Feb. 18--On a recent Saturday morning, an 11-year-old girl ran screaming from her room at Doernbecher Children's Hospital, the front of her T-shirt aflame.
Now, as Ireland Lane undergoes skin grafts and burn treatment before heading home to Klamath Falls, state investigators are trying to determine how the fire happened -- and whether a mix of flammable hand sanitizer and static electricity is to blame.
The girl, a cancer survivor, was at the hospital after hitting her head at school and losing consciousness. As far as the fire, says her father Stephen Lane, "She still has bad dreams, but she doesn't recall the actual incident, which from my perspective is very good."
Hand-sanitizer has become ubiquitous at hospitals, schools, day care centers and elsewhere -- a top weapon in the war against cold and flu virus, and bacteria. In certain instances, its alcohol content can also be dangerous. The Oregon State Fire Marshal continues its investigation of the rare hospital fire, but early indications are that its origin lies in a very unlikely combination of factors that nevertheless could happen to anybody.
Lane had stayed in his daughter's room overnight, and was dozing. The 34-year-old disabled Navy veteran awakened as Ireland rushed from the room, but quickly caught her in the hallway and smothered the flames with his own body. She was taken to intensive care, then to Legacy Oregon Burn Center. She suffered third-degree burns from just above her belly button to her chin as well as parts of her arms and the bottom of her earlobes. Her hair also caught on fire, her father says.
No one apart from Ireland saw the fire start and investigators' initial examination unearthed no clear cause. But the girl's father says investigators told him an alcohol-based hand sanitizer from a wall-mounted dispenser is the only thing that makes sense.
Ireland was due to leave the hospital the day of the fire. The last thing she recalls that day is using sanitizer to clean the table that rolled over her bed, where she had painted a wooden box as a gift for her nurses. Ireland's father recalls that before the fire, she was playing, making static electricity with the sheets on her bed. He'd never heard of that being a danger, let alone causing a fire.
But other, similar incidents have happened. In 2002, doctors in Kentucky reported that a nurse's hand antiseptic ignited from a spark of static electricity; and in a 1998 Arizona case, a patient suffered serious injuries in an operating room fire involving an alcohol-based antiseptic. Makers of alcohol-free sanitizer cite fire risk as a reason to choose their product over one with alcohol. But hospitals typically use what the Centers for Disease Control recommends as more-effective, a sanitizer with at least 60 percent alcohol.
Doernbecher officials say it's premature to review safety policies before the fire marshal investigation is complete, which is expected later this week. Already, the hospital conscientiously follows fire safety practices, using flame-retardant bedding and electrical equipment that's certified to ensure fire safety, said Ben Richards, safety manager at Oregon Health & Science University facilities, including Doernbecher. Fires at OHSU facilities are rare, and often are traced to unapproved items such as a patient's hair dryer or curling iron, he added.
OHSU and Doernbecher stock the sanitizer Avagard D, produced by 3M. It is 61 percent ethyl alcohol, and the label warns to avoid fire or flame. A 3M spokesperson said the company was not aware of the Portland investigation, but defended the product's safety.
"When used as directed, it is entirely safe," said Donna Fleming Runyon of 3M.
Mark Bruley has studied the flammability of sanitizer and investigated numerous hospital fires for ECRI Institute, a Pennsylvania nonprofit that consults for the government and the health care industry.
"I've never heard of a fire of that magnitude involving hand sanitizers," he said of the Doernbecher fire. He says sanitizer fires are extremely rare but possible, and a "surprisingly small" amount of static electricity could have ignited vapor from the sanitizer foam. Sliding a patient from a stretcher to a bed can create a shock, and so can sliding sheets on a plastic mattress, he says.
If a large amount of sanitizer was used on the table, and Ireland wiped her hands on her shirt, it could explain the Doernbecher fire, Bruley speculated. ECRI has warned health professionals to avoid sparks by making sure hands are dry before touching devices or hand linens. But Bruley says the risk is so small, most people don't need to worry. It can take 20 seconds or more for sanitizer to evaporate, according to ECRI testing. After the gel or foam disappears, it doesn't generate flammable vapor.
Now, Ireland's father wants people to know about sanitizer's fire danger. "As readily available as hand sanitizer is nowadays, and how everybody sends it to school with their kids, it makes me much more worried," he says.
Raised in Klamath Falls, Ireland was diagnosed with a rare childhood kidney cancer while visiting relatives in Tennessee in 2007, and then spent the next five years there undergoing treatment. With dozens of surgeries, three rounds of chemotherapy, one of radiation therapy and stem-cell treatment, she beat the cancer twice. Her family recently returned to Oregon.
Ireland, the oldest of four siblings, is trying to keep her characteristic positive outlook, her father says, adding that he hopes her triumph over hardship will inspire others.
Her prognosis is good, though it may be a year before they know if cosmetic surgery is required. "She's quite a tough one. She's been through more than any child I've ever heard of, and to still walk around with a smile on her face and enjoy the things of the day that are going on, and be a kid is to me pretty amazing," her father said.
The sight of 4-inch flames licking from his daughter's chest, and the smell of the fire haunt him, Lane said.
"I can't get it out of my head" he says of the Feb. 2 fire. "I can handle all of it -- I'm a dad and I'm supposed to. But I hate seeing her unhappy stuck in a hospital again."
Ireland's second skin graft surgery is scheduled for Thursday -- her 12th birthday.
--Nick Budnick
Twitter @nickbudnick
Copyright 2013 - The Oregonian, Portland, Ore.
