MONDAY, Nov. 15 (HealthDay News) -- It rarely happens, but
that's little comfort for those involved: Sometimes surgical
instruments and sponges are left inside children undergoing
surgery, according to researchers from Johns Hopkins
Children suffering from such mishaps were not more likely to
die, but the errors result in hospital stays that are more than
twice as long and cost more than double that of the average stay,
the researchers found.
And that's not even counting the psychological toll on
"Certainly, from a family's perspective, one event like this is too many," said lead researcher Dr. Fizan Abdullah, an assistant professor of surgery at Johns Hopkins. "Regardless of the data, we as a health care system have to be sensitive to these families," he said.
"The amazing thing is that when you look at the numbers, it translates to one event in every 5,000 surgeries," Abdullah added. "When there are hundreds of thousands of surgeries being performed on children across the U.S. every year, that's a lot of patients."
The report is published in the November issue of the
Archives of Surgery.
For the study, Abdullah's team collected data on 1.9 million
children under 18 who were hospitalized from 1988 to 2005. Of all
these children, 413 had an instrument or sponge left inside them
after surgery, the researchers found.
The mistakes occurred most often when the surgery involved
opening the abdominal cavity, such as during a gynecologic
procedure. Errors were less likely to occur during ear, nose,
throat, heart and chest, orthopedic and spine surgeries, Abdullah's
Of the 17 patients who had a surgical tool left in them during a
gynecologic procedure, 15 had undergone ovarian cyst or
cancer-related procedures, one had had a cesarean section and one
had undergone a procedure for pelvic scars.
"It's not that people are lazy or careless," Abdullah said. "What happens sometimes is there are places where a sponge will slip, because the body has areas that are hard to see or reach, particularly in the abdomen," he explained.
In the operating room there are safety procedures, such as
counting the sponges and instruments before and after the
operation. If these procedures were not in place, many more errors
would occur, Abdullah added.
After surgery, patients who have a foreign body left inside them
often develop punctures, lacerations, infection, fever and pain. An
image of the area will reveal the object, and surgeons must perform
another operation to remove it.
All this adds considerable time and money, Abdullah noted.
For children who had objects left in them, hospital stays
increased from an average of three days to a week. Moreover,
average costs soared from $40,502 to $89,415, the researchers
"From a health care system's perspective, we need to be more focused on this issue, and we need to be putting in additional safety measures and additions to our procedures and protocols to prevent these events from happening," Abdullah said.
Commenting on the study, Dr. Juan E. Sola, chief of the division
of pediatric and adolescent surgery and an associate professor of
surgery at the University of Miami Miller School of Medicine, said
that "any incident above zero is something we need to address."
However, overall, these events are few and far between, he
Sola noted that new systems involve bar-coding every instrument
and sponge. Scanning the code after they are removed insures that
no objects are left behind, because a computer is keeping track of
all the instruments and sponges used, he explained.
"Technology will eliminate a lot of these human errors," Sola said.
For more information on patient safety, visit the
U.S. National Library of Medicine.
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