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Retained Surgical Instruments

Every year, thousands of people have surgical instruments or equipment left behind in their bodies after surgery. The surgical team’s carelessness can result in pain, infections, and even death for the patient.

When this medical error occurs, an individual can seek recovery of damages through a medical malpractice lawsuit. A patient will likely need another surgery and experience pain from the object inside their body.

Surgical instruments

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What Types of Retained Surgical Items Are Left Behind?

The physicians and nurses operating may use hundreds of different tools during a surgical procedure. Many surgical items are used on and within the surgical opening to control bleeding and keep the area accessible.

Some common retained surgical objects are:

  • Sponges
  • Scissors, tweezers, needles
  • Scalpels
  • Gauze
  • Retractors
  • Clamps, forceps
  • Knife blades
  • Safety pins
  • Suction tips and tubes

By far, sponges are the most common equipment left behind, as they are often indistinguishable from the tissue surrounding them.

A sponge will be challenging to see on an X-ray reading because it can easily be mistaken for an abscess. It is estimated that two-thirds of all tools left behind in the body are sponges.

Most cases of retained surgical sponges include sponges that are left in the abdomen, vagina, thoracic cavity, and pelvis.

Risks Associated With Retained Surgical Instruments

Medical professionals must use many surgical instruments and not lose track of them during a surgical procedure. The longer a surgery may take, the more tools are needed to complete a procedure.

These two factors can increase the risk of human error. Human factors, including exhaustion, increased chaos, and distractions, can play a role in losing surgical instruments inside the patient’s body.

Surgical teams can become tired and distracted during a lengthy surgery. An emergency procedure or a change in procedure can create further chaos in the operating room and lead to a higher risk of retained surgical instruments.

According to the Joint Commission, unintended retained foreign objects have been the most frequent event reported that causes death or severe harm in patients.

Contributing Factors for Retained Surgical Instrument Errors

Surgeons and their teams must have procedures and organized systems to avoid leaving an instrument in a patient. Some of the contributing risk factors for retained surgical instruments are listed below.

Keeping an inventory of surgical items: There should be item counts made before and after the surgery, bar codes attached to tools to track inventory, and a complete examination that needs to be performed before closing the opening. Some facilities have electronic tracking systems in place to keep track of items.

These devices assist medical professionals in knowing that it is safe to close the patient’s opening. A surgical instrument is considered retained if found after complete skin closure.

A change in the procedure: If a complication occurs during a surgical procedure, the medical team will likely need to quickly change the types of tools they will need.

Emergency procedures: An emergency surgery can also have a high risk of human error due to the chaos and rush to prepare the proper instruments for use on the patient.

Poor communication: In cases where there is a chaotic situation, such as an emergency procedure, it may be difficult for the staff to understand who is in charge of keeping count of the items. If nurses and staff rotate in and out of surgery, a sound communication system must also be implemented.

Other Common Factors Result in Retained Items

Many factors can increase the chance of a patient suffering from a retained surgical item. Other common risks include:

  • Lack of tools necessary to have an accurate count of instruments
  • High BMI (body mass index)
  • Chaotic environment
  • Fatigue in the medical staff

Complications That Can Occur From Retained Surgical Instruments

Any retained surgical instrument left behind in a patient’s body can lead to serious adverse events. Sometimes retained items can have little effect on the patient’s health.

In many cases, severe injury and complications can occur from a retained item.

The Effects of a Retained Sponge

Retained surgical sponges will begin to rot and accumulate bacteria, resulting in infection and ulceration. A retained sponge in the patient’s body can further affect organs by wrapping around them.

A retained sponge is also likely to be left within the body cavity because they quickly become bloody and blend in. A patient with a retained surgical sponge will potentially need to undergo major surgery to remove it.

Complications That Result From Sharp Retained Objects

Sharp instruments, including needles, scalpels, and blades, can puncture tissues, veins, and vital organs. Heavy internal bleeding, internal tissue damage, and other complications can occur in a person with a sharp retained surgical instrument.

If a sharp retained surgical item punctures the stomach or one of the intestines, the contents of these organs can leak into the abdominal cavity causing an infection called peritonitis. Emergency surgery is required for this complication.

