A study done by researchers at Brigham and Women’s Hospital
and Harvard School of Public Health, in Boston was published in the January
16, 2003 New England Journal of Medicine reported on the high number of
surgical tools left inside patients during surgery.
The study on medical mistakes found that operating room
teams around the country leave sponges, clamps and other tools inside about
1,500 patients every year, largely because of stress from emergencies or
complications discovered during surgery. The researchers checked insurance
records from about 800,000 operations in Massachusetts for 16 years ending
in 2001. They counted 61 forgotten pieces of surgical equipment in 54
patients. From that, they calculated a national estimate of 1,500 cases
yearly. A total of $3 million was paid out in the Massachusetts cases,
mostly in settlements.
The study showed that two-thirds of the mistakes happened
even though the equipment was counted before and after the procedure, in
keeping with the standard practice. It also claimed that these types of
mistakes happen more often to fat patients, simply because there is more
room inside them to lose equipment.
Most lost objects were sponges, but also included were metal
clamps and electrodes. In two cases, 11-inch retractors, metal strips used
to hold back tissue, were forgotten inside patients. The study found that
emergency operations are nine times more likely to lead to such mistakes,
and operating-room complications requiring a change in procedure are four
times more likely. The lost objects were usually lodged around the abdomen
or hips but sometimes in the chest, vagina or other cavities. They often
caused tears, obstructions or infections. One patient died of complications.
Dr. Sidney Wolfe, health research director of the
public-interest lobby group Public Citizen, said the real number of lost
instruments may be even higher, because hospitals are not required to report
such mistakes to public agencies. Dr. Kaveh Shojania, author of a 2001
federal study on medical mistakes, summed the report up by saying,
"Something has to be done about this. It's just a very tough balance to