DURHAM -- An ailing newborn was burned over 5 percent of its body Monday after a fire erupted during a medical procedure in Duke Hospital's Pediatric Intensive Care Unit.
The baby had been suffering from an upper-respiratory illness, hospital spokesman Richard Puff said. Duke officials, at the request of the child's family, would not identify the baby or disclose its condition. They said the infant suffered first-, second- and third-degree burns over various parts of the body, but the injuries alone were not life-threatening.

The fire started at 1 p.m. Monday. Paper draped over the baby, then fabric bedding and a blanket ignited shortly after a medical team began performing the procedure. The fire was extinguished with sterile water within seconds, a hospital spokesman said.

Firefighters responded to an emergency call from the hospital, but there was no major damage to the PICU room or injuries to staff, a spokesman said.

The five-person team was supposed to attach a series of tubes to the baby that would feed into a machine designed to breathe for it and pump its blood. Duke doctors have performed the procedure hundreds of times since 1990, said Dr. William Fulkerson, chief executive officer of Duke Hospital.

The extracorporal membrane oxygenation treatment, or ECMO, can last days to weeks. At Duke, the initial procedure is traditionally done in a PICU room instead of an operating room.

Medical staff performing the procedure must carefully drape the baby and aerate t bedding. Highly flammable oxygen surrounds babies throughout the procedure while doctors use a heated cauterizing tool to staunch bleeding.

The hospital's initial investigation has not shown what caused the fire, Fulkerson said. Hospital investigators are still testing patient monitors. The cauterizing tool passed routine tests and had not malfunctioned before, he said.

Equipment usually isn't the cause of fires during medical procedures, a health professional says. He says staff error is.

"These operating room fires are entirely preventable tragedies," Dr. John Faulkner said.

Faulkner, a family physician who has no connection to Duke, saw his wife seriously burned when a cauterizing tool ignited oxygen during a routine operation at Franklin Regional Medical Center in Louisburg last June. The North Raleigh couple have sued the hospital, and in the process they learned how uncommon operating room fires are.

There are about 50 to 100 such fires in the country each year. Although Faulkner's wife survived, she suffered second- and third-degree burns to her face, neck and chest. Her upper lip melted away. The effect would be magnified on a baby, he said.

"It would be much more serious, life-threatening to a baby or infant because the proportion of the total surface area involved is much greater," he said, adding that the chances of survival are slimmer yet for a sick baby. "Typically a child wouldn't have the reserves of a healthy adult."

After the fire, hospital staff immediately told the baby's family, Duke officials said Wednesday. The family could not be reached for comment.

On Wednesday, the hospital notified state and federal regulators about the incident.

Duke Hospital has been under added scrutiny since the Feb. 22 death of 17-year-old Jesica Santillan. She received a heart-lung transplant with organs that did not match her blood type. State inspectors acting on behalf of federal Medicaid and Medicare programs, initiated an inquiry into the hospital's transplant programs.

At the time, Fulkerson pledged to correct problems at the hospital and to evaluate how the hospital handled all procedures. On Wednesday, he said that was still his goal.

"We take care of the sickest people here," he said. "We do the most complex procedures. We have the most dedicated staff. If there's something to learn from this, we'll learn it, and we'll teach everybody else, too."

Staff writer Molly Hennessy-Fiske can be reached at 829-4884 or mhenness@nwsobserver.com.