Summary — HB 390: "Alleviate the Dangers of Surgical Smoke"
Status snapshot
- Bill number: HB 390
- Short title: Alleviate the Dangers of Surgical Smoke
- Introduced: Filed November 12, 2024 (House sponsors in the NC edition include Reps. Cunningham, White, Blackwell, Reeder)
- Last recorded procedural status (multiple entries across records): reported out of committee in April 2025 but later indefinitely postponed / withdrawn from committee (recorded actions include “Currently Indefinitely Postponed” on 2025-05-06 and “Withdrawn From Com” on 2025-05-19).
- Proposed effective date (if enacted): January 1, 2026
Purpose and intent
- Require hospitals and ambulatory surgical facilities to adopt and implement policies that require the use of smoke evacuation / filtering systems whenever surgical procedures are likely to generate “surgical smoke.” The aim is to reduce exposure of surgical staff and patients to airborne contaminants produced by energy-based surgical devices.
Key provisions
- Definitions:
- “Surgical smoke” — gaseous by-products from energy-generating devices (e.g., surgical plume, laser-generated airborne contaminants, bio‑aerosols).
- “Smoke evacuation/filtering system” — equipment (stand-alone or portable) that captures, filters, and eliminates surgical smoke at the site of origin before it reaches occupants’ eyes or respiratory tracts. The bill specifies such equipment is not required to be tied into the facility’s ventilation or medical gas systems.
- Hospital requirement (new G.S. 131E-78.4): Each licensed hospital must adopt and implement policies mandating use of an approved smoke evacuation/filtering system for any surgical procedure likely to create surgical smoke.
- Ambulatory surgical facility requirement (new G.S. 131E-147.2): Same policy and implementation requirement for licensed ambulatory surgical facilities.
- Enforcement: The Department of Health and Human Services (DHHS) may take “adverse action” against a hospital under G.S. 131E‑78 or against an ambulatory surgical facility under G.S. 131E‑148 for violations of the new sections. The bill does not specify new civil penalties beyond DHHS’s existing adverse action authority.
Who is affected
- Directly: hospitals and licensed ambulatory surgical facilities operating in the state; surgical teams (surgeons, nurses, anesthesiologists, OR technicians); facility administrators responsible for policy, purchasing, and compliance.
- Indirectly: patients undergoing procedures that generate surgical smoke; equipment manufacturers and vendors of smoke evacuation systems.
Potential impacts and considerations
- Occupational health benefit: expected reduction in staff and patient exposure to airborne surgical by-products, with potential long‑term reductions in respiratory and other health risks.
- Facility costs: capital outlays to purchase smoke-evacuation units, plus ongoing maintenance, consumables (filters), and staff training. Cost magnitude will vary by facility size and procedure volume.
- Implementation issues: the bill leaves technical standards (e.g., minimum capture efficiency or certification) unspecified, potentially resulting in varying facility policies unless DHHS or rulemaking later provides standards or guidance.
- Enforcement: reliance on DHHS adverse action mechanisms rather than new fines; practical enforcement and inspection protocols would need to be developed.
Procedural/timeline notes
- The bill text specifies an effective date of January 1, 2026 if enacted.
- Legislative records show movement through committee and floor processes in 2025 but also indicate the measure was later postponed indefinitely or withdrawn from committee. Confirm current status with the chamber clerk or legislative website for the most recent disposition.
Bottom line
HB 390 would mandate that licensed hospitals and ambulatory surgical facilities adopt policies requiring the use of smoke-evacuation equipment during procedures likely to produce surgical smoke, empowering DHHS to enforce compliance. If enacted, the law would raise facility compliance costs but aim to improve workplace and patient safety by reducing exposure to hazardous surgical plumes.
