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Wrong-site surgery rate still high after guidelines adopted

Imagine going into the hospital for a knee replacement on your right knee, but the doctor operates on and replaces your healthy left knee. Imagine instead that the surgeon gives you a total hip replacement. Or, that he gives a complete stranger the new knee you were scheduled to have gotten. These types of surgical errors seem impossible, but a new report says these types of negligent "wrong-site surgeries" are happening across the country at a rate of 40 per week.

Not every state's department of health records the number of wrong-site surgeries happening in a year. However, tracking the personal injury and medical malpractice lawsuits gives researchers an idea of the number and type of wrong-site surgeries happening. One such Chicago lawsuit alleged that during an operation on a patient's brain, the surgeon operated on the wrong part of the brain. Another surgeon reportedly performed a reconstructive surgery on a patient's healthy knee.

It is not as if wrong-site surgeries are not regulated, however. The Joint Commission Center for Transforming Healthcare has been looking into wrong-site surgeries and has created a set of universal protocols to reduce the risk to patients. Part of its work includes accrediting hospitals and health care centers on how well they follow these protocols. The Commission has accredited over 19,000 facilities.

While these guidelines and accreditation procedures are in place, the Commission has noted 29 areas in which errors have started to appear. The Commission is concerned that these errors are one of the causes of wrong-site surgeries.

One of the more easily correctable errors is using non-washable ink to mark the surgical site. The Commission has seen surgeons mark patients with the wrong type of pen and when the patient is prepped for surgery, the ink will wash away.

Other errors include a failure to correctly complete documentation prior to surgery, distractions during surgery, or not taking an appropriate timeout in the moments before the surgery starts. The timeout is meant to ensure the correct patient is receiving the correct procedure on the correct body part.

The Commission says that one of the reasons why these errors are happening is that many hospitals have not had to deal with wrong-site surgeries in the past and do not recognize the gravity of such negligence.

Source: Chicago Sun-Times, "Surgical errors happen as much as 40 times a week around country despite guidelines," Monifa Thomas, 4 July 2011

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