Retention Of Equipment During Surgery

A recent Harvard Study into the issue of the retention of equipment following surgery revealed that almost 70% of retained objects are sponges. The retention of equipment following surgery is thankfully rare, but it is potentially lethal. It occurs during abdominal or pelvic surgery. There are a range of issues resulting from the retention of surgical equipment. The error can go undetected for your or may cause extremely minor issues.

Signs Of Retention Of Equipment During Surgery

Signs can include the following:

  1. Fistula: this is an abnormal link between organs, either between organs such as a Gastrojejunocolic fistula – which results in fecal matter passing from the colon to the stomach causing halitosis, within organs, such as an Enteroenteral fistula - a fistula between two sections of the intestine or between organs and the abdominal wall or the skin.
  2. Perforation: bowel perforation is a hole or nick in the bowel which causes the contents of the intestine to leak into the abdominal cavity.
  3. Obstruction of the bowel: this can often be treated within 2-5 days non invasively but surgical intervention may be required. In the case of a retained instrument surgical intervention is always required.
  4. Sepsis: a severe inflammatory response to bacteria or other germs. In this case a foreign object, sepsis is extremely dangerous, cause the body to go into shock and can cause multiple organ failure and death.
  5. Death - in the most severe cases if retained equipment is not noticed it can lead to fatality due to internal damage.

Surgical instruments are retained mostly due to counting errors by the surgical team , therefore it is recommended that counts of equipment are made when the equipment is set up, before surgery begins, as closure begins and during skin closure to minimise the risk of a retention occurring or a miscount happening.

However, high risk factors have been pointed out, these are obesity, change of surgical procedure and emergency surgery. The likelihood of an error occurring in these cases is higher than in other surgical procedures.

In any scenario when the count is wrong following closure, post-operative radiography is imperative. However 10% the time swabs will not be detectable via this technique.

Retained Equipment Medical Negligence Claims

Medical negligence claims can be successfully made for a variety of reasons, including failing to count the amount of swabs used, failure to check x-rays and failure to check the operative field as detailed below.

1. Claims relating to the swab or instrument count:

  • No count occurred
  • Miscount deeming the amount correct when in fact items were missing.
  • The count came back incorrect but this issue was ignored by the surgical team

2. The surgeon failed to check operative field

3. Claims relating to x-rays

  • No x-rays were undertaken
  • X-rays were done but the radiographs were misread

If you are the victim of retained equipment during surgery, we can provide you with a completely free, no obligation explanation of your legal rights.


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