When Your Surgeon Doesn't Count Their Tools

In 2002, the National Quality Forum published a list of “serious reportable events,” also known as “never events.” Never events are medical events that are seriously harmful, largely preventable, and clearly identifiable—making public accountability for these events necessary. Some of these events are horrifying mistakes, such as the amputation of the wrong limb or the discharge of a baby to the wrong parents.

Why Tool Counts Are Vital to Your Health

So, why are surgeons required to count their tools before and after a procedure?

Because the leading never event is when a surgeon leaves their tools inside the patient’s body.

When your surgeon leaves a surgical tool inside of you—a sponge, gauze, anything that isn’t designed to remain in your body—the mistake is referred to as a "retained surgical item.” These are unambiguously preventable mistakes, so why are a dozen patients a day ending surgery with harmful items left in their bodies?

How Often “Retained Surgical Item” Mishaps Occur

According to a report by USA Today, thousands of patients each year are left with surgical items in their bodies—mostly sponges used to soak up blood and fluid during surgery. Despite these mishaps occurring on a regular basis, few hospitals have adopted technology that can all-but-eliminate the risk of retained items.

Because of this negligence, many patients suffer for years before anyone can discover the cause of their symptoms, which include crippling pain and raging internal infections. Even once the cause of the problem is determined, a retained surgical item can cause irreversible damage: some patients with this injury will lose portions of their intestines, and others may even die as a result.

While there’s no way to determine the exact number of patients who suffer because of retained surgical items, best estimates based on research studies suggest between 4,500 and 6,000 patients are injured this way annually. Federal reporting of these events is not mandatory, so exact figures are difficult to find.

Healthcare professionals admit that these figures may be lower than the actual rate. Retained sponges are often the most underreported incidents in healthcare, despite the fact that it is already the most common never event. The hidden nature of this issue is partially from a lack of accountability.

An Easy Fix for a Serious Problem

The figures alone are staggering, but what’s far worse is that there is an easy solution readily available that hospitals are choosing not to use. Electronic tracking devices can be attached to sponges to eliminate the risk of retained items. These sponge-tracking systems only add about $8 to the cost of an operation, yet fewer than 15% of American hospitals employ the technology. For patients who bear the brunt of these hospitals’ cost-cutting decisions, the financial toll is almost as bad as the physical one—hospitalizations caused by retained surgical objects often cost more than $60,000. Hospitals save patients and costs with better safety.

Manual Counting Is Not the Best Solution

Most hospitals forego sponge trackers in favor of sponge counts in order to keep track of their gauzy pads during surgery. The system is simple—count the number that go in; count the number that come out. However, it also subject to human error, meaning patient safety may be affected by a tired or distracted surgical team.

By contrast, hospitals that use the electronic tracking systems say they have not lost a single sponge since employing the technology. The average annual cost to a hospital for using the tracking system is between $200,000 and $300,000, but the health benefits are well worth the price.

The medical injury attorneys at Arnold & Itkin believe those who suffer retained surgical object injuries have the right to demand compensation from their hospitals, who did not take the necessary steps to keep patients safe.

If you’ve been injured by negligent surgeons, call our firm at (888) 493-1629 for a free consultation.


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