Expert Witness in Surgery Construction
Empire Projects, Inc., through its principal William N. Bernstein, AIA, has provided expert witness services in matters involving the construction, renovation, and project management of surgical facilities and related properties, including hospital operating suites (general, orthopedic, cardiac, neurosurgical, transplant, robotic, and hybrid operating rooms), ambulatory surgery centers, hospital-based outpatient surgery departments, office-based surgery practices, and endoscopy suites. Attorneys litigating cases that involve the construction, renovation, or project management of these facilities will need an expert witness such as William N. Bernstein, 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, operating room and procedure room construction defects, air-handling and pressurization installation failures (positive pressure, temperature, humidity, and air change rates per ASHRAE 170), medical gas, vacuum, WAGD, and emergency power installation defects, sterile processing department workflow construction problems, infection-control and ICRA failures during phased construction, hybrid OR construction problems including integration of imaging equipment, accessibility violations, fire safety and egress under healthcare occupancy classifications, water infiltration and building envelope failures, and other claims related to surgery construction. Mr. Bernstein is an expert witness who understands both the applicable codes, standards, and contractual frameworks and the practical realities of how surgery construction and renovation projects are managed and executed in the field.
About Surgery Construction
Surgery construction and renovation encompasses a range of surgical facility types, including hospital operating suites (general, orthopedic, cardiac, neurosurgical, transplant, robotic, and hybrid operating rooms that integrate imaging equipment such as intraoperative CT, MRI, or angiography), ambulatory surgery centers, hospital-based outpatient surgery departments, office-based surgery practices, endoscopy suites, and the support spaces that serve them, including operating and procedure rooms, sub-sterile and decontamination areas, sterile processing departments (instrument decontamination, preparation and packaging, sterilization, and sterile storage with appropriate workflow and pressurization), pre-operative areas, recovery (PACU and Phase II) areas, scrub and sub-sterile alcoves, equipment storage, soiled and clean utility rooms, and patient and staff support spaces. Surgery construction is among the most technically demanding of healthcare construction work because it must coordinate complex MEP and medical-gas systems with rigorous infection-control, life-safety, and equipment-integration requirements, often in occupied hospital settings.
The construction and renovation of surgical facilities 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 Hospitals and Outpatient Facilities (Surgical Services chapters), CMS Conditions of Participation, AAAHC and Joint Commission accreditation standards, AAMI ST79 standards for sterile processing, and state and local department of health requirements. In addition, surgery construction projects are governed by private agreements — the prime contract and subcontracts, equipment manufacturer site planning agreements for hybrid OR imaging equipment, 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 surgery construction commonly arise over scheduling and delay claims, particularly when occupied phased work disrupts the surgical schedule and case throughput; change order disputes driven by department of health and accreditation review, hybrid-OR equipment manufacturer coordination, ICRA and ILSM issues, late-discovered field conditions, 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 MEP, medical gas, fire alarm, low-voltage, equipment-vendor, and architectural trades whose work must be carefully sequenced and tested in operating rooms; ICRA and ILSM non-compliance during construction, including breaches of dust containment, negative-air containment, and barrier integrity in active surgical environments; construction defects affecting operating-room air-handling, pressurization, humidity, and temperature control; installation defects in medical gas, vacuum, WAGD, and emergency power systems; sterile processing workflow installation defects including non-compliant separation of soiled and clean functions and inadequate decontamination room pressurization; hybrid OR construction problems including structural reinforcement, ceiling-mounted equipment integration, and imaging-equipment shielding; accessibility and fire-safety construction defects; building envelope and water-infiltration failures; commissioning and balancing failures; and disputes arising from phased construction. Responsibility for these issues is allocated, in different ways, among the operator, the contractor, subcontractors and specialty vendors (including hybrid-OR equipment manufacturers), 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 Surgery Construction
Expert witness services in 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, OR air balance reports, medical gas certifications, hybrid OR equipment vendor coordination records, commissioning 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 surgery construction, and the quantification of delay, disruption, and damages.
An effective surgery construction expert witness must be able to explain technical and project-management issues — construction sequencing and scheduling in phased and occupied surgical environments, change order management, contract interpretation (including AIA-form contracts and ConsensusDocs), construction means and methods, ICRA and ILSM implementation, operating-room and procedure-room construction and air-handling installation and balancing, medical gas, vacuum, WAGD, and emergency power installation, sterile processing and decontamination construction, hybrid OR construction including structural reinforcement and equipment integration, 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, equipment manufacturers, 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 surgery construction.