Surgical Objects Left Behind

By Josh Silverman on October 23, 2013

To err is human, but some mistakes are inexcusable.  1500 times per year a patient leaves an operating room with surgical material mistakenly left in his or her body.  These objects include surgical sponges, towels, needles and other instruments.  Women appear to be at heightened risk.  I'm working on at least my third case involving a surgical sponge left inside of a woman who had a c-section.  Statistically female pelvic surgery and abdominal surgery (for men and women) are the surgeries that most commonly result in objects being abandoned in a patient.

During surgery it should be a team effort between the nurses and the surgeon to prevent objects from being left in a patient.  One of the most important responsibilities of the circulating nurse is to keep an accurate count of all instruments in the surgical field.  That means having an accurate count of sponges prior to surgery, maintaining a count of all sponges put in the body during surgery, keeping an accurate count of all sponges removed during surgery and prior to closure of the surgical incision, and doing a final sponge and instrument count.  If the count is ever off, the nurse must notify the surgeon.

The surgeon should never disregard the nurse if the nurse reports that the count is off.  If the retained object can not be found, an intra-operative x-ray should be taken to locate the object and then the surgeon should remove it.  There are rare occasions when the patient is too unstable to wait for an x-ray, but that is the exception not the rule. 

The consequences of failing to follow these operating room procedures are serious.  In almost all cases the patient will have to undergo a second surgery with all the risks of complications that come with any operation.  In many cases, the object will only be suspected after the patient develops a serious life threatening infection. 

Virginia has a two year statute of limitations for most medical malpractice cases.  However, because retained foreign surgical objects may not be detected until several years after the event, later the patient is given an additional year after the object is detected to file a lawsuit with a maximum of ten years after the surgery.  These cases can be complex so if you or a family member has been injured due to a retained foreign object you should consult with an attorney promptly so your rights can be protected. For more information, I've set up a practice page on my website on retained surgical objects.

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