Surgical Checklists Can Prevent Surgical Errors

by | Jun 8, 2011 | Firm News, Medical Malpractice, Surgical Errors |

In 2009, the World Health Organization (WHO) introduced its Surgical Safety Checklist, a patient tool designed to improve safety and reduce the incidence of errors and complications. Since its introduction, scientific evidence has supported the use of checklists as a component of patient care. While the WHO checklist has not been universally implemented, a study published in the April 2011 edition of the Annals of Surgery proves the promise of the process.

In trying to improve patient outcomes and reduce the risk of medical malpractice, the Surgical Patient Safety System (SURPASS) checklist was developed. Considering relevant literature and validated observations in the field of surgery, SURPASS covers the entire surgical pathway from admission to discharge. In their study, Dr. Eefje N. de Vries and others reviewed medical malpractice claim data from the largest Dutch insurance company. Evaluating surgical complications and outcomes, the researchers concluded that had the SURPASS checklist been used, 40 percent of deaths and 29 percent of incidents leading to permanent damage could have been prevented.

The 18-page SURPASS checklist consists of more than just patient data. Among the categories in the comprehensive list is a reference of complications, medical personnel-specific completion percentages, location-specific tasks and questions that cover staff as well as patient interactions.

Beyond checklists, the number of medical errors can be reduced in other ways. Experts believe that greater patient involvement is one such way. Becoming educated on medications and methods, researching facilities and seeking clarity on post-operative or discharge instructions are just some of the ways by which a patient can protect himself or herself.

While a last resort in some cases, surgery is often the only procedure that can alleviate disabilities, repair injuries and reduce the risk of death. However, medical errors can cause even worse complications than the intended intervention was meant to treat. Patients should be aware that when adverse medical events occur, they have the right to seek damages for medical expenses, wage loss, reductions in quality of life and pain and suffering.

Five to 10 surgical errors occur daily in the United States. Surgical complications or error incidents can result in permanent injury, infection, increased medical costs and even death. While surgical intervention is a very common therapy, medical professionals and facilities should seek a means to reduce the chance of human errors that result in human losses. Checklists and other methods will only help in this mission.

Surgical Errors May Be The Third Leading Cause Of Death In The United States

Not many people in Cleveland would think that doctors and surgeons may be responsible for the third-leading cause of death in the United States, but one anesthesiologist speculates that over 250,000 people die each year because of surgical and medical mistakes. In addition, there are millions more who are seriously injured by their doctors. Some of these errors are extremely frightening.

One man’s intestines were perforated after the surgeon left surgical implements in the patient. He had gone in for surgery on his abdomen, but something wasn’t right. Doctors eventually realized they had left a 144 square inch sponge inside the man’s abdomen. By the time it was removed, it had started to rot and caused serious damage to his intestines. Though it is not entirely clear how the sponge was left inside him, the most common cases of surgical equipment being left in patients occur when the surgical team fails to count the equipment prior to a surgery. If the team miscounts, there is also the possibility of leaving something in a patient.

Another common issue is wrong-site surgery. Imagine going into the hospital needing a right knee replacement only to have the surgeon give you a left knee replacement. Not only would he or she have given you an artificial knee in place of your good knee, you may not be able to have your bad knee replaced immediately. Of course, both situations could cause considerable pain and injury.

Finally, one of the most horrific surgical errors that could befall a patient is that he or she does not receive the proper amount of anesthesia. Too much anesthesia could come with its own risks and dangers, but not getting enough may mean that a patient is awake during his or her surgery. When this happens, patients may feel nothing, but they may also feel absolutely every incision.

With their serious nature, it is important that Cleveland patients who are injured work with an attorney who can help recover some of the costs stemming from surgical errors.

Sponges Are The Most Common Item Found Inside Patients’ Bodies

In the medical world, surgical items being left in patients’ bodies is called a “never event” – meaning it is never supposed to happen. Unfortunately, a significant number of patients leave surgery each year with a surgical item, sponge or other medical instrument left inside their bodies..

