Foreign Items Left Behind After Surgery
Did you hear the story about three Patients waiting to see Dr. Jones, a great, but absent minded surgeon? “He cured me, but left a scalpel behind and had to open my stitches to take it out”, said patient number one. The second said, “He had to reopen me to take out a clamp he forgot”. With a sigh of relief, the third patient, said, “I’m lucky. He cured me and didn’t leave anything behind”. Just then Dr. Jones walked in and said, “Has anyone seen my umbrella?”
IT’S NO JOKE
Not so funny if you’re the one who needs a second surgery, or who contracts a serious, potentially fatal infection, or suffers for days, weeks, months and even years with unexplained pain, nausea, or shortness of breath, among other unpleasant symptoms because of a surgical item left in your body. Despite procedures designed to account for every tool, pad, needle, drain, sponge or apparatus placed or used inside the body during surgery, tools and materials are left behind so often (estimated to happen in 1 in every 100 surgeries) there are multiple acronyms for the things surgeons leave behind – including, “RSI” (retained surgical items), “RFB” (retained foreign bodies) and “RFO” (retained foreign objects). We’ll refer to them as “RSIs”. The medical boards that certify surgeons call RSI “a never event” – an event that simply is not supposed to happen – an event for which there can be no excuse.
WHAT IS LEFT BEHIND
Any tool, needle, device, screw, plate or material that is used in surgery can be left behind. Our focus is on “textiles”, by far the most frequent RSI – cotton gauze surgical sponges (usually 4”x4”) and 18”x18” laparotomy pads – yes indeed, these textiles are quite large and bulky. The most common textile RSI sites are the abdomen, pelvis, vagina and chest.
RSI COMPLICATIONS
Our bodies are living, breathing things, full of movement and change. Blood courses through our arteries and veins, nourishment through our digestive tracts, and waste through our organs and intestines. Our tissues are moist and sometimes adherent. When a surgical textile is left behind our bodies work to excrete the RSI or to move it to neutralize its danger. In that process the alien RSI material migrates throughout our bodies, wreaking havoc, adhering to or invading our stomach, lungs, kidneys, heart, and other essential organs, becoming entangled with our intestines, and strangling our reproductive organs. Perhaps most frightening, RSIs are a nidus – a fertile place – for the development of hard to treat infections that can lead to sepsis and even death.
AN OUNCE OF PREVENTION
The most important thing to do to monitor your recovery is to request an x-ray be taken of the site of your surgery BEFORE you are released. When you are discharged be sure to take that x-ray with you along with the pre and post-surgical reports.
You know your own body! If you are not recovering as expected, see your doctor and be firm with your request for additional post-surgery testing. If your doctor says “It’s all in your head” get a second opinion.
Resources you can reference that can offer information on RSI:
NoThing Left Behind®: A National Surgical Patient-Safety Project to Prevent Retained Surgical Items
USA TODAY ARTICLE: “Erica Parks knew something wasn’t right in her belly when she left the Alabama hospital that performed her cesarean section in the spring of 2010”. Click HERE to read her story.
