Foreign objects left inside a patient after surgery can result in dangerous medical situations. Medical sponges or gauze can accumulate bacteria, often leading to serious infections that can spread faster and result in severe illness or potentially death.
The estimated number of objects left behind after surgery (also called “retained objects”) varies each year, ranging anywhere from between 1 in every 1,000 surgeries to 1 in every 18,000 surgeries. However, hospitals vary widely in how many retained objects they report.
Retained surgical items place patients at risk of a wide range of complications, including infection, internal bleeding, and permanent disability related to the removal of infected tissues or organs. When this happens, the patient is entitled to compensation in a malpractice case.
Some of the most common objects left inside patients' bodies include sponges, scalpels, scissors, drain tips, needles, clamps, forceps, scopes, surgical masks and gloves, tubes, and measuring devices. Sponges, in particular, are hard to keep track of because they are used to soak up blood during surgery.
Retained surgical bodies (RSB) are any foreign bodies left inside the patient after the operation and in general, a further procedure is necessary. The consequence of foreign bodies after surgery may manifest in different forms immediately after the operation, months or even years after the surgical procedure.
Among the various types, the most common occurrence of RSIs are “gossypiboma” which is a surgical sponge, or a laparotomy pad left involuntarily in the body after a procedure. Retained surgical sponges account for 48% to 69% of RSIs, per a 2019 report from the ECRI Institute.
Retained surgical sponge — The most commonly retained surgical item is a woven cotton surgical sponge, which includes both laparotomy pads and smaller sponges (eg, Ray-Tec) [4,5].
Retained foreign objects are most commonly detected immediately post-procedure; by X-ray; during routine follow-up visits; or from the patient's report of pain or discomfort.
While some states like Louisiana, Georgia and Mississippi have legislation against owning human remains, there is no federal law against taking organs, tissue or devices home after surgery, though there are some limitations.
It is estimated that one in every 5,500 procedures involves an RFB,2 leading to adverse outcomes for patients, including the need for additional operations, readmission or prolonged length of stay, infection or other health risks, and even death. The cost of one RFB averages $70,767 because of the extra care needed.
The consequences of leaving a surgical tool inside the body can vary from minor to deadly. When foreign objects are left inside the body, they can lacerate or puncture vital organs, causing heavy internal bleeding and other life-threatening complications. In some cases, these objects can cause serious infections.
The most common symptoms are discomfort, pain, unexplained fever or feeling generally unwell. In some cases, the patient is asymptomatic and the retained surgical swab is only diagnosed incidentally.
Very rarely — in only one or two of every 1,000 medical procedures involving general anesthesia — a patient may become aware or conscious.
However, when a doctor makes an error on the job, people can suffer serious injuries or death. Unfortunately, surveys show that some doctors are willing to cover up their mistakes in an effort to preserve their reputations and avoid legal consequences.
Patient awareness under general anesthesia (or anesthetic awareness) is a rare experience that occurs when surgical patients can recall their surroundings or an event – sometimes even pressure or pain –related to their surgery while they were under general anesthesia.
Such objects generally pass through the gastrointestinal system within four to six days, although the precise time frame can depend on additional factors, such as the person's metabolism, as well as the item swallowed.
The swallowed object is expected to move through your digestive tract and pass out of the body in the stool with no problems. This may take about 24 to 48 hours, but could take longer depending on your bowel habits.
The most important way to avoid infection is to completely remove the foreign body.
A Mayo Clinic study found that one in 5,500 operations results in a retained surgical object. About two-thirds of these cases involved surgical sponges left inside patients.
Infections after surgery are caused by germs. The most common of these include the bacteria Staphylococcus, Streptococcus, and Pseudomonas.
In multivariate analysis, factors associated with a significantly increased risk of retention of a foreign body were emergency surgery (risk ratio, 8.8 [95 percent confidence interval, 2.4 to 31.9]), unplanned change in the operation (risk ratio, 4.1 [95 percent confidence interval, 1.4 to 12.4]), and body-mass index ( ...
Intraoperative blood loss of more than 500 mL, operation length, more than one sub procedure, a lack of surgical counts, more than one surgical team, unexpected intraoperative factors, and an incorrect surgical count are some of the factors that have been found to increase the risk of RSI.
Most often found in abdominal and pelvic cavities, retained gauze can cause a variety of symptoms, including fever, palpable mass and pain. Symptoms depend on the location (and possible migration) of the retained gauze and local tissue reaction (inflammatory or aseptic).