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The alarming frequency of items left inside patients

On Behalf of | May 10, 2024 | Medical Malpractice

Despite rigorous safety protocols, American operating rooms face a disturbing issue with nearly a dozen sponges and surgical tools inadvertently remaining inside patients’ bodies daily. Retained Surgical Items, or RSIs, refer to any foreign object unintentionally left in a patient’s body during surgery that is found after the surgical site has been closed.

According to one study, the occurrence of RSIs, which can range from one in a thousand to one in nineteen thousand procedures, is widely acknowledged as a preventable surgical error that qualifies as medical malpractice. In 2019 and 2020, RSIs were the second most common preventable incident reported to the Joint Commission International’s database, and in 2021, they were the third most frequently reported event. Sponges comprise about 70% of these retained objects, and clamps and retractors are also common RSIs. These can go undetected for years, leading to severe health complications and distress.

Why items get left behind

A myriad of factors contributes to the oversight of surgical items in patients. These include:

  • The chaos of emergency surgeries
  • Procedural distractions
  • Intraoperative changes
  • The high-pressure environment leads to mistakes

The repercussions can be severe

The aftermath of retained surgical instruments extends beyond immediate postoperative complications. Long-term retention can provoke the body to develop scar tissue and adhesions, causing persistent pain and potential gastrointestinal issues or infections. Tragically, autopsies found that RSI has also caused fatalities.

Strategies and innovations to combat RSI

Efforts to combat the risk of retained surgical instruments are diverse and innovative. Japanese hospitals often mandate pre-closure imaging, particularly after abdominal surgeries, to prevent such oversights. The American Association of Operating Room Nurses advocates for multiple surgical counts during procedures. Meanwhile, some institutions employ technology like bar-coded sponges for automated counting and radiofrequency-sensitive materials for enhanced detectability on X-rays, paving the way for safer surgical practices.