Meet
Dr. Ervin Moss, Medical Director for MGM
Jan
Szijarto
Ervin Moss, M.D., a
well-known and highly respected anesthesiologist has devoted his
professional life to quality care and patient safety in medical gas
systems. This commitment led to his introduction to Fred Evans and his
appointment to the position of Medical Director for Medical Gas Management, LLC The two men have collaborated on projects designed to
educate the medical community to importance of safety in medical gas
systems. Recently, I had an opportunity to review with Dr. Moss his
distinguished career, and his passion for quality care in anesthesiology.
Excerpts from that conversation follow:
MGM: Dr. Moss, how did
you choose the field of anesthesia as your life’s work?
EM: In the mid-50s,
anesthesiologists administered only 16 percent of anesthetics. I
recognized an opportunity to participate in a new and much needed
specialty. More important was the negative reaction I had to other
divisions of medicine during my clerkship in Chicago. At that time,
hospitals had huge wards filled with very sick patients who were cared
for under rather primitive conditions. The only truly organized
department I saw was during my clerkship at Chicago’s Sinai
Hospital. Thus, my exposure to a well-managed, up-to-date anesthesia
department resulted in my choice of specialty.
MGM: Was there a
particular incident that motivated you to take an active role in
promoting safety and understanding of medical gas systems?
EM: Before becoming
actively involved in medical gas systems safety, I was very involved in
patient safety. In 1975 there was a malpractice crisis in New Jersey. It
was then that I conceived the idea that in a near-perfect world of
well-equipped and trained anesthesiologists using the latest anesthesia
machines and monitors, the exposure to malpractice could be limited or
prevented through high quality care. The concept was a form of preventive
medicine in the anesthesia specialty.
While in Florida, on an
inspection assignment for an insurance company, I was introduced to
particulate contamination of medical gas pipelines. This was a problem I
knew nothing about. Pete Winborne, an associate of Medical Gas
Management, had identified the contamination and it was he who introduced
me to Fred Evans and MGM. Recognizing that medical gas systems
represented another loophole in the anesthesia patient safety net, I flew
to Bethany, Oklahoma to learn all I could about med gas systems from MGM.
This was an area of anesthesia patient safety yet to be explored by the
anesthesia community.
MGM: You have a history
of involvement with the Anesthesia Patient Safety Foundation and are
Chairman of the APSF Work Group on Medical Gas Vacuum Systems. What is
the main focus of the Committee you chair?
EM: As a member of the
Board of Directors of the Anesthesia Patient Safety Foundation (APSF) and
as a member of the Committee on Technology, I have been able to create an
awareness, within the APSF, of medical gas system problems. I invited
Fred Evans to present an exhibit of "horrors" found by MGM in
hospital medical gas vacuum systems to the APSF. The exhibit was shown in
New York, San Francisco, San Diego, Atlanta, Atlantic City and
Philadelphia.
Another success was the
inclusion of a chapter on Patient Safety and Medical Gas Systems that I
co-authored for the text, Patient Safety and Anesthetic Practices. I like
to believe that these efforts resulted in the recent expansion by the
JCAHO into medical gas system inspections.
MGM: How do you
influence medical professionals to pay attention to their medical gas
systems?
EM: Primarily by making
them aware of medical gas systems. The lack of awareness starts in
residency programs. No attention is given to the vital anesthesia system
that is beyond the walls. I hope to see residency programs include
lectures on medical gas systems, starting at the bulk site and ending at
the patient anesthesia machine interface. An anesthesiologist should know
the entire system. Interested anesthesiologists are aware of the
anesthesia machine, but are ignorant of what is beyond the
walls.
MGM: What problems do
you encounter most often in medical gas systems?
EM: Lack of education,
not only with anesthesiologists but also with many state and local
inspectors who certify new or modified systems. They have little
understanding of the NPFA codes that apply to medical gas systems. For
example, I recently visited a new five room OR suite and, at first
glance, noticed the master alarm panel was set up for only 4 rooms. There
was no alarm for the fifth room. Yet, the state inspector approved the OR
for use with one room missing from the master alarm panel.
MGM: What innovations
would you like to see in medical gas systems over the next 5
years?
EM: I believe there are
many things that need to be done. First, the anesthesia community must
become educated to MGVS starting with residents, progressing to CME and
refresher courses for the entire anesthesia profession. If this can be
accomplished, other improvements will follow.
Educated anesthesiologists must
be involved in the construction or modification of ORs. Currently, the
end user, the anesthesiologist is often ignored in the planning phase of
new construction and remodeling.
Certification should not be
left in the hands of local fire or building inspectors. We need a
nationally recognized organization much like the FAA is to aviation or
FDA is to drugs, to oversee certification of medical gas systems.
Anesthesia gases are medicines and should be treated as all other
medications in the United States.
These goals can be achieved. My
focus has always been on patient safety, not only in MGVS but also in
hospital, office and surgery-center venues. As Executive Medical Director
of the New Jersey State Society of Anesthesiologists, I am involved in
politics, including the politics of patient safety. At this time, New
Jersey is the only state with regulations for all three
venues.
MGM: How do your spend
your leisure time?
EM: My schedule keeps me
quite busy, so I don’t have a lot of leisure time. I still
administer anesthesia whenever I am able. I have given interviews on
office based anesthesia and patient safety for USA Today, the New York
Times, the Boston Globe and George. I appeared on a segment of Dateline,
NBC that aired on April 11, 2000. Recently, I was appointed Clinical
Professor at Robert Wood Johnson Medical School. Lecturing is another
avenue I am pursuing to achieve my goal of educating the medical
community and the public to the dangers of office based anesthesia
including improperly designed and installed medical gas
systems.
MGM: Thank you for your
time and insights.
Note: Dr. Moss can be contacted
via E-mail at ervmo@aol.com or by
telephone, at (973) 744-8158.
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