 miles of the fire--they can still inhale small particles that drift long distances in the wind, and these can cause serious lung problems now and over the lifetime of the affected person.

So keep this in mind if you ever hear of a large fire in a town near yours. If so, take precautions with people you know who have breathing problems or who are very young or very old. Keep them indoors or perhaps even have them wear masks. And even if you are perfectly healthy, if you smell fire in the air even though that fire is far off, that air is not completely safe for you to breathe. Go indoors until it passes.

April 19, 2011

Measuring Severe Burn Rates for Surfaces Found at Home and Work

An interesting, though very academic, paper was published recently about the ways that investigators can measure how quickly skin can receive painful second-degree burns as well as far more damaging third-degree burns from coming in contact different surfaces. At the top of the list of fast skin-burning surfaces was aluminum, then steel, then brass, and then concrete (which most people might not have thought of). Actually, make sure you keep that last one in mind come the summertime, when people walk around outside in bare feet more often, and children play outside more often on such a surface.

Anyway, the research paper talked about a tool called a thermesthesiometer, which can be placed against the top or side of different appliances and other objects to see how quickly skin can burn on that surface. This is a test that a personal-injury attorney could ask for if a client received third-degree burns and wanted to investigate if another party was liable for the subsequent burn injury the victim received.

On a larger scale, it is critical that people know which surfaces in their homes, work sites, and other places can get hot and burn the epidermis, or outer layer of skin. Why? Because the epidermis is just .08 of a millimeter thick, so it can be burned away in just a few seconds on the types of surfaces listed above. And once that outer layer is burned away, you reach the dermis--the layer that holds the blood vessels and nerve endings. When the epidermis is burned away to the point that the dermis gets damaged, that is the classic definition of a third-degree burn.

April 14, 2011

A Terrible Story That Offers Lessons in Fire Safety

In addition to the tragic shopping-mall and nightclub fires I detailed in my last blog entry on April 11, this next story should be a lesson to anyone about thinking of fire safety wherever you are. When at home, you simply must check all possible means of escape on a regular basis to make sure they are free of obstructions and can be opened, in case a fire ever happens.

This story appeared in the Des Moines Register newspaper on April 2:

Sieh and Annie Toffoi were getting ready for bed when the floor in their second-story apartment began burning their feet. No smoke alarms went off in the apartment to alert the couple a fire was raging below, according to a wrongful death lawsuit filed in early April in Polk County, Iowa, District Court.

Sieh tried to escape down a stairway inside the house, but smoke and flames blocked the exit. He tried the windows, but said he could not pry them open.

"The floor was melting," Sieh, 67 years old, said through an interpreter. Sieh and Annie, who were married in Liberia in 1980, were now trapped. And somewhere amid the smoke was their granddaughter Czu, 10.

The lawsuit filed against the landlord, Terry May of Des Moines, claims the windows were either designed not to open, or were nailed or painted shut.

Sieh crawled into his bedroom, the floor searing his hands and knees, before passing out on his mattress. His wife lost consciousness in the living room.

When fire crews arrived at the house on April 4, 2009, flames were shooting from the front window, and heavy black smoke billowed from the second story. They somehow managed to pull the couple to safety. But Czu, an elementary school student, died 24 hours later of smoke inhalation.

Sieh and Annie were transferred to University of Iowa Hospitals in Iowa City in critical condition with third-degree burns and smoke inhalation. They were each in a coma for a month. Upon awakening, they spent another month in physical therapy learning how to walk.

Throughout their recovery, they kept asking about their granddaughter. "She is fine. She is in the city," friends and family said.

The smoke caused permanent damage to Sieh and Annie's respiratory systems. Annie uses oxygen before bed every night. Sieh Toffoi uses an inhaler and swallows several medications daily. His damaged eyesight has not recovered either.

The man who started the fire, Ronald Murchison, then 51, had ignited a chair in his bedroom when he fell asleep smoking, according to witnesses and police. No charges were filed against him. Murchison had nearly started fires at the house twice before, the lawsuit said. A fire report said Murchison, who had been diagnosed with paranoid schizophrenia, was known to the fire department.

The lawsuit alleges the landlord, May, should have warned the Toffois about the danger posed by Murchison, and that the windows were in improper and dangerous condition.

The landlord said he visited the hospital the morning after the fire. "My heart goes out to them, believe me. It's something that will always be on my mind." May added that the fire was a "terrible accident" but that there was nothing he could have done to prevent it. The house met city codes and had passed inspections, he said. He said he owns 12 rental properties and all meet city codes. When asked about the smoke detectors and windows that wouldn't open, May repeated that the house had met city codes.

Sieh and Annie Toffoi had cared for Czu since she was an infant, rescuing her from a refugee camp in the Ivory Coast in 1999 where they were also staying. In 2004, the couple gained refugee status and moved to Iowa. Czu was 4 years old. Before the fire, Sieh worked at a meatpacking plant, while Annie worked in child care.

