Retained Foreign Object

Going into surgery can be an unsettling experience, regardless of the circumstances.  A person who is being operating on is completely at the mercy of the surgeon and the surgical team. They need to be able to trust that they are skilled at what they do, that they will effectively communicate with one another, and will have the ability to bring their full attention to the task at hand.  In most cases, all of this is true — or at least true enough to make the surgery successful.  But not always.

Every year there are approximately 1500-2000 cases reported where foreign objects are retained inside the body after a surgical procedure is complete. This is often referred to as retained foreign objects, but there is a push to use the term retained surgical items (RSIs) in order to properly distinguish between materials that are unintentionally inserted into and left in the body after a surgical procedure is complete. It would not include foreign objects such as swallowed pennies or bullets that get into the body before an operation begins.

RSIs are classified into four different categories,

  • Soft goods
  • Sharps
  • Instruments
  • Small miscellaneous items

Some of the odds and ends that are inadvertently left behind include things like sponges, wound packing materials, catheter tips and guide wires.

Depending on the area of the body involved, and the item left behind, RSIs can cause problems of varying severity. Frequently, some sort of negligence is involved, and the incident constitutes grounds for a medical malpractice lawsuit.  Failing to act in a way that a reasonable person would in a specific situation, or acting in a way that a reasonable person would not act is considered to be negligent, and a preventable human error.  Aside from the discomfort associated with these errors, there is an added downside that the expenses incurred are not eligible for reimbursement from the Centers for Medicare and Medicaid Services.

How Do Foreign Objects Get Left in the Body?

There are several reasons that can contribute to an RSI medical error. The most common involve the use of several surgical instruments or the necessity to preform multiple procedures in a single operation. Fatigue of the surgical team also plays a strong role.

Taking steps to prevent fatigue and keep surgeons and their teams alert is a shared responsibility. In many cases hospitals push staff members to produce more or take on high volumes of patients that can drive up fatigue levels. This may cause surgical teams to feel confused or rushed, and can lead to the breakdown of communication during an operation, particularly when there are staffing changes in the middle of an operation.

Less prevalent reasons for objects being left in the body include a high body mass in the patient or a situation where the patient is experiencing an excessive loss of blood.

Discovering and Reporting RSIs

When items are left in the body after surgery, they are not always discovered right away. At times the error is found just hours after an operation, and in other cases years can pass before it is noticed. In many cases the patient needs to undergo an additional surgery and take on the associated risks in order to have the item removed.

The protocol involved for a hospital to report the incidents in somewhat inconsistent, and can vary between states. In most cases, serious reportable events (SREs) get reported to the National Quality Forum (NQF).

The NQF has guidelines in place that distinguish between what needs to be reported and what does not.  Objects that are already in the body, and are left where they are not reported.  Some objects that enter the body unintentionally during a procedure are also not reported if it is determined that removing the item poses a greater danger to the patient than leaving it in place.

Also, the NQF only considers an incident reportable when it is not discovered until a surgical procedure is complete and the patient is out of the operating room.

Another OB/GYN consensus group makes similar reporting guidelines for objects that are left in the body after a spontaneous vaginal birth. This reporting period ends 1-2 hours after the birth when the woman has passed her immediate recovery period.

Fighting Back When Things Go Wrong

When an object is left in the body where it doesn’t belong, it seems logical to assume that an error took place. Many would assume that winning a medical malpractice lawsuit in such a case would be easy, and some may even believe that working with a lawyer on the case wouldn’t be necessary. However, just because a case should be easy doesn’t mean it will be.

One case that should have been easily settled in a case where a surgical towel measuring one foot by two feet was left in a woman’s upper abdomen and was not discovered until four months after her operation. This caused her considerable discomfort, additional medical problems, and put a serious damper on her quality of life. Still, there was no settlement reached during negotiations, and the case was forced to trial.

Working with a medical malpractice attorney is vital, and it is a given that the hospital will have a lawyer to help them present their case. If you have experienced problems because of an object that was left in your body after surgery, or suspect medical negligence for any reason, Davis  Levin Livingston in Honolulu may be able to help. Contact us for a free case evaluation.