Retained surgical instruments

The consequences of retained surgical tools include injury, repeated surgery, excess monetary cost, loss of hospital credibility and in some cases the death of the patient.

Common instruments are needles, knife blades, safety pins, scalpels, clamps, scissors, sponges, towels, and electrosurgical adapters.

Also retained are tweezers, forceps, suction tips and tubes, scopes, ultrasound tissue disruptors, asepto bulbs,[6] cryotomes and cutting laser guides, and measuring devices.

[9] Khaled Sakhel, part of the Department of Obstetrics and Gynecology at the Eastern Virginia Medical School, reported that it is expected to occur at least once "in every 1,000–1,500"[6] stomach surgeries.

The Joint Commission on Accreditation for Healthcare Organization (JCAHO) stated that "unintentionally retained foreign bod(ies) without major permanent loss of function"[1] (qtd.

[11] Immediately after surgery, a case of gossypiboma can commonly be mistaken for an abscess, especially when it is near a passage between organs (a "fistula").

"[10] Gossypiboma is difficult to diagnose due to vague, inconsistent symptoms and images from x-rays that provide no solid evidence and unclear results.

Surgical tools left in the body can puncture vital organs and blood vessels, causing internal bleeding.

Michael Blum said "The incidents observed…took an average of 13 minutes to resolve, a time lapse which can significantly impact the flow of a busy emergency or perioperative department.

Many cases of a retained instrument originally reported a correct sponge count when the patient was released.

Mark Hulse from North Shore Medical Center said the following about surgery; "It's a process that's definitely subject to interruption and can be prone to errors.

The FDA's Centre for Devices and Radiological Health receives around 1000 adverse event reports each year relating to UDFs.

The FDA states: "The adverse events reported include local tissue reaction, infection, perforation and obstruction of blood vessels, and death.

"[20] In order to improve the system and reduce the number of accidents, some hospitals require four counts of sponges and instruments.

[8] Each surgical instrument has a bar code placed on it and nurses pass the items through a hand scanner.