According to USA Today, items are left in patients up to a dozen times per day. Sponges are the most common objects found in patients, making up approximately 70 percent of lost surgical items. Needles and other surgical instruments are also commonly lost inside patients. Needles make up less than 10 percent of lost items, while instruments make up around five percent.

If Items Are Not Found Initially, Proving Negligence May Be Difficult

According to Medicare data, the cost to a hospital for leaving an instrument in a patient’s body is approximately $60,000. However, this cost is minimal compared to the costs involved in a medical malpractice case filed by a patient, which can cost a hospital between $100,000 and $200,000 per case. However, if items left in a patient’s body are not discovered until months or years later, it is difficult to trace the item back to the negligence of a specific hospital or doctor.

Leaving an item inside a patient’s body is a form of medical malpractice. Medical malpractice occurs when a health care provider’s negligence results in treatment below the acceptable standard of care and causes harm to a patient.

To prove medical malpractice, a patient must show:

  • The doctor or hospital owed a duty of care to the patient.
  • The provider breached that duty of care.
  • The breach of the duty of care caused the patient’s injury.

Breach of the duty of care means that the medical treatment provided fell below the acceptable standard of care. A patient must also show the specific injury or harm caused by the hospital or doctor’s breach of the duty of care.

Proving medical negligence is difficult, especially when attempting to prove that the treatment provided fell below the appropriate care standard. Independent medical experts are often brought in to testify to the currently established standard of care used throughout the medical field.

National Reporting May Help To Prevent Surgical Errors

If a surgeon in Cleveland has made a medical error is there any way for the public to know about it? Many people in Ohio likely wonder about whether their doctors and surgeons have ever been subject to a medical malpractice lawsuit, whether they have been found liable for a medical error or whether any of their patients have ever died, but much of this information is unavailable or difficult to find by patients. Across the country, the situation is the same: each state decides on its own reporting procedures and physicians’ records are often kept from public view.

There are some people who believe, however, that it is important to not only have standardized, national reporting, but to also make these reports public. Ostensibly, the idea is that if records are made public, surgeons will be more careful about their work, as their names, reputations and careers will be easily linked to a public file. Moreover, these surgeons would be forced to answer for poor or negligent medical care.

One of the reasons why a national reporting system may be beneficial is because there would be one set of data that would be collected across the country, making rates of medical malpractice much more comparable. Currently, with each state requiring varying degrees of reporting there is no standard for what should be reported or what is an entirely unacceptable event.

In a recent study of patient care, researchers found that third-party review of medical charts is an effective way to find indicators of medical errors. By looking for specific “triggers,” such as a patient being sent to the intensive-care unit following a surgery, approximately 9 out of 10 medical errors were caught. As more hospitals and clinics move to digital records, looking for these triggers may be much easier.

Unfortunately, there are surgeons in Cleveland who will continue to make surgical errors, putting their patients’ safety and lives at risk. When something does go wrong, however, patients can work with experienced surgical error attorneys to file medical malpractice claims.

Surgical Errors Increase Revenue Streams For Hospitals

If a mistake puts money in your pocket it’s reasonable to expect that you will continue to allow that “mistake” to happen or at least not work too hard to prevent it.

With the large payouts that surgeons and hospitals have to make when settling a medical malpractice lawsuit, it would not be unreasonable to assume that the hospitals would have a financial incentive to reduce errors. Sadly, a new report has found that surgical errors actually make more money for hospitals. The reason, of course, is that when a surgeon creates a complication, the patient will need to stay longer and will need additional, billable care.

The study focused on 12 hospitals and 34,256 patients. Of those participating in the study, 1,820 had one or more surgical complication. The difference, on average, between the amount of money those that had surgical complication and those that didn’t is staggering: $49,400 for a complication and $18,900 for a normal surgery. Moreover, these figures are revenue, not just amount paid.

It would be terrible for hospitals not to train their surgeons to do better and reduce or eliminate errors just because they get more money. Although many hospitals are private enterprises or are otherwise budge conscious, it does not mean that Cleveland patients should be written off as necessary expenses. This is one of many reasons why it is so important to file medical malpractice claims to hold physicians and hospitals liable for their mistakes.


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