Noted Philadelphia Medical Malpractice Case Receives National Attention and Sparks Controversy: No Sponge Left Behind
Often times, surgical operations are bloody procedures. They involve the use of hundreds of instruments and dozens of surgical sponges which are gauze-like pads used for sopping up blood. Each time the doctor asks for a surgical sponge, a nurse is to count them aloud before handing them over, which is a standard way of keeping track of equipment to make sure no sponge is left behind.
Prior to closing the patient, at least one other count or exchange takes place between the surgical nurse and the surgeon. The Chief Surgeon is the "captain of the ship" and has a duty to make sure no instrument or sponge is left inside the patient. Otherwise an x-ray will have to be taken to detect one or more of the reflective strips on each sponge or the surgeon will have to go inside an open cavity, pushing organs around to hunt for lost instruments.
In one of the cases handled by the expert Philadelphia medical malpractice lawyers at Reiff and Bily, an unwanted souvenir of a surgical procedure was left inside a patient's body causing catastrophic injuries. For more than a year, our client walked around unaware of a surgical sponge that she carried inside of her body while she spiked fevers and had numerous infections and returned to her doctor complaining of the same. The client had to be hospitalized repeatedly until the client almost died from her uncertain cause of infection and injury.
According to a recent article, about 80 times per year in the Philadelphia region, the tools of surgery, including but not limited to surgical sponges, gauze, scalpels, needles, retractors and other instruments, are found left behind inside of patients. This medical malpractice mistake occurs about once in every 3,800 surgeries in Southeastern Pennsylvania according to the Philadelphia Inquirer analysis of hospital billing data.
Sometimes these mistakes can go undetected for years until they cause problems and sometimes, in fact, they are found by accident. Sometimes people are not even aware that they have an instrument accidentally sewn inside of them until they set off a metal detector in an airport, which is the case with a cancer patient in Seattle who did not learn of the reason for a searing pain in his stomach until he set off a metal detector at a local airport which indicated that there was a 13" metal instrument left inside his abdomen at the University of Washington Medical Center.
It is imperative that surgical teams try hard to count and recount instruments to determine that their instruments are safely removed. Presently, patients’ main protection comes from variations of medical practice whereupon two nurses count each instrument at key points throughout the operation.
The Philadelphia medical malpractice law firm of Reiff and Bily handled a case against a Philadelphia suburban hospital that won several national awards for its safety efforts. This particular case gained national attention. Last year an appeals court in Pennsylvania upheld a Reiff and Bily $1.5 million jury verdict against the hospital for a surgical sponge or gauze left inside a 67-year-old Philadelphia woman after a hysterectomy. The hospital called the verdict unreasonably large. Even one of the best Philadelphia hospitals whose system ranks nationally in federal research grants faces a suit from a New Jersey man who says his doctors left a sponge inside of him for fourteen months after removing part of his colon.
Medical experts have been trying to do away with areas such as this for decades. Regulators have been slow to collect cases and study them. New Jersey health authorities state that they lack a comprehensive system to track medical errors and Pennsylvania is hoping to start such a system within the next year under a new patient safety authority. The main national group that assures hospital quality, the joint commissioner and accreditations of health organizations, also does not specifically collect information on foreign body cases. A recurring issue in all of these mentioned cases is the legal responsibility of the surgeon, often a private physician, as opposed to the nursing staff employed by the hospital. The surgeon is generally in charge of the surgical procedure but often designates to his/her staff the responsibility to count sponges to make sure all are properly accounted for before the patient is closed up.
Unfortunately true incidents of surgeons leaving instruments or sponges behind happens too frequently and is a serious problem in medical care today. The American College of Surgeons has issued a statement of policy designed to prevent the problem of leaving foreign bodies inside surgical patients. (ST-51) American College of Surgeons noted that prevention of foreign body retention requires good communication among peri-operative personnel (personnel follow up with the patient just before, during and after surgery involving nurses, surgical technologists, anesthesia professionals and surgeons) as a consistent application of reliable and standardized procedures of care.
Recommendations to prevent the retention of sponges, sharps, instruments and other designated miscellaneous items include but are not limited to: 1. Consistent application and adherence to standardized counting procedures; 2. Performance of methodical wound exploration before closure of the surgical site; 3. Use of x-ray detectible items in the surgical wound; 4. Maintenance of an optimal operating room environment to allow focused performance on operative tasks; 5. Employment of x-ray or other technology (e.g. radio-frequency detection bar coding) as indicated to ensure there is no unattended items remaining in the operative field; 6. Suspension of these measures as required in life threatening situations; 7. Documentation of surgical item counts for notification of surgical team members of items left intentionally and of any count discrepancies; 8. Surgical facilities must provide resources to ensure equipment and personnel are adequate to implement these safety measures; 9. Policies and procedures for the prevention of retained foreign bodies should be developed, reviewed periodically and revised as necessary. See the bulletin of the American College of Surgeons Vol. 90, #10, October, 2005.
When such foreign objects are left inside the patients after surgery, doctors, nurses, anesthesiologists and the entire medical team may be found liable for medical negligence. If you or a loved one has been hindered by such medical negligence and would like to speak to an experienced Pennsylvania medical malpractice lawyer at Reiff and Bily, please contact us for a free consultation about your legal rights at 1-800-421-95959 or online at www.reiffandbily.com.