Unretrieved Device Fragments

Unretrieved device fragments are broken or fractured parts of medical devices left in a patient’s body. These device fragments can include broken screws, needle tips, and part of a drill bit.

Adverse events from unretrieved device fragments can include local tissue reaction, perforation and obstruction of blood vessels, infection, and death.

Infections Caused by Retained Retained Items

Infection is likely with any retained item and can lead to pain, swelling, fever, organ damage, and even death. If a patient has an infection, they must seek medical attention immediately

Signs That You Have a Retained Surgical Instrument

The primary symptom of a retained item for an individual will be severe pain. Other signs that can indicate you have a retained surgical instrument are:

  • Severe pain
  • A high fever
  • Fatigue
  • Infection
  • The incision area contains pus or blood
  • Discoloration around the incision area
  • Edges of the incision start to open
  • Constipation or difficulty urinating
  • Vomiting or coughing up blood
  • Difficulty breathing
  • Numbness or tingling in the hands or feet
  • Strong odors coming from the incision area

Symptoms can occur very soon after the surgery, but there are also cases where symptoms can take years to surface. If a long time has passed since the procedure, it can be difficult for a doctor to determine that a retained item is the cause.

You should consult your doctor as soon as you experience these symptoms to prevent further damage.

Precautions and Testing for Identifying Retained Objects

Medical professionals may use X-rays to find retained items, but small objects, such as needles, may not be found in a scan. It can be challenging to find a retained item due to the location of the fragment, possible migration of the object, and patient anatomy.

Magnetic resonance imaging (MRI) testing may also be used to locate an item and can cause metal fragments to migrate. Once the retained item is found, the patient will have to undergo another surgery.

There are some cases where removing a small retained item may be unnecessary. A method that allows retained instruments to surface before a patient experiences any symptoms are thorough follow-up examinations.

A missing sponge or device fragment can be easily missed during and after surgery. A patient may undergo an X-ray during a follow-up visit, revealing any surgical item left inside.

A precaution that the surgery team can take during a procedure is to place used sponges in clear bags before disposing of them so that the staff can make an accurate count. The hospital can also perform audits and observe staff members when they perform surgical counts.

Retained Foreign Objects Are Preventable Medical Errors

According to the National Quality Forum, this medical error is one of the “never events” that should never happen in a medical facility. Yet, hundreds of people are victims of retained foreign objects every month.

These medical errors are considered clearly identifiable, preventable, and can result in severe consequences to the patient.

These errors also reveal a problem in patient safety and the credibility of the health care facility where this complication occurs. Medical facilities need well-maintained systems to prevent patients from enduring devastating injuries.

The accurate number of retained foreign objects is difficult to determine because there are instances where medical staff has been encouraged not to report an inaccurate count to avoid liability issues. Facilities should work to improve their systems and enact new measures if necessary.

A patient that needs to undergo another surgery and more treatment will accrue additional medical costs and suffer a lower quality of life. The surgeon, other staff members, and the hospital will likely be held responsible for this error in a medical malpractice lawsuit.

Medical Malpractice Attorneys Prosecuting Cases When Surgeons Leave Instruments In The Body

When a surgical instrument is left in the body after surgery and causes injury, it is usually a clear medical malpractice case. This error should never happen, and the victim should receive financial compensation for their injuries and future medical care.

Patient safety must be handled seriously because patients are already in a vulnerable state during surgical procedures. When a surgical team is negligent in maintaining patient safety and keeping track of surgical instruments, a patient can suffer life-devastating consequences.

If you or a loved one is a victim of retained surgical instrument malpractice, our team ofmedical malpractice attorneys at Rosenfeld Injury Lawyers LLC can help. Our attorneys are experienced at handling these complex cases and will fight to compensate you for your damages.

Our Chicago law group will thoroughly investigate your situation and guide you through the process of filing a medical malpractice lawsuit. Call our office at (888) 424-5757 and will schedule a free consultation with one of our experienced attorneys.

All confidential or sensitive information you share with our legal team remains private through an attorney-client relationship.


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