Any medical procedure can cause patients to experience some level of anxiety. For one Chicago woman, those fears became a reality in the years following two unrelated procedures in two different Illinois hospitals. After the second surgery, she returned to the emergency department multiple times reporting extreme abdominal pain. On two occasions, CT scans were performed. However, she alleges that the health care staff implied she was imagining or fabricating the issue.
Four years later, the patient went to a third hospital. There, a scan revealed a foreign object inside her abdominal cavity. She retrieved her medical records from the first two scans and discovered that this unidentified foreign object was visible in these two scans, as well. As a personal injury attorney in Chicago knows, the Illinois statute of limitations restricts the filing of malpractice lawsuits to two years after the issue occurs, so she may not be able to receive compensation for her pain and suffering or the medical bills incurred by the repeated hospital visits.
Adverse surgical events
Adverse events, also known as sentinel events and never events, are issues that should never occur during the course of providing health care to patients. A retained foreign object, or RFO, is one such event when it is reported after surgery, which means the completion of skin closure. After this point, removal of the surgical item places the patient at a higher risk of adverse consequences because the surgical procedure must be extended, or a new procedure must be instigated. Either of these actions increases the time under anesthesia. A personal injury attorney in Chicago believes that a failure to identify and correct an adverse event at the point of skin closure represents a significant system failure.
The Centers for Disease Control and Prevention reports that there were 51.4 million inpatient surgeries in the United States in 2010. Johns Hopkins patient safety researchers examined medical malpractice claims located in the National Practitioner Data Bank in an attempt to analyze the rates of harm caused by issues such as wrong site surgeries and retained foreign objects. They discovered there were nearly 10,000 of these claims that resulted in judgments paid over a 20-year time period. The researchers estimated that a surgical instrument or sponge is left inside a patient’s body after surgery roughly 39 times each week.
A study published in the Agency for Healthcare Research and Technology stated that, out of 190,000 surgeries, they discovered that patients suffered from retained foreign objects at an actual rate of one out of every 5,500 operations. Most of these occurred in spite of the fact that correct counts were reported, and some even occurred in cases where intraoperative imaging was used.
Self-reporting systems
Organizations such as The Joint Commission, a patient safety group, warn that sentinel event reports represent a small proportion of the actual occurrences, and that no conclusions about the relative frequency of these events should be drawn from the studies that are available. Reporting the event is often voluntary, and a health care provider or facility may choose not to report a sentinel event if they fear recrimination or legal action. For this reason, researchers believe the documented numbers are much lower than the actual rate of surgical errors. An event that is purposely unreported by medical professionals may not become apparent before the statute of limitations makes it difficult or impossible to file a malpractice lawsuit.
Causes and prevention
According to The Joint Commission, sentinel event data shows a number of causes of the RFOs that are reported. These include a lack of policies and procedures or a failure to comply with them, hierarchy and intimidation issues among the medical staff, communication failures, and lack of adequate staff education. The Patient Safety Commission includes other risk factors, such as emergent surgery, unexpected changes during the procedure, and high patient body mass index.
Many health care facilities are attempting to reduce the incidence of retained foreign objects by addressing the issues and adding technology such as bar code scanners that detect items left behind before the patient’s incisions are closed. However, the majority of hospitals are apparently ignoring the problem, prompting some medical professionals to call for new legislation that addresses the root causes and mandates corrective actions.
Common RFOs
Surgical items left inside patients cause a number of complications in themselves, as well as problems stemming from immune system responses. Some responses are specific to the type of object. The Joint Commission reports that the most common retained foreign objects include the following:
- Sponges and towels
- Small items such as broken instrument parts, guidewires and catheters
- Sharps such as needles
- Surgical instruments
Non-fibrous objects such as broken or whole instruments, sharps and wires frequently cause infection. They may also puncture an organ, causing impairment of function and extreme pain. Fibrous objects such as sponges and towels often cause infection, abscess and obstruction. Organs may absorb them and develop leaks or tears.
Sponges also may cause a reaction called a pseudotumor, which is an enlargement that resembles a tumor and must be removed to prevent further damage. Sponges are the most frequently left behind because they resemble human tissue when they are soaked in blood, and they do not show up on scans before or after the patient is sewn up.
The early discovery of an RFO may prevent a great deal of future pain and make recovery possible. The Centers for Medicare and Medicaid Services show that the average cost of a hospital stay after an RFO correction is well over $60,000. Patients who are suffering excessively after a surgery should not hesitate to seek a second opinion. A personal injury attorney in Chicago may be able to help injured patients pursue justice in the case of medical malpractice.
