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Sponges, Knives, Needles Left in Surgical Cavity

Every year, physicians leave more than 1,500 items inside their patients on accident, according to WebMD. These items include medical clamps, needles, knife blades, and sponges. While some of the items are found quickly following patient pain and an x-ray, others are left for months or years. Sponges, like the one shown here, are particularly problematic, because they cannot be easily discovered except by reopening the surgical cavity.

The Agency for Healthcare Research and Quality estimates that surgical items are retained in one in every one-hundred to five-thousand surgeries. However, the number is hard to calculate because some items will sit dormant in the body for long periods of time without ever causing the patient pain.

A study in the January 16, 2003, issue of the New England Journal of Medicine sought to uncover some of the factors that increase a patient’s risk of having a sponge or other surgical item left inside them. Researchers found that emergency surgery increased the risk of retention by almost 900% and unexpected changes in the surgical procedure more than tripled the odds of object retention.

Other studies have suggested that item retention is due to surgical precautions that are not followed. Most commonly, a sponge miscount occurs. Four counts of the sponges are recommended. The first should occur when unpackaging the surgical instruments. Before a surgery, one of the nurses attending the operating room is responsible for the second count of the sponges. The third count should occur before the surgical cavity is closed. And a final count should follow the surgery, when the same nurse is responsible for counting the sponges again to ensure that none were left in the surgical cavity. Error occurs, however, when the initial count is misreported, a simple miscount occurs, or the sponge tears or rips inside the surgical cavity and falls apart.

New technologies such as CT scanning, ultrasonography, and RFID tagging of the sponges are being developed to aid sponge counting. However, these technologies are currently cost-prohibitive or otherwise impractical for now.

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Shapiro, Cooper Lewis & Appleton, P.C.
1294 Diamond Springs Road
Virginia Beach, VA 23455

Toll Free: (800) 752.0042
Phone: (757) 460-7776
Fax: (757) 460.3428

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