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What to Do About Wrong Site Surgery Errors

It may sound unbelievable that a doctor would take out a left healthy kidney instead of the bad right kidney. As a result, instead of one good kidney, the patient would be left with no good kidneys and require a kidney transplant even though they had a perfectly good kidney before the surgery. 

Waking up from anesthesia can be disorienting but imagine waking up from anesthesia only to be told there was a problem during surgery and the doctor operated on the wrong part of your body. How can this happen? How can a trained medical professional make such a terrible mistake? What can you do about a wrong-site surgery error?

If you suffered a surgical injury in the wrong part of your body because of medical malpractice and want to know about how much your claim might be worth, talk to experienced trial attorneys about your case. Your medical malpractice law firm can help you understand your options and help you recover money to compensate for your losses.

What Is a Wrong Site Surgery Error?

A wrong-site surgery occurs when there is a problem in the communication or understanding of the surgical team. Instead of a doctor doing the correct procedure, the surgeon operates on another part of the patient’s body. This can happen when the doctor mixes up the sides of the body (right vs. left), when the doctor mixes up the patients (patient awaiting leg amputation vs. patient for appendectomy), or other serious errors. 

Wrong-site surgeries are almost always preventable errors. These kinds of “accidents” only occur when something goes wrong and someone makes a mistake. In medicine, these are known as “never events.” According to the Agency for Healthcare Research and Quality, never events refer to particularly shocking medical errors that should never occur, like a wrong-site surgery. Surgical never events include: 

  • Surgery or other invasive procedure performed on the wrong body part
  • Surgery or other invasive procedure performed on the wrong patient
  • Wrong surgical or other invasive procedure performed on a patient
  • Unintended retention of a foreign object in a patient after surgery or other procedure
  • Intraoperative or immediately postoperative/postprocedure death in a healthy anesthesiologist patient

Example of Wrong Site Surgery Error

In this example, a Connecticut woman filed a lawsuit against the Yale-New Haven Medical Center over a wrong-site surgery that was allegedly covered up by the hospital. The patient had a painful lesion on the 8th rib and went in for surgery to remove the possibly cancerous lesion. A surgical trainee was added to the surgical team, under the supervision of other members of the Yale hospital staff. 

According to standard surgical procedures, radiologists marked the 8th rib using metal coils and injecting a dye into the treatment area. However, instead of removing the problem 8th rib, the resident removed the 7th rib that had no lesions. To make the never event worse, the medical team gave the patient erroneous information after the patient recovered. 

According to the patient, the surgical resident told the patient that not enough rib was removed and that it would require an additional surgery. However, X-rays showed that the 7th rib instead of the 8th rib was removed. It was only after the additional (and preventable) surgery that the patient found out what really happened. The wrong rib was removed and the patient was lied to about why there was a need for the second surgery. 

Wrong-Site Surgery Statistics

Most people are shocked to hear about something as outrageous as a wrong-site surgical error. However, even more shocking is how common wrong-site surgeries can be. They happen more often than most people realize, especially for such a preventable error. According to a paper published by the American Association for Hand Surgery, “Wrong site surgery is estimated to occur 40 times per week in hospitals and clinics in the USA.”

According to the American Hospital Association and The Joint Commission, there were 4 areas where the wrong site surgeries occurred: 

  1. Scheduling
  2. Pre-op/holding
  3. Operating room
  4. Organizational culture

Errors During Scheduling 

During scheduling, several factors were found to contribute to the risk of wrong-site surgery, including:

  • Office schedulers do not verify the accuracy of documents.
  • Schedulers accept verbal requests for bookings instead of written documents.
  • Unapproved abbreviations, cross-outs, and illegible handwriting.

Wrong Site Errors During Pre-op or Holding

During pre-op and holding, there are inconsistent site-marking protocols and inadequate patient verification. Causes of wrong-site surgery include: 

  • Surgical documentation is missing, inconsistent, or incorrect.  
  • Inconsistent use of site marking
  • Time-out process is inconsistent or absent. 
  • Inadequate verification by the surgical team because of rushing or distractions. 

Operating Room Errors

During surgery, operating-room defects include distractions and rushing during time-outs. Time-outs may occur without the full participation of the survival team or where there is poor handoff communication. Causes of errors in the operating room include: 

  • A surgeon is performing multiple procedures with no intraoperative site verification.
  • Ineffective hand-off communication or briefing.  
  • Surgery documentation is not used to verify patient, procedure, site, and side. immediately prior to incision. 
  • Distractions and rushing during time-out. 
  • Time-out occurs before all staff members are ready.  
  • Time-out without full participation. 

Organizational Culture that Leads to Errors

Some causes may be the result of problems with the organizational structure of the hospital, clinic, or surgery center. Cultural defects include leadership that is not actively engaged, passive staff, staff who are not empowered to speak up when something is wrong, and policy changes made without staff education. 

Universal Protocol to End Wrong-Site Surgeries

The Joint Commission developed a universal protocol to address wrong site, wrong procedure, and wrong person surgery. The protocol has 3 components: 

  • Preoperative verification
  • Marking of the operative site
  • Time-out

First, doctors are to conduct a pre-procedure verification process, to verify the correct procedure, correct patient, and correct site. If possible, the patient should be involved in the verification process. All items for the procedure should be identified. Doctors should use a standardized list to verify the availability of all items, including documentation, labeled diagnostic and radiology tests, and any required blood products, implants, medical devices, and special equipment. 

