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Troubling Rate Of Foreign Objects Left In Patients After Surgery And Preventive Measures

February 14, 2013

There are many complications that can occur during surgery. Some complications can occur under the best of care. Others occur because of preventable surgical errors. According to recent research conducted by John Hopkins School of Medicine spanning over two decades, at least 500 objects are mistakenly left inside patients during surgery every year. This figure is based on the number "paid medical malpractice claims" rather than all incidents of retained surgical instruments. According to the Department of Health and Human Services, the real number of surgical objects left behind could be as high as 5,000 every year.

During any given surgery, 100 or more surgical objects are used by the surgical team. For more complicated surgeries, more than 500 surgical items may be used. The most common mistakenly left behind object during surgery is a sponge. Other inadvertently retained objects left in patients include towels, needles, scalpels, clamps, knife blades, and suction tips.

The harms caused by retained surgical instruments vary widely. The greatest danger often involves sharp instruments. These items can puncture vital organs and vessels. When this occurs, patients can bleed out quickly and die well after leaving the hospital.

There are multiple reasons that explain how surgical instruments are accidentally left behind. The most common include human exhaustion, missing tools that would otherwise be used to obtain an accurate count, and chaotic surgical environments. All of these factors have been shown to increase the risk of retained surgical instruments.

There are various methods that can be used to substantially reduce, if not eliminate, the risk of surgical objects left behind. The most well-known measure used to prevent retained surgical instruments is a surgical checklist. Much like an aviation checklist for pilots, a surgical checklist forces the surgical team to identify or check off each item needed during surgery and returned after surgery. In addition to a surgical checklist, there is now a new technology being used during surgery that accounts for surgical instruments. Bar code technology has been implemented in some hospitals allowing surgical teams to scan instruments needed before surgery and returned after surgery. In the event the surgical teams realizes a foreign object was left behind before closing up the patient, a wand can be used that reads the bar code of the particular object through human flesh. Of course, not all objects left behind can have a bar code. That is why bar code technology and other emerging technologies should be used in conjunction with traditional measures like surgical checklists to dramatically reduce or eliminate the risk of surgical instruments left inside patients.

Sources Used:

Washington Post, Surgeons Left 4,857 Objects In Patients Over the Past Two Decades, December 20, 2012.

University of Michigan Health Organization, University of Michigan Health System Creates System To Prevent Retained Surgical Items, February 6, 2012.

Wikipedia, Retained Surgical Instruments, January 27, 2013.

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