Expert Witness in Ambulatory Surgery Construction
Empire Projects, Inc., through its principal William N. Bernstein, AIA, has provided expert witness services in matters involving the design and construction of ambulatory surgery centers (ASCs), office-based surgery practices. Attorneys litigating cases that involve the construction of ambulatory surgery centers will need an expert witness such as William N. Bernsten, AIA, to address: construction defects, scheduling and delay claims, change order disputes, contractor and subcontractor performance issues, project management failures, cost overruns and budget disputes, payment disputes and mechanic’s liens, contract administration and interpretation, means and methods, construction safety, infection-control and ICRA failures during phased construction in occupied medical office buildings, operating room and procedure room air-handling and pressurization disputes, medical gas and emergency power installation problems, sterile processing and scope reprocessing workflow construction defects, recovery area (PACU and Phase II) construction problems, accessibility violations, fire safety and egress under healthcare occupancy classifications, water infiltration and building envelope failures, tenant fit-out disputes in medical office buildings, licensing and certificate-of-need issues affecting construction, occupied-renovation problems in operating ASCs, and other claims related to ambulatory surgery construction. Mr. Bernstein is an expert witness who understands both the applicable codes, standards, and contractual frameworks and the practical realities of how ambulatory surgery construction and renovation projects are managed and executed in the field.
About Ambulatory Surgery Construction
Ambulatory surgery construction and renovation encompasses a range of outpatient surgical facility types, including multi-specialty ambulatory surgery centers, single-specialty ambulatory surgery centers (orthopedic, ophthalmology, gastroenterology/endoscopy, ENT, plastic and cosmetic surgery, pain management, oral and maxillofacial surgery, and others), office-based surgery (OBS) practices, hospital-based outpatient surgery departments, endoscopy centers, and the support spaces that serve them, including operating rooms, procedure rooms, 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. Ambulatory surgery construction nearly always occurs in occupied or partially-occupied medical office buildings where adjacent tenants must continue to operate, infection-control risk assessment (ICRA) and interim life-safety measures (ILSM) must be planned and maintained throughout construction, and coordination with infection prevention, clinical engineering, and facility staff is essential.
The construction and renovation of ambulatory surgery centers is governed by a complex framework of building codes, regulations, and industry 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 Outpatient Facilities, CMS Conditions for Coverage for Ambulatory Surgical Centers, 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 (including Article 28 licensure requirements) and, for office-based surgery, by the AAAASF, AAAHC, or Joint Commission accreditation required by New York Public Health Law § 230-d. In addition, ambulatory surgery construction projects are governed by private agreements — leases and work-letters in medical office buildings, the prime contract and subcontracts, and institutional procurement and approval procedures. These projects are also typically subject to insurance requirements, indemnification obligations, and bonding requirements that materially affect how risk is allocated and how disputes are resolved.
Disputes in ambulatory surgery construction commonly arise over scheduling and delay claims, including disruption to other building tenants and to ongoing surgical operations during phased construction; change order disputes driven by department of health and accreditation review comments, unforeseen field conditions in existing medical office buildings, and owner-directed scope changes; cost overruns and budget disputes; payment disputes and mechanic’s liens; contractor and subcontractor performance and coordination failures, particularly among mechanical, electrical, plumbing, medical gas, fire alarm, and low-voltage trades whose work must be carefully sequenced and tested in operating rooms and procedure rooms; ICRA and ILSM non-compliance during construction, including breaches of dust containment, negative-air containment, and barrier integrity; construction defects affecting operating room air-handling, pressurization, humidity, and temperature control; installation defects in medical gas, vacuum, waste anesthetic gas disposal (WAGD), and emergency power systems; sterile processing workflow installation defects, including non-compliant separation of soiled and clean functions and inadequate decontamination room pressurization; scope reprocessing room construction defects; accessibility and fire-safety construction defects; building envelope and water-infiltration failures; tenant fit-out disputes including work-letter interpretation and base-building coordination; commissioning and balancing failures; and disputes arising from phased construction and occupied renovation in operating ASCs. Responsibility for these issues is allocated, in different ways, among the ASC operator, the landlord, the contractor, subcontractors and specialty vendors, the construction manager or owner’s representative, the design professional, infection-prevention staff, and the party responsible for ongoing maintenance, and litigation in this area frequently turns on the allocation of responsibility for construction means and methods, sequencing, supervision, quality control, commissioning, and post-occupancy maintenance.
Expert Witness Services Related to Ambulatory Surgery Construction
Expert witness services in ambulatory surgery construction matters typically include a careful review of the project documents (drawings, specifications, submittals, RFIs, change orders, schedules and schedule updates, daily reports, meeting minutes, pay applications, lien waivers, permits, certificates of occupancy, ICRA plans, ILSM plans, department of health filings and approvals, certificate-of-need approvals, accreditation survey reports, commissioning reports, operating room air balance reports, punch lists, 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, contract documents, and industry standards of care for construction and project management, review of construction administration records and maintenance histories, and the preparation of clear, well-supported opinions regarding causation, responsibility, the standard of care applicable to the construction, renovation, and project management of ambulatory surgery centers, and the quantification of delay, disruption, and damages.
An effective ambulatory surgery construction expert witness must be able to explain technical and project-management issues — construction sequencing and scheduling in phased and occupied healthcare projects, change order management, contract interpretation (including AIA-form contracts and ConsensusDocs), construction means and methods, ICRA and ILSM implementation, operating room and procedure room air-handling installation and balancing, medical gas and emergency power installation, sterile processing and scope reprocessing workflow construction, accessibility installation, fire safety and egress construction under healthcare occupancy classifications, construction safety, code compliance, commissioning, and the allocation of responsibility among owner, contractor, subcontractors, construction manager, design professionals, and specialty vendors — 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 a construction project management firm, Empire Projects, Inc. (2003-Present), and as the founder/owner of an architectural firm, Bernstein & Associates, Architects (1990-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.
Contact
Please contact Empire Projects, Inc., for expert witness services related to ambulatory surgery construction.