When Sunday's tornado ravaged a Joplin, Mo., hospital, it wasn't flying debris or building collapse that accounted for the five patient deaths, it was loss of electricity. The hospital has confirmed that five patients who had been on respirators suffocated when the main power and the backup generator failed during the tornado.
St. John's Regional Medical Center's backup generator was sucked out of the building by the twister's 200 mph winds, leaving the hospital without power while workers scrambled to evacuate 183 patients to neighboring hospital facilities, which they did within 90 minutes.
Though St. John's emergency preparedness plan was able to protect the vast majority of patients and hospital workers, their critical loss of power raises questions for other medical facilities in Tornado Alley.
"Most hospitals will have some kind of emergency generator power, but placement is tricky. I've heard stories of having it in the basement but then it floods, or on the roof and then there's access problems," says Bob Wojtek, manager of security and emergency preparedness at St. Joseph's Medical Hospital in Maryland, a once-sister hospital to St. John's.
"Because a generator is basically a large motor, it usually has to be near the exterior wall and have major ventilation, so I imagine that something would happen to it in the case of a tornado. You have to consider which natural disasters you'll be at risk for and how long batteries will last in the [hospital] equipment," he adds.
When Sunday's tornado hit the hospital, patients had been moved away from windows and into the corridors, according to the hospital's emergency preparedness plan, says Tina Rockhold, a spokeswoman for Mercy, the health system that St. John's is a part of.
Once both regular and back-up electricity went out, "there was no light. We had very little flashlights," Sheila Harrington, who was in the hospital at the time, told ABC News. "[People] were screaming and looking for loved ones."
When Twisters Hit Hospitals
The last U.S. hospital to be leveled by a tornado was Phoebe Sumpter Regional Hospital in Americus, Ga., in 2007. Though the hospital was completely destroyed, their generator, located in the basement of the building, was operational the entire time and all patients were safely evacuated, says chief nursing officer Susan Bruns.
After the twister, the hospital had to be completely rebuilt on a new site and will open, now four years later, in December 2011. "We have a beefed-up tornado preparedness plan now," says Bruns, which includes Sky Guard, a helicopter-based weather warning system that gives the hospital advanced notice of inclement weather.
While normal "tornado preparedness" involves prepping the hospital for an influx of tornado victims from neighboring towns, Bruns says that tornadoes like the one that hit them in 2007 and Joplin just this week highlights the need to have a tornado evacuation plan -- a plan for how to get the patients out when a tornado hits the hospital itself.
Staff at Phoebe Sumpter have been in discussion with St. John's hospital in Joplin to offer them support and "lessons learned" as they enter their own rebuilding process. Hospital president Gary Pulsipher told the press Wednesday that the Joplin hospital is likely to be deemed "unsalvageable" by engineers -- in which case they will rebuild on a different site.
Until rebuilding begins in Joplin, hospital administrators are pulling together a 60-bed mobile hospital, complete with emergency, surgery, imaging, lab and impatient care that will be up and running in Joplin by Sunday. This mobile center will be able to withstand 100 mile-per-hour winds.