Expert Witness in Emergency Departments Design and Construction
Bernstein & Associates, Architects, through its principal William N. Bernstein, AIA, has provided expert witness services in matters involving the design and construction of emergency departments and related properties. Attorneys litigating cases that involve construction defects, triage and intake area design problems, treatment room and trauma bay layout and equipment integration issues, airborne infection isolation (AII) and pressurization failures, decontamination area design defects, ambulance bay and EMS workflow problems, behavioral health and psychiatric ED holding area design and anti-ligature failures, imaging within the ED (CT, x-ray, ultrasound) shielding and structural issues, medical gas and emergency power problems, accessibility violations, fire safety and egress issues under institutional occupancy requirements, water infiltration and building envelope failures, phased-construction and occupied-renovation disputes in operating emergency departments, and other claims related to the design and construction of emergency departments require an expert witness architect who understands both the applicable building codes and standards and the practical realities of how those requirements are applied in the design, construction, and renovation of real emergency departments.
About Emergency Departments Design and Construction
Emergency department design and construction encompasses a range of ED types, including general adult emergency departments, pediatric emergency departments, behavioral health and psychiatric emergency departments and psychiatric ED holding areas, trauma centers (Level I, II, III, and IV), freestanding emergency departments, and the support spaces that serve them, including triage, treatment rooms, trauma and resuscitation bays, fast-track and minor care areas, observation units, airborne infection isolation rooms, decontamination areas, ambulance bays, imaging rooms within the ED, and staff and patient support spaces.
The design and construction of emergency departments is governed by a complex framework of technical standards, including the applicable building code (for example, in New York City, the New York City Building Code), the International Building Code, ICC A117.1, NFPA 101 Life Safety Code, NFPA 99 Health Care Facilities Code, ASHRAE 170 ventilation standards (including requirements for airborne infection isolation rooms), ADA requirements, the FGI Guidelines for Design and Construction of Hospitals (Emergency Services chapter), CMS Conditions of Participation, EMTALA-related design considerations, Joint Commission standards, and state and local department of health requirements such as those administered, in New York, by NYSDOH.
Disputes commonly arise over construction defects affecting building envelopes, interior finishes, and clinical spaces within the ED; triage, intake, and waiting area design defects; treatment room and trauma bay layout problems; airborne infection isolation room pressurization, anteroom, and ventilation failures; decontamination area design and equipment integration defects; behavioral health holding area anti-ligature and safety failures; ambulance bay door, canopy, and weather-protection issues; shielding and structural problems at ED imaging rooms; medical gas, vacuum, and emergency power failures; non-compliant accessibility features; inadequate fire-rated assemblies and egress under institutional occupancy; and disputes arising from phased-construction and occupied-renovation projects in operating emergency departments. Responsibility for compliance with the applicable standards is shared, in different ways, among the operator, the landlord, the design professional, the contractor, subcontractors, specialty vendors, and the party responsible for ongoing maintenance, and litigation in this area frequently turns on the allocation of responsibility for design decisions, construction means and methods, and post-occupancy maintenance.
Expert Witness Services Related to Emergency Departments Design and Construction
Expert witness services in emergency department design and construction matters typically include a careful review of the project documents (drawings, specifications, submittals, RFIs, change orders, permits, certificates of occupancy, ICRA plans, department of health filings and approvals, lease agreements, commissioning reports, and as-built conditions), a site survey to measure and document the conditions at issue, comparison of those conditions against the applicable building codes, life safety codes, healthcare facility guidelines, accessibility standards, and industry standards of care, review of construction administration records and maintenance histories, and the preparation of clear, well-supported opinions regarding the cause of the defect or failure, the responsibility of the various parties, and the standard of care applicable to the design, construction, and maintenance of emergency departments.
An effective emergency department design and construction expert witness must be able to explain technical requirements — triage and intake flow, treatment room and trauma bay layout, airborne infection isolation room design and pressurization, decontamination area requirements, behavioral health holding area anti-ligature design, ambulance bay design, ED imaging shielding, medical gas and emergency power systems, fire-rated assembly construction, egress geometry under institutional occupancy classifications, accessibility clearances, and building envelope detailing — in plain language to judges, juries, arbitrators, and mediators, and must have the credentials, written record, and courtroom-ready communication skills to render credible opinions.
Mr. Bernstein is a Yale-trained, NCARB-certified, LEED-accredited, registered architect. He has expertise in architectural design, engineering design, and construction as the founder/owner of an architectural firm, Bernstein & Associates, Architects, (1990-present) and as the founder/owner of a construction project management firm, Empire Projects, Inc. (2003-Present). He has been the expert witness (as of May 2026) on (40) cases involving design and construction (2006-present) across the United States and Internationally.
Mr. Bernstein’s emergency department design experience includes general and psychiatric emergency department projects in hospital settings, including renovation and expansion work in occupied EDs. The firm has been awarded a psychiatric ED project featured in published healthcare design coverage. This depth of hands-on architectural design experience — from program development and code analysis through construction administration and commissioning — provides the technical foundation needed to render credible expert opinions on emergency department design and construction disputes.
Contact
Please contact Bernstein & Associates, for expert witness services related to the design and construction of emergency departments.