Retained Objects Miscounted in 13% of Surgeries

Retained objects, such as scalpels, sponges and other surgical instruments, can create serious problems for patients. Cases involving retained foreign objects are rare, occurring in only 1 out of every 5,000 surgeries, but a new Annals of Surgery study suggests that inconsistencies in counts occur in 13 percent of surgeries.

The National Quality Forum classifies a retained object case as a “never event” or seriously reportable event. Medicare recently implemented a new program where it will no longer pay hospitals to correct surgical mistakes. There are 10 conditions that Medicare deems to be reasonably preventable and will therefore no longer reimburse the hospital for expenses associated with these conditions. Many insurers have also stopped paying for conditions in which they believe to be preventable.

The Annals of Surgery study found that most discrepancies regarding instrument counts are the result of surgical technologists or nurses misplacing surgical items, usually sponges, in the operating room. According to researchers, it takes an average of 13 minutes to resolve these discrepancies.

“For the number of sponges and instruments that need to be tracked during complex cases, it’s beyond what we should expect human beings to be able to do. We know there’s inevitable human error there,” stated Caprice C. Greenberg, MD, MPH, the lead author of the study and surgical oncologist at Brigham and Women’s Hospital in Boston.

Some hospitals are starting to use technology as a way to track surgical instruments. For example, Mayo Clinic in Rochester, Minnesota has begun using bar-coded surgical sponges that must be scanned in and out. These sponges only cost $9 per surgical case and help to improve detection of count discrepancies.

ClearCount Medical Solutions of Pittsburgh, Pennsylvania sells a radio-frequency identification system. The system includes dime-sized RFID tags, which are embedded in sponges. The sponges are then tossed into a receptacle that counts them. A reusable wand is used to detect unaccounted-for sponges that could be inside the patient or around the operating room.

There are differences in opinion regarding whether or not the new technology implementations will correct the problem of retained objects. Some experts believe that the lack of standardized processes can prevent the technology initiatives from being fully effective.

If you were a patient and had a retained object following surgery, contact the law offices of Lilly, O'Toole & Brown, LLP at (863) 683-1111 to speak with a Florida medical malpractice attorney.

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