Surgery can be a major medical intervention. Most patients don’t undergo surgery without giving it serious thought. In most cases, patients will undergo surgery after carefully considering the risks and benefits. There are still risks associated with surgery, even for the best surgical teams in the country. However, errors can occur that only happen because of medical negligence.
Surgical errors are more common than most people know. The surgeons and hospitals don’t like to broadcast how often surgical mistakes happen and may even downplay the frightening numbers. Surgical errors happen thousands of times a year, causing everything from unnecessary procedures to fatal accidents.
If something happened during a surgical procedure that didn’t seem right or you are not getting the answers you need from your medical team, you may want to get a consultation from a medical malpractice law firm. If you or a loved one was injured because of a surgical mistake, contact our office today online or by phone at 800-529-6162.
Surgical Errors and Never Events
According to a study published in the journal Surgery, surgical errors caused by negligence happen more than 4,000 times per year in the United States. “More than a decade ago, stories of wrong site surgeries and retained surgical objects galvanized the patient safety movement. Despite public uproar and attention focused on these never events, such incidents continue to occur at alarming rates.”
What Is a Never Event?
A “never event” refers to a medical error that should never happen and when they do occur, it generally involves medical negligence of the doctor, surgeon, hospital, or other healthcare workers. Never events are avoidable and preventable. Researchers track never events because they should not occur and end up costing the healthcare industry a lot of money and they cause unnecessary harm to patients and their families.
The National Quality Forum (NQF) tracks 28 events as “never events.” The primary surgical never events include:
- Wrong body part surgery
- Wrong patient surgery
- Wrong procedure surgery
- Unintended retention of a foreign object
According to a study by Johns Hopkins Medicine, surgical ‘never events’ occur at least 4,000 times per year in the U.S. That means that every year, 4,000 patients wake up after coming out of anesthesia and find that something went wrong during their surgical procedure. If the patient asks what went wrong, the surgical team may just shrug their shoulders because they don’t know what went wrong.
In many cases, the patient never gets a chance to find out what happened because death occurred in about 6.6% of the patients. Most patients (59.2%) fortunately only suffered a temporary injury. However, almost one-third of the patients who suffered a surgical never event error were left with a permanent injury, including loss of organ function, loss of a body part, disability, disfigurement, or chronic pain.
Unintended Retained Foreign Object
During surgery, the surgical team uses a variety of surgical tools, including scalpels, scissors, retractors, forceps, clamps, needles, gauze, towels, and sponges. These items are to be used during surgery and removed when surgery is completed. Surgical procedures often require a checklist to make sure that every tool and object used is accounted for at the end of surgery.
When a surgical team is negligent and leaves behind a surgical object inside the patient’s body, it can cause serious harm. Unfortunately, the statistics for retained objects in patients show that it is more common than it should be. A foreign object is left inside a patient’s body an average of 39 times per week in the U.S.
When an object is left inside a patient, it is not just an unwanted souvenir. Instead, a foreign object inside the body can cause serious damage. The body’s immune response tends to attack foreign bodies, like bacteria, viruses, and other things that shouldn’t be there. The body can’t tackle foreign surgical objects, which can lead to serious infection, tissue damage, inflammation, pain, discharge, and other symptoms. In some cases, if the foreign object is not addressed, it can be fatal.
Infections can be serious, leading to septic shock, sepsis, septicemia, infection shock, bacteremia, or SIRS systemic inflammatory response. In response to a serious infection, the body can shift the blood supply away from certain parts of the body to make sure the important organs are getting blood and oxygen, which can lead to sepsis-induced low blood pressure. If not corrected septic shock can be fatal.
In many cases, a retained foreign object takes a long time to discover. It can be difficult to identify a retained foreign object with some imaging scans and it may only be discovered after re-opening the surgical site. As a result, many left-behind errors are not discovered for weeks, months, or even longer. In one case, it was 7-years before a heart surgery patient was told that there was a piece of a broken catheter tube that was left in her aorta.
Wrong Site and Wrong Patient Surgical Errors
These are other types of never events that seem almost unbelievable when a patient learns what happened. This is not like going to a coffee shop and being handed someone else’s drink order. Surgical procedures are complex and involve a surgical team of trained professionals. Surgeons undergo years of education, training, and first-hand experience before they are even qualified to perform surgery. Making a mistake and performing the surgery on the wrong person is simply negligent.
According to the Johns Hopkins study, surgeons performing the wrong surgery or operating on the wrong patient happens about 20 times per week, and operating on the wrong body part happens about 20 times every week.
The Joint Commission is a nonprofit organization that accredits health organizations and care centers. The Joint Commission has made recommendations to address surgical errors and so-called “sentinel events,” to reduce surgical never events. “A sentinel event is a patient safety event that results in death, permanent harm, or severe temporary harm. The Joint Commission works closely with its organizations to address sentinel events and to prevent these types of events from occurring in the first place.”