The couple now live on Social Security benefits, because their disabilities prevent them from working. The government pays for a home health aide to visit five days a week. The Toffois don't know the total cost of their medical bills, but their attorney said they carry hundreds of thousands of dollars in debt. "They fled from Africa to save their granddaughter's life, only to come here and have this happen. It's just one of the saddest cases I've ever worked on. The whole thing is sad."

April 12, 2011

Practicing Fire Safety in Public Places

On Sunday, a fire broke out in a three-building shopping mall in the downtown area of Xining City in northwest China. According to media reports there one woman died, while another 12 were rescued and treated in the hospital for injuries mainly caused by smoke inhalation.

The local media also reported that nearly 600 firefighters responded, but rescue work was hindered by the raging fire and waves of choking smoke.

Just because this fire happened in a faraway place like China does not mean that we cannot learn something from it. You see, when we are in public buildings, we must at least have an awareness of our surroundings so that if an emergency does take place, we know which way to go that will get us out of the building quickly. Following the herd of people in whichever direction they are going is not necessarily the best idea!

If you don't believe me, then consider this story: On February 20, 2003, The Station night club in West Warwick, RI had a fire on its stage that was sparked by pyrotechnics used by the band that was playing at that time. Only as the fire reached the ceiling and smoke began to thicken did people realize this was not part of the act and the fire was uncontrolled. In less than a minute, the entire stage was engulfed in flames, with most of the band members and crew fleeing for the west exit by the stage.

By this time, the night club's fire alarm system had made everyone aware of the impending danger. But even though there were four possible exits, most people did not use the other exits in the building; instead, most people headed for the front door through which they had entered. The ensuing stampede led to a crush in the narrow hallway leading to that exit, quickly blocking the exit completely and resulting in numerous deaths and injuries among the patrons and staff. Of the 461 people in attendance, 100 died, and about half were injured, either from third-degree burns, smoke inhalation, or trampling.

So the lesson is this: Whenever you are in a mall, a movie theater, a government office, or any other public building, make sure to find more than one emergency exit that is near you, before you go about your activities. This gives you the best chance to escape in case of fire or other emergency because you have options--you won't have to rely on other people's actions to show you where an exit might be. This could mean the difference between life and death!

April 11, 2011

Necrotizing Fasciitis and Third Degree Burns (Part II)

Risk factors for Necrotizing fasciitis:

  • Trauma to the skin (minor or major).

  • Burns

  • Immunosuppression and imunosuppressive drugs such as prednisolone.

  • Diabetes.

  • chronic diseases such as chronic renal failue.

  • Malignancies.

  • Alcoholism and intravenous drug misuse.

  • Obesity.

  • Peripheral vascular disease.

  • malnutrition.

  • Age over 60 years.

  • Varicella.

  • Clinical features:
    There are local and systemic signs and symptoms of Necrotizing fasciitis:

    Local signs and symptoms may include:

    1. Skin erythema.

    2. Skin edema (swelling).

    3. Skin ulceration with gangrenous edges.

    4. Skin necrosis.

    5. Skin numbness.

    6. Pain which is out of proportion to the degree of inflammation.

    7. Grayish-brown discharge.

    8. Vesicles, bullae.

    9. Crepitus (crackling or grating feeling or sound under the skin).

    Systemic signs and symptoms may include:
    1. Fever.

    2. Chills.

    3. Hypotension (decrease blood pressure).

    4. Tachycardia (increased heart rate).

    5. Diaphoresis (excessive sweating).

    6. Hemodynamic instability.

    7. Altered mental status.

    8. Organ failure.

    Necrotizing fasciitis is a life threatening rapidly expanding infection that can lead to systemic toxicity and death therefore early diagnosis and treatment is critical to reduce the risk of complications and death. Diagnosis include:

    • Full history and physical examination including all parts of the body to search for skin inflammation.
    • Lab work .
    • Tissue biopsy which can reveal necrosis of deep tissues.
    • Plain x-ray which can demonstrate subcutaneous gas.
    • CT scan and MRI.
    • Surgical exploration.
    Differential Diagnosis:Diseases that may have similar features of necrotizing fasciitis include:
    • Cellulitis.
    • Erysipelas: an infection of the superficial dermis with well defined borders.
    • Gas gangrene.
    • Lymphangitis.
    • Treatment of necrotizing fasciitis is composed of patient stabilization, surgical debridement and rapid administration of broad spectrum antibiotics. Some patient may need to be admitted to the intensive care unit for monitoring and treatment may involve an interdisciplinary care team. Patients are typically taken to surgery based on a high index of suspicion determined by the patient's clinical features. During surgical debridement collection of tissue cultures and tissue samples are done for microscopic evaluation, excision of all nonviable tissue, and delineation of the extent of the disease. Multiple surgical debridement may be needed leaving a large opened wound which may reuire skin grafting.
    • Intravenous antibiotics should be started as soon as necrotizing fasciitis is suspected. Wide spectrum antibiotics are usually used.
    • Amputation of the affected organ or organs may be needed.
    • Hyperbaric oxygen may be used as an adjunct to surgery and antibiotics.
    This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.
    April 7, 2011

    A Hot Debate About Fire Sprinklers in Homes and Condos

    An article written for the Associated Press this past week covered a topic that every head of a household should know something about: A regulation calling for homes built after January 1, 2011 to install fire sprinklers.

