Expert Witness in Surgery 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 surgical facilities and related properties. Attorneys litigating cases that involve construction defects, operating room design and air-handling problems, hybrid OR and integrated OR equipment integration issues, infection-control and ICRA failures, sterile processing and instrument reprocessing workflow defects, scope reprocessing room design defects, medical gas and emergency power problems, recovery (PACU and Phase II) area design problems, accessibility violations, fire safety and egress issues under the applicable occupancy classifications, water infiltration and building envelope failures, tenant fit-out disputes, phased-construction and occupied-renovation problems, and other claims related to the design and construction of surgical facilities 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 surgical facilities.
About Surgery Design and Construction
Surgery design and construction encompasses a range of surgical facility types, including hospital operating room suites, hybrid operating rooms (combining surgery with imaging), integrated and image-guided ORs, ambulatory surgery centers, office based surgery practices, endoscopy and procedure suites, cath labs and interventional procedure rooms, labor and delivery surgical suites and cesarean rooms, and the support spaces that serve them, including pre-operative areas, recovery (PACU and Phase II) areas, sterile processing departments, scope reprocessing rooms, soiled and clean utility rooms, medical gas storage, and staff and patient support spaces.
The design and construction of surgical facilities 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 for operating rooms and procedure rooms, ADA requirements, the FGI Guidelines for Design and Construction of Hospitals and Outpatient Facilities, CMS Conditions of Participation (for hospitals) and Conditions for Coverage (for ASCs), AAAHC and Joint Commission accreditation standards, AAMI ST79 standards for sterile processing, 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 surgical spaces; operating room air-handling, pressurization, humidity, and temperature control problems; hybrid OR and integrated OR equipment integration defects; infection-control failures and ICRA non-compliance during phased construction in occupied surgical suites; failures of medical gas, vacuum, waste anesthetic gas disposal, and emergency power systems; sterile processing workflow defects including non-compliant separation of soiled and clean functions and inadequate decontamination room pressurization; scope reprocessing room defects; recovery area design problems; non-compliant accessibility features; inadequate fire-rated assemblies and egress under the applicable occupancy classifications; tenant fit-out and landlord-tenant matters; and disputes arising from phased-construction and occupied-renovation projects in operating surgical facilities. 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 Surgery Design and Construction
Expert witness services in surgical facility 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) (along with ICRA plans, ILSM plans, commissioning reports, and operating room air balance reports), 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, accreditation standards, 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 surgical facilities.
An effective surgical facility design and construction expert witness must be able to explain technical requirements — operating room air-handling and pressurization, hybrid and integrated OR equipment integration, infection-control and ICRA requirements, sterile processing and scope reprocessing workflow, medical gas and emergency power design, fire-rated assembly construction, egress geometry under the applicable occupancy classifications, accessibility clearances, recovery area design, 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 surgical facility design experience includes operating room suites, ambulatory surgery centers, and office based surgery projects, including new construction, renovation, and conversion of office-based surgery practices to licensed ambulatory surgery centers. The firm has worked with a range of hospital surgical departments and freestanding surgical facilities. 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 surgical facility design and construction disputes.
Contact
Please contact Bernstein & Associates, for expert witness services related to the design and construction of surgical facilities.