Like millions of Americans, Dr. Ryan Katz plans to celebrate the Fourth of July at a barbecue with his family in Canton.
The only difference is that Katz, an attending hand surgeon at Union Memorial Hospital's renowned Curtis National Hand Center, knows not to stray too far from home. Katz, 39, is scheduled to be on call July 4-5, when people will be most at risk for fireworks-related injuries to hands, fingers and thumbs and upper extremities.
"I'll be local," he said. "I definitely see lots of fireworks injuries."
"Lots" is a relative term; Katz, one of four surgeons at the hand center, said they are "on the front line." He estimates that he alone has seen 6-10 patients with injuries in his 2 1/2 years there — everything from open wounds to fractures and loss of digits.
"Typically, they light a firework. It doesn't go off. They pick it up to see why, and it goes off," Katz said. "It's very common for them to lose some digits."
According to Union Memorial Hospital, 5,000 people went to hospital emergency rooms nationwide in a 30-day period around the Fourth of July last year. Also, 112 fires were reported in Maryland between 2008-12, the State Fire Marshal's Office reports. Fireworks-related fires and injuries appear to have declined since 2008, although a house fire related to fireworks has already been reported in Annapolis this year, officials said.
Most cases the hand center gets involve injuries to teenage boys. They recall one case in particular in which a teenage boy's thumb was blown off by a large M-80 firecracker. Surgery to reattach the thumb was successful, but, "That was two weeks in the hospital to accomplish that," said Dr. Ray Wittstadt, another attending hand surgeon in the center, who spoke at a State Fire Marshal's Office press conference June 27 to warn the public about the dangers of fireworks.
In many cases, the damage is so severe that there is little left to reattach digits to, doctors and fire officials say.
During the press conference, fire officials from around the state demonstrated the dangers of fireworks by blowing up a watermelon, a hard-boiled egg and a rubber hand attached to a firecracker.
Examining the rubber hand after the explosion, Wittstadt said, "You don't want one moment of carelessness to lead to a lifetime of regret."
'Let the professionals do it'
Fire officials' main advice was to avoid using any consumer-grade fireworks, and to enjoy public fireworks displays instead.
"Consumer fireworks are explosives," said William Goddard III, Howard County fire and emergency management services chief and chairman of the Metropolitan Fire Chief's Council.
"Let the professionals do it, while you sit with your family and enjoy the Fourth," said Jacqueline Olsen, president of the Maryland State Fireman's Association.
Baltimore City Fire Chief James Clack said his jurisdiction is one of three in Maryland that prohibits firecrackers of any kind, but that his staff has a "terrible" time trying to catch people violating the law.
"It's hard to enforce," Clack said.
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Part of the problem, Barnard acknowledged, is that laws are not uniform around the state, and conflict with laws in surrounding states. Though Baltimore City, Prince George's County and Montgomery County ban all fireworks, state law allows some ground-based sparkling devices and novelty fireworks, Barnard said.
Howard and Harford counties, as well as Ocean City, allow novelty but not ground-based sparkling devices, and Baltimore County and Anne Arundel County follow the state law, Barnard said. Pennsylvania law allows the sales of fireworks, but prohibits setting them off, so many consumers buy fireworks in Pennsylvania and light them in Maryland, he said.
Barnard thinks all consumer-grade fireworks should be banned in Maryland, but proposed legislation to do that has failed in the state legislature in recent years.
"The lobbying effort from the (fireworks) industry got through," he said.
For Katz, the surgeon on call July 4-5, it's a tense time, although, "After awhile you get used to taking calls," he said.
That includes fireworks injuries that occur July 5, "when people light the leftovers," he said.
Although Katz doesn't like to see fireworks injuries — — he looks at the injuries as a medical challenge and said, "It's not a burden. Trauma surgery can be very rewarding. I'd rather be down in the trenches."