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Jennifer Heisler, RN

Surgical Error Causes Lasting Harm-Sponge Left In Surgery Patient

By September 18, 2010

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In October of 2009, Nelson Bailey had surgery on his intestines, and expected to feel better after the procedure, not worse.

The first mistake that was discovered was that Bailey, a judge, had been sent home with the wrong medicine.  His blood pressure was sent sky high, instead of being lowered as intended. That problem was fixed, but he didn't see a dramatic improvement in his condition, in fact, he felt worse than he did before surgery.

After five months, he was finally told what was wrong with him: a 12 inch by 6 inch surgical sponge (picture thick gauze) had been left in his abdomen during surgery.  To make matters worse, the sponge was now rotting, sending Bailey back to surgery.  During surgery it was found that the rotting cotton had caused damage to his intestines that was so severe that doctors removed part of his intestines along with the offending sponge.

Neither the hospital, nor the surgeon, had ever told Bailey that there was a chance that a sponge had been left inside him.  Unfortunately, there is a strong likelihood that they were aware of the possibility and chose not to share it, even when complications became an issue.

So what does this mean for you?

Hospitals and surgical centers have extensive procedures in place to avoid exactly this type of mistake.  Every sponge that is used in a surgery is counted, before and after the procedure, so that a missing sponge can be accounted for before closing any incisions.  If the missing piece of surgical equipment is metal, such as an instrument, most hospitals require that the patient have an x-ray to insure that it was not left inside the body.

As a patient, there is little you can do after the fact.  What you can do is inquire before surgery to make sure the operating room where you are having your procedure follows some basic safety guidelines including counting all equipment before and after surgery and perhaps even more importantly, that they do a time out prior to incision (a check to make sure you are the right patient, having the right procedure, by the right doctor, etc).

If you suspect that something was left behind after surgery, many items are now "tagged" so they can be spotted on an xray, including surgical sponges.  In Bailey's case, the xrays were misread several times, but the tags did show up on the images. You can also contact the hospital, request your medical records and look at the operating room documentation that should detail the actual equipment count before and after surgery.

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