The Retained Foreign Object.

Something is going on and I am not sure what it is or why.  The incidence of objects being left behind in the body of the patient is increasing.  What is being left behind, you ask?  Mostly it is the usual things:  sponges, towels, laparotomy pads, surgical instruments, and fragments of broken objects.  Recently, I have had three patients come to me with guide wires left behind.  I have no idea how anyone can leave a nearly three foot long guide wire behind.  Needless to say, none of these objects should be left in patients after medical procedures.

An example of retained surgical clamp (ntRSFB). Clinical presentation... | Download Scientific Diagram

The problem of foreign objects left behind following the performance of a medical procedure is one which has been around since the first surgeries were performed.  A lot of thought and effort has gone into developing safeguards to prevent it from happening.  In spite of all of the effort and thought, however, the problem still occurs with depressing regularity.  In fact, the problem seems to be increasing in its frequency.  More and more objects are being left behind.

Among the likely explanations for an increase in cases of surgical items being left behind, the Covid pandemic is at or near the top of the list.  Like so many aspects of our lives, the Covid pandemic upset the lives and routines of the surgical teams at hospitals.  Elective surgeries were postponed.  Highly skilled and experienced surgical teams were not allowed to perform surgeries and their teamwork and precision suffered.  Study after study has shown that teams which perform the same procedure over and over have the lowest complication rates.  They are like a well-oiled, precision machine.  The other side of the coin is that teams that only occasionally perform a procedure are more likely to have mistakes and poor outcomes.  Even good teams that have had their practices interrupted are going to accumulate some rust during the down time.

Not only has the Covid pandemic interrupted the routines of surgical teams, it has caused some highly competent medical professionals to leave the field or to shift to another area.  I have written in other posts about the ripple effects of traveling nurses being highly paid.  Some operating room nurses have chosen to leave the operating theater in return for a larger paycheck.  Some skilled nurses and technicians have just had it with the medical profession and the risk of infection and have moved to other fields or have retired.  When elective surgeries did resume, new teams had to be created and trained.  Even experienced teams had to work hard to get back to their pre-pandemic form.

The root problem is, of course, the fallible nature of the human beings who work in the health care system.  They are people and people make mistakes.  One of the procedures which has been developed to prevent objects from being left behind is the requirement that every object introduced into the operative field be counted before being used and again at the conclusion of the procedure.  If the counts do not match, the operative team must locate the missing object.  In almost every foreign object case I have ever seen, the counts were recorded as being correct.  Clearly, if an object was left behind, there was some error in the process of counting it.  Either it was not properly recorded before being used or was improperly counted as being present at the end of the procedure when it was in fact still in the patient’s body.

Retained foreign objects can cause catastrophic problems, including death and paralysis.  They routinely cause pain to the patient.  If not detected immediately after the operation, and many are detected at that time, they can cause infection and chronic health problems.  At a minimum, they are going to require another procedure to remove them from the body.

If you have had a medical procedure and an object has been left behind, if it is not discovered shortly after the procedure, it is usually only going to be discovered because you have unexplained pain that just won’t go away or because you develop chronic problems for which there is no good explanation.  The moral of the story is for you to be polite but persistent when you have prolonged pain or problems following a surgical procedure.   In most cases, it won’t be because of a retained object, but you want the doctors to get to the bottom of your problem, whatever it may be.

If you have had a foreign object left behind in your body following a procedure, go see an experienced medical malpractice attorney.  There is no excuse for objects to be left behind and you are entitled to compensation for the error.

Posted in blood infections, disclosure of medical mistakes, Doctors, Hospitals, Medical Devices, medical errors, Medical Malpractice, medical malpractice lawyers, medical mistakes, Medical Negligence, never events, Nurses, retained sponge, retained surgical instruments, Sepsis, Surgical Errors |