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A sales associate demonstrates how to use an electronic cigarette in this 2011 file photo.

(Associated Press)

Syracuse, N.Y. - A Syracuse hospital is warning patients not to use electronic cigarettes after a patient on oxygen caught fire while puffing on one of the devices.

Joe Galloway, a Syracuse Fire Department investigator, said the cause of the March 22 fire at St. Joseph's Hospital Health Center has not been determined yet, but he confirmed the patient had an electronic cigarette.

Dr. Sandra Sulik, the hospital's vice president of medical affairs, is convinced an e-cigarette sparked the fire. "There's no doubt about it," she said.

Electronic cigarettes, or e-cigarettes, deliver nicotine or other substances to a user in the form of vapor. The fire investigation at St. Joe's comes at a time when there is growing concern nationally about the safety of e-cigarettes which are not regulated by the government and have been linked to poisonings and fires.

The patient, whose identity was not released by the hospital, was burned across her face from ear to ear, said St. Joe's spokeswoman Kerri Howell. The patient had an e-cigarette in her mouth and was using oxygen when the fire started, Howell said. The patient is now at home doing well, Howell said.

The woman suffered first- and second-degree burns and was transported to the burn unit at Upstate University Hospital, according to Galloway.

Brandon Leonard, a St. Joe's patient safety representative, was in the patient's first-floor room helping her roommate when he heard a loud pop and saw flames through a privacy curtain separating the patients' beds.

Leonard, who is also an emergency medical technician, ran to the other side of the room where he saw flames around the patient's nose and fire shooting out of the end of a hose connected to an oxygen outlet in the wall. Leonard said he grabbed a blanket and put out the flames on the patient in less than a minute. Gyan Dahl, a nursing student working on the floor, came into the room and turned off the oxygen. As a precaution, the hospital briefly shut off oxygen to the entire floor and patients who needed oxygen were hooked up to oxygen tanks.

Oxygen itself is not flammable. But medical oxygen increases oxygen levels of normal air, making it easier for fires to ignite. That's why people are advised not to smoke or have other ignition sources near oxygen.

Jennie DeLee, a registered nurse at St. Joe's, heard yelling and went into the room where the fire occurred. "The patient was standing at the side of the bed," she said. "I just saw black soot and charred skin. She was in shock."

DeLee summoned the hospital's rapid response team who stabilized the patient and moved her to the intensive care unit before she was taken to Upstate.

Hospital officials said the quick response of Leonard, Dahl, Delee and other staff prevented what could have been a catastrophe and more serious injury to the patient.

E-cigarettes typically contain a rechargeable, battery-operated heating element, a replaceable cartridge filled with liquid nicotine or other chemicals and an atomizer that when heated converts the contents of the cartridge into a vapor. Manufacturers of the smokeless, odorless devices say they can be used almost any place.

Thomas Kiklas, cofounder of the Tobacco Vapor Electronic Cigarette Association, said he's not heard of any cases of e-cigarettes igniting oxygen.

Kiklas said there have been a few reports of e-cigarettes exploding. He said those cases involved e-cigarettes that were overcharged or users who put the wrong batteries in them.

The federal Centers for Disease Control and Prevention recently reported a dramatic increase in calls about e-cigarettes to poison control centers. Many of the calls involve children who got sick after swallowing or touching liquid nicotine.

The U.S. Food and Drug Administration also has received at least four reports of e-cigarettes causing fires. Those reports are listed on its website.

Three of the reports indicate e-cigarettes exploded while the devices were charging. Those reports say the explosions burned an e-cigarette user, set a 3-year-old's clothing on fire and ignited a house fire. A fourth report says an e-cigarette exploded while the user was driving a car, causing second-degree burns to his mouth and face.

The York Press, a British newspaper, recently reported an e-cigarette exploded in a crowded pub, scorching the dress of the bartender.

There is no government regulation of e-cigarettes. The FDA is expected to issue proposed rules governing e-cigarettes soon.

The FDA says e-cigarettes have not been evaluated for safety and effectiveness. Limited laboratory studies by that agency found significant quality issues. The FDA says cartridges labeled as containing no nicotine contained nicotine. It also found three different electronic cartridges with the same label that emitted a different amount of nicotine with each puff.

Since the fire, St. Joe's has been telling patients e-cigarette use is not allowed. The hospital has a policy that prohibits tobacco use inside its buildings or outdoors on its campus. The policy also prohibits e-cigarette use.

Sulik said some e-cigarette users who have quit smoking regular cigarettes do not consider themselves smokers and assume anti-smoking rules do not apply to them. Sulik said the patient who was burned had quit smoking three years ago, but had not told hospital staff about her e-cigarette use before the fire.

Now when staffers question patients about tobacco use they ask if patients use e-cigarettes and explain why they are not safe to use in the hospital, Sulik said. The hospital also is making new signs to alert patients, visitors and staff that e-cigarette use is prohibited.

You can contact health writer James T. Mulder at jmulder@syracuse.com or (315) 470-2245. Follow him on Twitter @JamesTMulder.