Here's an example of how a hospital pinched pennies too tightly and almost lost a patient because of it.

Summer storms can be dangerous. For one small southern California town, this threat recently became a reality after a lightning strike blacked out power in an entire 12-block area, which included a new hospital addition. Created to function as an independent facility through any disaster, designers isolated the new operating wing from other buildings on the medical campus with illusions of a complete self-sufficient power backup system. They installed an emergency generator to restore power if needed to the critical load emergency bus within the 1-min design specification. However, this arrangement proved ineffective at the most inopportune time.

At the time of the extensive power outage, emergency surgery was in progress at the hospital in one of the four operating rooms. Instead of the generator powering light for the surgeon, the staff immediately found some searchlights. However, these provided only enough light for the surgeon to temporarily close-down the operation.

The hospital administrator called the fire department with hopes they could light the second-story rooms. Within minutes, two fire trucks with portable lights attached to the trucks' ladders arrived and passed enough illumination through the windows to help the surgeon complete the operation, ultimately saving the patient's life.

The hospital's insurance company called us (forensic engineers) the next afternoon in an effort to learn exactly what prevented the emergency power system from functioning and to determine who was at fault. In the interim, the hospital's plant engineer rented a couple of portable generator sets with long cords and adjustable lights in case another blackout occurred.

After receiving the insurance call, we arranged to visit the next morning and meet with the hospital administrator, his senior staff, and the hospital's plant engineer.

Upon arrival, we received a full explanation of events leading up to the blackout as well as attempts to get the emergency system going again. The emergency engine-generator set started with no problems, but there was no electrical power. The day tank was full, and the main tank had just received its initial full load of fuel. Medical administrators feared testing the emergency system to simulate conditions of loss of normal power because it might jeopardize the facility's ability to respond to a real emergency. Therefore, no prior testing occurred; even though the consulting electrical engineer and electrical subcontractor recommended it.

We were determined to learn the cause of the trouble and get to the bottom of the matter. Though the hospital engineers were perfectly capable of dealing with anything below 600V, they gave us full authority to find the problem and resolve it.

Arriving at the site fully prepared, we brought extensive testing equipment, in case we had to do a full diagnostic study of the entire building starting with the 3000A, 480V main circuit beaker. We started our investigation and determined all nominal systems seemed to be operating perfectly and constructed in accordance with the design blueprints. Then, we used an infrared tester for some quick checks of loose or intermittent connections. This is also a good way to check for high-resistance grounds.

Finding no deficiencies, we checked the automatic transfer switches (ATS) for their connection to the emergency bus. With this test, we had to start-up the generator. Although this interrupted the busy hospital, we believed it to be the most effective way to identify the problem. After three days of negotiating, we convinced the hospital's management our approach was in their best interest. They finally gave us the authority to open the normal (utility) main circuit to learn what was wrong with the emergency system. Meanwhile, another hospital took all new cases while we continued our forensic study.

We opened the primary circuit breaker that feeds the second-floor operating suites. The emergency generator, sensing loss of normal power, dutifully reached full speed within the 1-min requirement. The ATS sensed the outage as it should and worked perfectly. But still, no power! The emergency panels were dead. There was no power at all to the emergency circuits. What could possibly be the problem?

Not knowing what we would find, we began removing electrical panel covers. Our flashlight beam swept across the main terminals of the emergency section of the ATS. There was the problem! There were no conductors to the terminals! The generator output panel covers came off next. There were no conductors leaving the generator terminals! There was simply no connection between the generator and the ATS.

To correct the problem as fast as possible, we notified the hospital authorities. With their approval, we made arrangements to have the missing conductors installed within hours.

How could such a thing happen? Why did the electrical subcontractor slip up? What about the city code authorities? Were they not responsible for inspecting the new building?

What accountability did the engineers, both plant and outside electrical consultants, have? Why weren't the normal acceptance tests conducted on the emergency system?

This is where forensic engineering really gets interesting. The technical investigation part was over, and the problem was fixed. Now, it was time to find out why the problem existed in the first place. We questioned those who witnessed the installation as well as those understanding the hospital's policies. We learned the hospital administration had responsibility for the construction of the operating wing addition, to keep the cost to an absolute minimum.

Hospital construction costs are the highest per-square-foot cost of most any category of building. To minimize costs, they didn't hire the architect or consulting engineers for necessary continual inspection of the work. The hospital staff served as their own project management, assigning less than competent people to oversee the construction, while doing other duties. Specializing in steel and concrete, the general contractor did his work. However, hospital administrators hired and directly supervised the subcontractors, including the electrical team.

The code authority had done little more than see that minimum requirements were met. There had been no acceptance testing of the emergency power system normally expected for such a project, even though the consulting electrical engineer and electrical subcontractor recommended otherwise.

Once normal power fed the facility, hospital management thought all connections were made (a reasonable assumption) and didn't wish to do any testing. Upon completion of construction, the hospital's management paid the contractors, hung a ribbon across the entrance, cut it, and opened their new facility for business.

The lesson to learn here is: Before you accept a project, be sure competent personnel carries out proper testing. And, don't save money where you should spend it.