Time Out Procedures in Surgery
A time-out in surgery is just what it sounds like. The surgical team takes a short pause just before the incision. During the time out, the team can confirm the patient’s identity, confirm the surgical procedure, and confirm the body part to be operated on. For example, the team member introducing the time out can confirm:
- Correct patient
- Correct side and imaging
- Correct site and position
- Correct procedure
- Correct instrumentation
Every team member should participate in the time-out to confirm the correct patient, procedure, and site. The time-out should not just be the duty of the surgeon because each member of the operating team brings their own unique perspective. Unfortunately, according to the Joint Commission, “the most common root causes with failures in the time out process have to do with human error, leadership, and communication.”
Comprehensive Surgical Checklist
The Association of periOperative Registered Nurses (AORN) developed a Comprehensive Surgical Checklist. These checklists are based on input from the Joint Commission and World Health Organization (WHO). Hospitals and surgical centers that use these types of checklists have improved communication and reduced the occurrence of surgical errors.
The checklist includes a preoperative check-in, sign-in, and time-out. As part of the preoperative checklist, the patient or patient representative first confirms with the registered nurse (RN):
- Procedure and site
- Site marking
The RN also confirms the presence of a history and physical, preanesthesia assessment, nursing assessment, diagnostic and radiology test results, blood products, and any special equipment, implants, or devices.
Are Risks and Adverse Events the Same as Surgical Errors?
All surgery carries some level of risk. However, surgical risks are not the same as surgical errors. Some risks cannot be totally eliminated, even when everything goes right. A risk is a possible danger that could happen during surgery. For example, common risks of surgery may include:
- Anesthesia risks
- Bleeding requiring blood transfusion
- Nerve damage
- Blood clots
- Heart attack
- Allergic reactions
- Damage to teeth (with anesthesia)
Risks may be unavoidable but medical negligence is avoidable. This is the difference between a surgical risk and surgical errors. With a surgical error, the doctor or surgeon makes a mistake because they fail to follow medical standards. Deviation from medical standards is a breach of the doctor’s duty of care. If the breach results in an injury to the patient, the doctor may be held responsible for the patient’s injuries, including paying compensation.
For example, a patient may understand that there are infection risks associated with surgery. However, if a surgeon does not wash their hands and causes the patient to become infected, that is not the same as a risk of infection. Proper medical standards require proper sanitation and disinfection procedures for surgery. According to the Centers for Disease Control and Prevention (CDC), hand hygiene for surgery provides:
- “When performing surgical hand antisepsis using an antimicrobial soap, scrub hands and forearms for the length of time recommended by the manufacturer, usually 2–6 minutes.”
If the surgeon failed to follow proper surgical procedures and it was demonstrated that the doctor’s deviation from hand hygiene procedures caused the patient’s infection, that could be considered medical malpractice.
Informed Consent and Medical Malpractice
A patient should be informed of all the potential risks of a surgical procedure, even if the risks are not common. This is part of getting informed consent from a patient to undergo a procedure. Informed consent involves understanding the surgical procedure, including the risks, benefits, alternatives, possible complications, and consequences of non-treatment.
Lack of informed consent can be a basis for medical malpractice. When it comes to informed consent, a doctor must disclose:
- The condition being treated;
- The nature and character of the proposed treatment or surgical procedure;
- The anticipated results from the proposed treatment or surgical procedure;
- The recognized possible alternative forms of treatment; and
- The recognized serious possible risks, complications, and anticipated benefits involved in the treatment or surgical procedure, as well as the recognized possible alternative forms of treatment, including non-treatment.
Perhaps not surprisingly, one study found that nearly 3/4ths of consent forms do not include the basic elements of informed consent. The Joint Commission put out a safety advisory on problems with informed consent, titled: Informed Consent: More Than Getting a Signature. In the paper, the commission identified several barriers to understanding the information involved, including:
- A lack of basic information on the consent form
- Ineffective communication between the provider and patient
- Lack of shared decision-making
- Lack of consideration of patients’ health literacy
- Lack of consideration of patients’ cultural issues
What Are the Consequences of Surgical Errors?
The consequences of a surgical error can depend on several factors, including the type of error, health of the patient, other medical conditions, and time after the error when action was taken to address the injury. Consequences of surgical errors can range from:
- Minor temporary injury
- Serious temporary injury
- Minor permanent injury
- Severe permanent injury
When it comes to medical malpractice errors, surgical errors can be more serious because it involves the dangers and risks associated with surgery. There are increased risks of:
- Surgical site infection
- Scarring and disfigurement
- Perforation injuries
- Nerve damage
- Oxygen deprivation
- Brain damage
- Organ damage
- Anesthesia injuries
The consequences for a patient who has suffered because of a medical mistake can be costly. The patient may need to undergo additional treatment to address the injuries. A serious injury may require continuing medical care for the foreseeable future. Injury victims may not be able to work because of their injuries or have lower earning potential because of limitations caused by the negligent surgery. As part of a surgery medical malpractice case, the injury victim can recover compensation for their economic damages and non-economic damages, like pain and suffering.
Find a Medical Malpractice Attorney After a Surgical Mistake
If you believe you suffered harm or injury because of the careless actions of your surgeon, contact a law firm that handles surgical error medical malpractice cases. Contact Gilman & Bedigian online or at 800-529-6162 for a free consultation.