Next, the medical team should mark the site before the procedure is performed. The licensed practitioner that marks the site is accountable for the procedure and present during the procedure. The type of marking should be consistent in the organization, unambiguous, and at or near the procedure site. 

Finally, the time-out procedure is to be conducted immediately before the procedure. A designated member starts the standardized time-out involving the immediate members of the procedure team. All members are to actively communicate during the time out, and agree to the correct patient, correct site, and correct procedure. The time-out should be documented. 

Despite the protocols, the World Health Organization (WHO) has a more in-depth checklist process recommended to address wrong site surgical errors. In 2008, the WHO launched a global patient safety challenge under “Safe Surgery Saves Lives.” The WHO checklist also has 3 components: 

  • Sign in (before induction of anesthesia)
  • Time-out (after induction and before surgical incision)
  • Sign out (during or immediately after wound closure but before removing the patient from the operating room) 

What Causes Wrong-Site Surgery Errors?

A wrong site surgery can occur because of many different reasons. In general, the errors occur because the surgeon or medical team is not properly following checklist procedures or failing to complete all steps of the pre-surgery protocol. Errors in judgment and lack of performing a time out are other common causes of wrong site surgery injuries. 

Errors can begin with an initial admission form for the patient that incorrectly indicates the wrong side, wrong patient, or wrong surgery. This incorrect admission information can be transferred to other medical forms and surgical documents, spreading and enforcing the misinformation. 

Having the patient confirm the side or procedure is not always foolproof. If the patient is under the influence of medication or anesthesia, they may simply agree with what the surgical team says or even repeat the wrong information. A patient under the influence of heavy medication is not always reliable. 

Another possible cause of wrong-site surgery is the misuse of imaging studies or misinterpreted X-rays. In some cases, the surgical team may be looking at an X-ray backward, showing the area of concern on the other side of the body. Even when the surgeon comes in expecting to operate on the left side, the scrub nurses or radiologists may indicate the other side. 

The location of the surgical site is important but many operations are performed with no mention of which side of the body the operation occurred. Omitting location can potentially lead to a never event surgical injury. 

Is Wrong Site Surgery Under-Reported?

The actual number of wrong-site surgeries may be higher than reported because not all medical errors are reported. Doctors may be worried about their reputation or the financial costs of paying for their errors. Support staff may be resistant to report any errors out of concern for losing their job or because of fear or respect for their senior’s authority. 

Another reason wrong-site surgeries may be under-reported is because the staff think that reporting the error won’t change anything. The surgical staff may have previously reported other errors and have seen no action taken, giving up on any future reporting. 

A Wrong Site Surgery Is Not Your Fault

Many patients blame themselves after they suffer a serious medical error. The injury victim may try to bear the responsibility by thinking they should have done something different, they should have gotten a second opinion, or they should have asked for a different surgeon. This may cause some injury victims to stay silent and not take their case to court. 

For example, a patient who goes to a cosmetic surgeon for liposuction may wake up to find they had breast augmentation. If the cosmetic surgeon got the patient mixed up with someone else, the patient may find their body forever changed with a surgery they never wanted. Looking in the mirror, the patient will forever be reminded of their unwanted disfigurement. However, the patient may not go to court over the injury because they blame themselves for getting an elective and cosmetic procedure done in the first place. 

Filing a personal injury lawsuit is an important part of dealing with the injuries from a wrong-site surgical error. Compensation may help you cover the financial and other costs of suffering the injury. Compensation can also act as a way to motivate the hospital and surgeon to improve care so that a similar problem does not happen again in the future. By filing a malpractice lawsuit, you may be protecting future patients from possible medical injuries. 

How Much Is a Wrong Site Surgery Claim Worth?

Even if the doctor or hospital acknowledges the mistake or apologizes, that is not likely enough to compensate you for your losses. In a medical malpractice lawsuit, the injury victim can recover compensatory damages for their injuries to address their losses. Damages in a medical malpractice claim can depend on the type of injury, the extent of the injury, and the age of the victim. 

In a wrong site surgery claim, the economic and non-economic damages could include: 

  • Loss of income
  • Pain and suffering
  • Medical bills
  • Cost of correcting wrong surgery 
  • Any additional medical care
  • Future medical care
  • Compensation for scarring or disfigurement
  • Loss of quality of life
  • Mental distress

Who Should I Call for Help After a Wrong Site Surgery Error?

If you suffer a wrong site surgery error, do not expect the hospital or doctor to take care of your needs. If you were injured, do not accept the insurance company’s settlement offer without understanding the full extent of your injuries. Make sure you understand your rights and legal options after a tragic injury with the help of an experienced medical malpractice legal team.

An experienced medical malpractice attorney will help evaluate your claim, explain your options, and fight to get you the maximum compensation available for your injuries. A medical malpractice lawsuit can help you recover money for medical bills, loss of income, and pain and suffering. If you want to find out about your case, contact an experienced legal defense team for a case evaluation. Do not hesitate to contact Gilman & Bedigian today for a free consultation.

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