No Thing Left Behind in a Patient

Every year there are an estimated 4000 cases of surgical items left behind in patients after surgery, and the vast majority of them are sponges used to soak up blood.  Doctors often use dozens of them inside a patient to control bleeding.

Many different items are mistakenly left behind in patients such as clamps and scalpels, but sponges account for about two-thirds of the items.

When balled up, soaked in blood and tucked inside a patient, a 4-by-4-inch cotton sponge is easy to miss, especially inside large cavities. Abdominal operations are most frequently associated with retained sponges, and surgeons are more likely to leave items in overweight patients.

Hospitals traditionally require that members of a surgical team, usually a nurse, count — and then recount, multiple times — every sponge used in a procedure. But studies show that in four out of five cases in which sponges are left behind, the operating room team has declared all sponges accounted for.

In recent years, new technology and sponge-counting methods have made it easier to remedy the problem. But many hospitals have resisted, despite the fact that groups like the Association of Operating Room Nurses and the American College of Surgeons have called on hospitals to update their practices.

As a result, patients are left at risk, said Dr. Verna C. Gibbs, a professor of surgery at the University of California, San Francisco.

“In most instances, the patient is completely helpless,” said Dr. Gibbs, who is also the director of NoThing Left Behind, a national surgical patient safety project. “We’ve anesthetized them, we take away their ability to think, to breathe, and we cut them open and operate on them. There’s no patient advocate standing over them saying, ‘Don’t forget that sponge in them.’ I consider it a great affront that we still manage to leave our tools inside of people.”

Now hospitals have a more technological approach at their disposal. They can track sponges through the use of radio-frequency tags. In a study published in the October issue of The Journal of the American College of Surgeons, researchers at the University of North Carolina at Chapel Hill looked at 2,285 cases in which sponges were tracked using a system called RF Assure Detection. Every sponge contained a tiny radio-frequency tag, about the size of a grain of rice. At the end of an operation, a detector alerts the surgical team if any sponges remain inside the patient. In the U.N.C. study, the system helped recover 23 forgotten sponges from almost 3,000 patients over 11 months.

Read entire story by Anahad O’Connor of the New York Times.

When doctors and nurses make mistakes, it can have a devastating effect on your life.  The Lawyer Referral Service of the New Hampshire Bar Association can help with a referral to an experienced attorney who has maintained specific education and experience standards in Medical Malpractice law.  Call 603-229-0002 for a free consultation, or fill out our online request form.

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