Hyperbaric Physician and Tech Charged with Manslaughter in 2009 Florida Chamber Fire

Three years after the first fatal hyperbaric chamber fire in the US, on 1 May 2009 at Neubauer Hyperbaric Neurologic Center, formerly Ocean Hyperbaric Neurologic Center, in Lauderdale-by-the-Sea, Florida, medical director Dr George Daviglus, 81, and hyperbaric technologist Lance Bark, 51, have been arrested and charged with aggravated manslaughter. The fire killed an Italian boy, Francesco Martinisi, 4, and his grandmother, Vicenza Pesce, 62.

Broward County Sheriff's Detective Frank Ilarraza, pictured above, spoke April 25 about the "gross negligence" revealed by his investigation. The South Florida Sun Sentinel summarizes the arrest report:

• Static electricity caused a spark that ignited dust inside the chamber.
• Neither the chamber hull nor Pesce and Francesco were properly grounded to prevent static electric shocks.
• Pesce's and Francesco's garments included metal and flammable synthetic fabrics, polymers, plastics, and ink.
• Baby wipes containing alcohol and other combustible chemicals were inside the chamber.
• No operator was present.
• The chamber intercom system was not working.
• Operators did not follow emergency procedures for 30-second chamber depressurization.
• The chamber was over 40 years old and had been improperly rewired.

Click here to download the 11-page [PDF] complaint affidavit.

State Fire Marshal's Office Detective Edwin Tapanes called for stricter regulations of hyperbaric facilities across Florida. All across the country, physicians and technicians will be studying these findings and redoubling their efforts to ensure the safe delivery of hyperbaric oxygen therapy. Patients and families should feel confident in asking facility and equipment operators about safety procedures, regulatory compliance, and equipment certifications. More about chamber types and safety here.

[Image: Sun Sentinel video capture]