Retained Surgical Instruments

retained surgical instruments

Surgical instruments can be left in a patient’s body after surgery. This medical error can result in serious complications, including pain, infection, and in some cases, death. At a minimum, a patient will face additional surgery so that the items left behind can be removed.

What is RSI?

Retained surgical instruments are sometimes called “RSI” or retained foreign bodies and can happen while being treated in a hospital. These are things that were not designed to be left in the body, but are items that may be utilized during a surgical procedure. Examples of retained foreign bodies include sponges, towels, needles, knife blades, safety pins, scalpels, clamps, scissors, tweezers, forceps, suction tips and tubes, scopes and many other devices inadvertently left in a patient’s body. Sponges, in fact, are the item most frequently left behind. The abdomen is the most common location for an RSI incident. The most frequently reported retained instrument is a malleable (shapeable) or ribbon retractor.

It is not unusual during a procedure for surgical clips and staples to be utilized and left in the body. These items are generally designed with the understanding that they may need to be left in the body. While there are times that a clip may migrate and create a problem for an individual, that does not mean that it would be negligent on the part of the healthcare provider to have left it from the outset.

Prevalence of RSI Cases

A 2011 study in the World Journal of Surgery says there are an estimated 1,500 to 2,000 retained surgical instrument cases a year in the U.S. If a retained item is expected to do little or no harm, the surgical team has no obligation to report the incident. That’s why many organizations that have studied RSI say estimates of how many cases arise each year are lower than the actual number of incidents. Regardless, leaving a surgical instrument in a patient’s body may be medical negligence that resulted in serious harm to a patient.

Regardless, leaving a surgical instrument in a patient’s body may be surgical malpractice that resulted in serious harm to a patient. As the World Journal of Surgery says, “We now know that retention has very little to do with patient characteristics and everything to do with operating room culture.”

For wronged patients and/or their families, the only recourse is to seek compensation for the physical, emotional and financial harm imposed on them through a personal injury or fatal injury lawsuit. Call our Indiana medical malpractice lawyer at our toll-free number or fill out our online contact form to schedule a free consultation.

How Retained Surgical Items are Left Behind

An invasive surgery can involve hundreds of surgical items and instruments. They must all be accounted for so that none are left in the patient’s body. It may seem obvious that the key to making sure no surgical instruments are left behind is to keep a count of what surgical items are used and where each one ends up.

Unfortunately, a surgical environment is stressful and often fast-paced. Making a count quickly can lead to mistakes. A 2008 study by the Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts, found miscounts in one out of eight surgical cases.

Authors of the Center for Surgery and Public Health study observed 148 elective general surgery operations. They found 29 discrepancies in 19 operations involving:

  • Sponges (45%)
  • Instruments (34%)
  • Needles (21%).

The Joint Commission, a non-profit accrediting and certification service, identified high risk categories for retained surgical instruments that include:

  • Emergency surgery – Organizing a surgical team quickly is difficult in such situations, which makes maintaining an accurate count of materials used a greater challenge.
  • Deviations from planned procedures – Unexpected complications during surgery can create confusion and increase the risk of losing track of how many implements have been used.
  • Patient weight – A higher mean body-mass index (obesity) puts a patient at increased risk for retained objects.
  • Failure to follow counting procedures – It is standard practice for operating room nurses to count sponges once at the start of a surgical procedure and twice at its conclusion, the Joint Commission says. Instruments are to be counted in all procedures involving open cavities. If all materials are not accounted for at the conclusion of a procedure, radiography or manual exploration must take place.
  • Communication breakdowns – In complex and lengthy surgeries, teams of nurses and technicians may change at some point. Poor communication between the teams can lead to miscounts and retained surgical instruments, the Center for Surgery and Public Health says.

Even when a miscount is identified during surgery, the incident puts the patient at risk as the operation is delayed while a count is repeated. The Center for Surgery and Public Health found that each discrepancy in surgical item accounting took an average of 13 minutes to resolve.

Retained surgical instruments and items can lead to post-procedure infections, bowel perforation, abscess, undue pain, return to surgery, and even death, the Joint Commission says.

And, according to the Joint Commission, “The consequences extend beyond clinical complications and often include additional financial burdens such as extended lost time from work, additional expenses related to frequent follow up visits and additional medications.”

Retained Surgical Instruments and Your Legal Rights

Medical professionals have a duty to meet a recognized standard of care. When they fail to live up to their duty, patients and their families have a right to seek money damages.

If you or a loved one has been harmed by an incident of retained surgical instruments/items, you may seek compensation for medical expenses, lost wages, pain and suffering and other damages through a wrongful death or personal injury lawsuit.

Statute of Limitations: Except in certain cases, in Indiana you only have two years from the date you believe a health care provider acted negligently in which to file a formal Complaint for Damages against the health care provider. If you fail to do so within that period of time, your claim will be forever lost. If a patient does not know of the negligence, or in the exercise of reasonable diligence, could not discover that he or she sustained an injury within the two years after the negligent care was provided, then the patient has two years from the date when he or she discovers the negligence and resulting injury or discovers facts that, in the exercise of reasonable diligence, should lead to the discovery of the negligence and the resulting injury in which to file a lawsuit.

This means it’s important to act immediately if you or a loved one has suffered injury because of a retained surgical instrument or item. Contacting a skilled and experienced Indiana retained surgical instruments attorney at the Law Office of Kelley J. Johnson can be crucial.

Contact Our Indiana Surgical Errors Attorney Today

With nearly 20 years of litigation experience, malpractice attorney Kelley J. Johnson has the knowledge and skill to hold medical professionals and hospitals accountable for the physical, emotional and financial harm they cause by incidents of retained surgical instruments (RSI) or retained foreign bodies.

To schedule a free and confidential review of your surgical malpractice case, call an Indiana surgical errors attorney at the Law Office of Kelley J. Johnson today at our toll-free number or fill out our online contact form. We’ll respond within 24 hours.

Last Updated September 18, 2015