When something is left behind: the issue of “retained surgical items”

Every year, dozens of surgical items like sponges, needle tips, retractors and fragments of drill bits are left inside patients across the country.

All surgeries - particularly ones involving general anesthesia or conscious sedation - come with risks. There is a chance that the patient could have a bad reaction to the anesthesia medications and not wake up. It is possible that even the most skilled surgeon could knick a vital organ or blood vessel, resulting in serious harm or even death to the patient. Infections could be introduced into the patient's body despite meticulous hygiene of the operating room and members of the surgical team.

One risk of surgery isn't often talked about, but happens all too frequently: surgical items being left behind in patients following procedures (known in industry terms as "retained surgical items").

Important terminology

The term "retained surgical item" actually encompasses a wide range of different surgical tools and implements that are unintentionally left inside patients after surgery has concluded. The Joint Commission, a private watchdog organization that regulates medical providers across the country, reports that there were nearly 800 reported cases of retained surgical items between 2005 and 2012. Of course, this doesn't account for the unreported cases, and the real number could easily be 10-20 times higher.

Another important distinction that should be understood when discussing the phenomena of retained surgical items is that the reported cases only involve items left behind that were discovered after the patient had left the operating room. That being said, there is still the potential for harm to a patient if he or she needs to be opened back up immediately following a procedure; this would mean that the patient must spend longer under anesthesia, would face a higher risk of infection and is more susceptible to surgeon errors like accidentally cutting a vital organ.

Stopping this trend in its tracks

The most commonly retained surgical items are sponges (pieces of gauze used to remove blood from the surgical field during a procedure), broken components like needle tips, screws or drill bits, and retractors or clamps. These items are small and easily misplaced during the hustle and bustle of surgery. Patients who are overweight and those dealing with an emergency surgery situation are at the highest risk, since these situations might make it more difficult for a surgeon to see a bloody surgical implement.

Though the number of these cases is alarming, it is important to note that there are relatively easy ways to decrease the chances of this occurring. For example, patients are at a lower risk for retained surgical items if the hospital or facility has in place a strict policy about the counting of surgical implements before and after surgery.

In addition, using technology like bar codes or radiofrequency tags on surgical items will ensure that counts are correct in real time, and will allow for rapid detection of misplaced items. Furthermore, using radiopaque materials will allow retained cloth surgical items like sponges or surgical towels to show up on x-rays should the patient develop complications after surgery.

Even though the methods of "attacking" this problem are relatively simplistic, the matter of retained surgical items is a very serious one. These items can breed infection, puncture internal organs, damage blood vessels, perforate organs and cause severe pain or even death in patients. If you or a loved one has been injured by a surgeon's or other medical provider's negligence - regardless of whether that negligence was in the form of a retained surgical item or something else - speak with a medical malpractice attorney in your area today.

Keywords: retained surgical item, surgical error, surgeon error, hospital negligence, medical negligence, medical malpractice