Retained Surgical Foreign Bodies

Retained Surgical Foreign Bodies

It should almost go without saying that any instruments that are used by a medical professional during a surgical procedure should not be left inside the patient’s body unless this was intended as part of the procedure.

Indeed, NHS guidelines dictate that all of the appliances used should be accounted for, both before the procedure and once it has been completed.

Despite these rigorous checks, retained surgical foreign bodies are not unknown and some studies suggest that as many as one-in-500 operations leave foreign bodies behind.

The discovery of a foreign body in a patient following surgery normally occurs due to a non-specific complaint. The foreign body can present as a mass usually in the abdominal cavity and is diagnosed through radiological interpretation. If a patient complains in the period after the operation of pain, frequent infections and a palpable mass, then this would suggest the presence of a foreign body.

The presence of a foreign body will often necessitate a further operation to remove the object which can lead to more serious complications, such as septic shock or damage to internal organs.

The most common objects left behind in patients after surgery are surgical swabs and gauzes used to stem and absorb blood flow during an operation, although in rarer cases solid objects such as clamps, drains and scalpels have been found.

In 2008, the World Health Organisation introduced its Surgical Safety Checklist – a 19 point guide to help operating staff avoid surgical blunders. The Checklist was endorsed by the Royal College of Surgeons of England and the Royal College of Anaesthetists, and within months, the National Patient Safety Agency called on all NHS Trusts to implement it immediately.

The Checklist states:

“Retained instruments, sponges and needles are uncommon but persistent and potentially calamitous errors. The scrub or circulating nurse should therefore verbally confirm the completeness of final sponge and needle counts. In cases with an open cavity, instrument counts should also be confirmed to be complete. If counts are not appropriately reconciled, the team should be alerted so that appropriate steps can be taken (such as examining the drapes, garbage and wound or, if need be, obtaining radiographic images).”

Despite the universal acceptance of the Checklist, studies are now showing that 88% of retained surgical foreign bodies occur in a situation where the instrument counts were declared “correct”. It is argued that counting instruments during operations is difficult, especially during emergency surgery such as abdominal trauma, in which the whole team is engaged in treating the patient.

At Wolferstans we recognise the adverse effects that retained surgical foreign bodies can have on individuals and have an experienced team of medical negligence lawyers who can provide help and support in securing compensation awards in respect of these injuries. Recently at Wolferstans we have recovered £7,500 for a client who suffered a right pneumothorax and had a guide wire left in his chest following the insertion of a drain and £2,000 for a client who suffered an infection arising from a retained surgical tampon following the repair of an episiotomy site.

If you have suffered an injury as a result of a retained surgical foreign body, then please telephone Michelle Nkomo on 01752 292248 or e-mail for a free consultation and advice.

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