    This rule in some areas has ignited a fight around the country between fire safety officials, who say home fire sprinklers save lives, and home builders who are struggling to recover from the real-estate crash. Many of the builders contend that sprinkler installations should be voluntary, meaning it's up to the home buyer.

    The International Code Council, an organization of building inspectors, fire officials and others who set building standards, recommended in 2009 that states and municipalities adopt codes requiring sprinkler systems in homes and town houses less than three stories high. These regulations took effect this past January.

    But with the home-building business down so much in the past few years, the last thing builders want is a new rule requiring them to spend thousands of dollars to install home sprinkler systems that many customers don't even say they want.

    According to the National Fire Sprinkler Association, such systems have been required in most nightclubs, hotels, schools and other public buildings (depending on their height) for more than 60 years. And in 2009, more than 2,000 people died in one- and two-family homes, while 9,300 burn and smoke-inhalation injuries occurred as well.

    The National Fire Protection Association says sprinklers will particularly help young children, the elderly and the disabled by giving them time to escape burning homes. On the other hand, a spokesman for the National Association of Home Builders countered that studies do not show that mandatory sprinklers improve safety. Smoke detectors, required by most building codes for decades now, help save lives, as do better materials used in home construction, the association claims.

    As of now, officials in California, Maryland, Pennsylvania and South Carolina and numerous local jurisdictions have adopted the code, according to the National Fire Protection Association. Maryland will allow counties to opt out and Pennsylvania lawmakers are taking steps to repeal the rules. A measure to adopt the fire code has lost momentum in the Connecticut legislature. And six other states--Arizona, Florida, Georgia, Idaho, Louisiana and South Dakota--actually prohibit sprinkler requirements.

    One real-estate executive in Connecticut said many of his customers refuse to buy homes that have sprinkler systems because of the very unlikely possibility that sprinklers will go off accidentally and ruin furniture, carpets, and belongings. The $8000 price tag only makes the idea less friendly to home buyers.

    At the least, any head of a household should weigh the pros and cons of having home fire sprinklers in addition to smoke detectors. If there are children, elderly, or handicapped people living in a dwelling, sprinklers could give them enough time to escape a fire without suffering third-degree burns or deadly smoke inhalation.

    April 5, 2011

    Real-World Lessons for Preventing Home Fires, Severe Burns, and Smoke Inhalation

    Here are three items that were in the news last week that provide good lessons for anyone--but especially families--as they examine their home for fire hazards, and also to make sure their fire-escape plans are known by everyone in the family.

    First, New York city fire officials say a lumbering pet turtle sparked a fast-moving fire in a a Brooklyn apartment after crawling out of its tank and knocking over the terrarium's heat lamp.

    The six-year-old African tortoise, about the size of a basketball, survived. But officials say one firefighter and three police officers suffered smoke inhalation. The reptile was housed in their owner's bedroom, an eighteen-year-old who was not home at the time, nor was his family.

    Fire officials say the heat lamp crashed to the floor, igniting a pile of art supplies, including thinner and paint. Within minutes, the fire spread through the third-floor apartment and caused some damage to surrounding units as well.

    Next, a space heater sparked a fire that damaged a single-story home in San Diego County, CA, and left at least one person without a place to live. An 89-year-old woman who lives at the home was taken to the hospital for smoke inhalation. Smoke and flames had already enveloped the rear part of the house by the time fire crews arrived, The fire started at around 12:30 p.m.in a bedroom, when a space heater was placed too close to sheets, pillows or curtains. Crews were able to keep the fire contained in the bedroom and extinguished the flames in 19 minutes. Structural damage to the home was estimated to be $200,000 and damage to content inside the home was estimated to be $50,000.

    Lastly, a large producer of box fans, which are used by many homeowners in windows or in doorways to cool a room rather than using air conditioning, has recalled thousands of its products due to a fire hazard within the box fans. The U.S. Consumer Product Safety Commission, in cooperation with Lasko Products, announced a voluntary recall of 4.8 million box fans.

    An electrical failure in the fan's motor poses a fire hazard to consumers, says the CPSC. Lasko has received seven reports of fires associated with motor failures, including two house fires and one barn fire, resulting in extensive property damage. Fortunately, no injuries such as third-degree burns or any other type of burn have been reported. This recall involves Lasko box fans with model numbers 3720, 3723, and 3733 and Galaxy box fans with model number 4733 that have date "2002-03" or "2003-04" stamped on the bottom of the metal frame. "Lasko" or "Galaxy" is printed on the front of the fan. The model number is either stamped or printed on the bottom of the fans.

    Consumers should immediately stop using the recalled fans and contact Lasko to receive a free fused plug safety adapter. It is illegal to resell or attempt to resell a recalled consumer product.