# How can this happen? Surgical question
**URL:** https://boards.straightdope.com/t/how-can-this-happen-surgical-question/170365
**Category:** Factual Questions
**Created:** [April 22, 2003, 6:18pm UTC](https://boards.straightdope.com/t/how-can-this-happen-surgical-question/170365 "2003-04-22T18:18:53Z")
**Posts on this page:** 10
**Page:** 1
### Author:  [@Rob\_V](https://boards.straightdope.com/u/Rob_V)
#### Post date: [April 22, 2003, 6:18pm UTC](https://boards.straightdope.com/t/how-can-this-happen-surgical-question/170365/1 "2003-04-22T18:18:53Z")
An 8yr old boy goes in for routine tonsilectomy in San Jose Ca.
According to this story [http://www.thekcrachannel.com/news/2150335/detail.html](http://www.thekcrachannel.com/news/2150335/detail.html)
The surgical equipment “catches fire” severly burning his mouth, throat and LUNGS? WTF?
I mean I could see if they were using some type of “electric knife” that the main unit, presumably on a rack or table, could catch fire, but the instrument in the patients mouth???
Any surgeon dopers out there to explain this?
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### Author:  [@gotpasswords](https://boards.straightdope.com/u/gotpasswords)
#### Post date: [April 22, 2003, 7:09pm UTC](https://boards.straightdope.com/t/how-can-this-happen-surgical-question/170365/2 "2003-04-22T19:09:29Z")
Electro-cautery, aka “Bovie” can and has ignited inflammable anaesthetics. In this case, it not only lit off the immediate area, but also the anaesthetic in the patient’s lungs.
Not being an anaesthesiologist or surgical tech, I can only take a guess that they used an inappropriate anaesthetic agent. Rest assured that the hospital’s “M&M” committee will look very carefully at the whole case. (M&M = Morbidity and Mortality - these folks investigate all “unfortunate” patient care outcomes.)
As you guessed, it is an “electric knife” that actually burns rather than cuts. The technique works very well on soft things like mucous membranes and the tissues in one’s mouth and throat. It seals off blood vessels as it goes, rather than slicing with a scalpel, which would result in the stereotypical bloody mess.
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### Author:  [@Toddly](https://boards.straightdope.com/u/Toddly)
#### Post date: [April 22, 2003, 7:55pm UTC](https://boards.straightdope.com/t/how-can-this-happen-surgical-question/170365/3 "2003-04-22T19:55:09Z")
Oh My, that is awful. Something went way wrong. There is not much information in that article.I think the machine malfuntioned somehow although I am not familiar with how they actually work. I had thought that most anesthesia gases had to be inflammable.
**How are tonsils removed?**
There are many techniques used for tonsillectomy. General anesthesia is usually employed; but it is possible to perform tonsillectomy with sedation and local anesthesia. In the United States, some degree of electrocautery assisted dissection is most commonly employed, because of the ability to rapidly stop bleeding. Some surgeons use very little cautery…with more bleeding, but with less burned tissue. Use of lasers has been studied and considered by most surgeons. We feel that laser use is primarily a marketing gimmack at this point, since it offers no apparent advantage over certain cautery techniques, and has some very real hazards and extra costs.
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### Author:  [@Rob\_V](https://boards.straightdope.com/u/Rob_V)
#### Post date: [April 22, 2003, 8:18pm UTC](https://boards.straightdope.com/t/how-can-this-happen-surgical-question/170365/4 "2003-04-22T20:18:14Z")
Ah, brilliant! I hadn’t thought about the anesthetic. That might explain it. Poor little guy. Probably going to have lung probelms the rest of his life.
On one hand, that alone might justify a legal settlement. But on the other, what with malpractice insurance becoming almost unaffordable to the point of doctors giving up practice, where is it going to end? Are we even going to HAVE a healthcare system in this country in the forseeable future?
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### Author:  [@ratatoskK](https://boards.straightdope.com/u/ratatoskK)
#### Post date: [April 22, 2003, 10:02pm UTC](https://boards.straightdope.com/t/how-can-this-happen-surgical-question/170365/5 "2003-04-22T22:02:31Z")
I was just at the dermatologist’s, and in the exam room was some kind of electric contraption and it had a sign on the side that said not to use it with flammable anaesthetics. It looked like a machine that would burn off warts, etc.
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### Author:  [@bryanmaguire](https://boards.straightdope.com/u/bryanmaguire)
#### Post date: [April 22, 2003, 11:55pm UTC](https://boards.straightdope.com/t/how-can-this-happen-surgical-question/170365/6 "2003-04-22T23:55:18Z")
> [@](#):
>
> \*Originally posted by Toddly \*
> \*\*Oh My, that is awful. Something went way wrong. There is not much information in that article.I think the machine malfuntioned somehow although I am not familiar with how they actually work. I had thought that most anesthesia gases had to be inflammable.
> \*\*
I think you mean ininflammable.
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### Author:  [@bryanmaguire](https://boards.straightdope.com/u/bryanmaguire)
#### Post date: [April 23, 2003, 12:14am UTC](https://boards.straightdope.com/t/how-can-this-happen-surgical-question/170365/7 "2003-04-23T00:14:07Z")
> [@](#):
>
> \*Originally posted by bryanmaguire \*
> \*\*I think you mean ininflammable. \*\*
And I think I mean non-flammable.
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### Author:  [@Eats\_Crayons](https://boards.straightdope.com/u/Eats_Crayons)
#### Post date: [April 23, 2003, 12:41am UTC](https://boards.straightdope.com/t/how-can-this-happen-surgical-question/170365/8 "2003-04-23T00:41:02Z")
\ Boy, I learnt that the hard way! \
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### Author:  [@Toddly](https://boards.straightdope.com/u/Toddly)
#### Post date: [April 23, 2003, 1:43am UTC](https://boards.straightdope.com/t/how-can-this-happen-surgical-question/170365/9 "2003-04-23T01:43:55Z")
> [@](#):
>
> \*Originally posted by bryanmaguire \*
> \*\*And I think I mean non-flammable. \*\*
Yep I did mean non-flammable.
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### Author:  [@PhuQan\_G\_Nyus](https://boards.straightdope.com/u/PhuQan_G_Nyus)
#### Post date: [April 23, 2003, 2:44am UTC](https://boards.straightdope.com/t/how-can-this-happen-surgical-question/170365/10 "2003-04-23T02:44:45Z")
it doesnt necessarily mean they used an improper anesthesia. There is a cuff that inflates after you intubate a patient when general anesthesia is used, that is supposed to prevent gases from entering or exiting directly. A leak or puncture in the cuff could easily allow the anesthetic gas to escape and be ignited by the cautery unit.
Fires are one of the biggest hazards in the operating room and doctors and nurses get that drummed in pretty thoroughly. It was more likely an accident or equipment failure than negligence.