Health Care Newsletter
Failure to Remove Foreign Instruments After Surgery
As alarming as it may seem, surgical teams have left objects and instruments used during operation inside the body of a patient. Every year, foreign bodies are left in nearly 1,500 patients in surgeries performed in the United States.
What are Foreign Bodies?
Foreign bodies can be a variety of equipment used during a surgical procedure. Foreign bodies include sponges, clamps, retractors, needles, knife blades, safety pins, electrodes, clips, cotton and gauze. Sometimes, even a combination of foreign bodies can be left inside a patient after a surgical procedure.
Why Does a Foreign Body Get Left Behind?
Many studies have been conducted to determine the reason that foreign bodies would be left behind, in order to deter future similar accidents. However, a singular cause could not be pinpointed.
The accidents were found to be attributed more to the stress of an emergency or complication that manifests while the patient is on the operating table, as opposed to physician fatigue. One study established that emergency room surgical procedures were nine times more likely to leave a foreign body in the patient, and a complication requiring a change in procedure made the likelihood of a retained foreign body four times more likely.
What are the Safeguards to Protect Against a Retained Foreign Body?
There is a standard practice, that after every surgical procedure, the surgical team is to count every piece of equipment that is on the table and compare it with the number of tools that was placed on the table prior to the commencement of the procedure. Two-thirds of the foreign body mistakes happen despite this procedural safeguard.
The American College of Surgeons recommends that the following procedures be followed to prevent the retention of foreign bodies in the patient:
- Consistent application and adherence to standard counting procedures
- Performance of methodical wound exploration before closure of the surgical site
- Use of x-ray detectable items in the surgical wound
- Maintenance of an optimal operating room environment to allow focused performance on operative tasks
- Employment of x-ray or other technology (i.e. bar coding, radiofrequency detection) to ensure items have not been left in the patient
- Suspension of these measures as required in life-threatening situations
The Aftermath of a Retained Foreign Body
As a result of the foreign body, most patients endure excruciating pain, and later discover the presence of the retained foreign body through a subsequent doctor visit. Usually, a patient will require an additional surgical procedure to remove the object as a foreign body will rarely come out on its own.
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