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Liability Risks in Healthcare Facilities
 

Timothy R. Hughes, Esq.
Hughes & Associates, P.L.L.C.

Contractors need to develop highly specialized knowledge

Healthcare facilities present the potential for financial gain for properly qualified electrical contractors. These projects also present a downside of risk of increased liability due to the nature of the projects and potential damages. Electrical contractors working on these types of projects need to develop highly specialized knowledge of codes, construction practices, materials and equipment specific to healthcare facilities.

Why do these projects present such risks? Healthcare facilities present extremely complex technical, design and construction challenges. The potential non-ambulatory nature of patients in a healthcare facility has led to development of specific requirements applicable to the design and construction of such structures. These requirements are further complicated by the need for special equipment to provide lifesaving or sustaining treatment. Such equipment must remain operational regardless of the situation.

A contractor trying to understand the design, code and construction requirements of a healthcare facility must start with an understanding of its basic use. Potential limitations of the non-ambulatory occupants translate to additional express code and building requirements for fire suppression, fire alarms, fireproofing and alarm annunciation.

In response to the requirements of healthcare facilities, and the specific possible limitations of their occupants, organizations responsible for developing model building codes have developed requirements specific to healthcare facilities, such as the National Electrical Code (NEC).

The first area from the NEC to note is the broad definition of a healthcare facility. NEC 517.1 and 517.2 define healthcare facilities as including “… Buildings or portions of buildings in which medical, dental, psychiatric, nursing, obstetrical, or surgical care are provided.” Healthcare facilities expressly include not just hospitals, but also nursing homes and medical and dental offices. An electrical contractor performing any work in a facility providing medical services needs to know the terms of all of NEC 517. This broad scope could translate to potential liability problems for an electrical contractor who is working on a doctor’s office in an office building without regard to special requirements for the health treatment areas contained within the structure.

In general terms, NEC 517 mandates specific code requirements for such matters as type, number, location, grounding and electrical service requirements for receptacles for patient areas, critical care areas and the like. NEC 517 dictates specific Code requirements for ground fault protection systems for different areas of healthcare facilities that deviate from, or extend well beyond, ground fault protection requirements for other types of facilities. NEC 517 also includes the requirement for installation of redundant grounding systems in some circumstances.

Perhaps most importantly, NEC 517 includes a highly detailed set of requirements for backup emergency power systems for healthcare facilities. The mandates of NEC 517 include specific emergency power backup for the defined “life support” system, the “critical” system, and the defined “equipment” system, which fall into the defined “essential electrical system” as set forth in the Code. Specific areas which fall into the definition of the essential electrical systems must be identified and addressed in the design and construction of the electrical system for a healthcare facility.

An electrical contractor working on healthcare facilities should intimately know the Code requirements for these specific structures. The temptation is to rely upon applicable design professionals and follow their instructions to the letter. Many contractors believe this is the ultimate panacea to avoid being held liable for problems. Even following explicit design instructions is not a certain protection from liability.

There are two basic arenas of liability exposure on healthcare facilities. The first is that of personal injuries. The threat of catastrophic levels of personal injuries is always present in electrical work; these risks are enhanced with a pool of non-ambulatory occupants in a structure. The second arena relates to “economic damages” flowing from delays in construction or increased construction costs, etc.

While reliance on expert design professional guidance is often warranted, blind adherence to the designer presents risks. For example, if the design professional dies after the project, goes bankrupt, or is underinsured, you can expect that injured plaintiffs will look to other pockets for collection, including yours. Further, the level of detailing and coordination varies on jobs.

Healthcare facilities require effective design and construction coordination, talent and knowledge of the Code by all parties involved. Electrical contractors performing work on these facilities should educate themselves to become experts on the Code requirements before performing work. Education and awareness places the electrical contractor in a far better position to ensure that design and construction of the project meets the Code and building requirements.