An article published in the DailyMail.uk website in 2010 reported of a 79 year old woman named Iris Cole who had died after a surgical swab was left in her body for 9 months. In August of 2007, Cole was hospitalized following a bout of abdominal pains, which prompted an emergency cholecystectomy and partial appendectomy. The surgery was deemed a success and the patient was discharged soon after, but the problem started when in May of 2008 she had a fever and greater abdominal pain. Upon consultation, it was discovered that a surgical swab was left in her body since the previous operation, and since then an abscess had formed and damaged her other internal organs. Cole died of organ failure in January 2009.
While this is rather frightening news, the accidental leaving of a surgical swab in a patient is not an unusual occurrence. These kinds of happenings are called “never events”, meaning that these kinds of events are preventable and yet recurring in the health care setting. Foreign objects left in a patient post-operatively can pose serious complications, like in the case of Mrs. Cole above, organ failure. Depending on the foreign object left in the patient, the consequences can be that either the instrument, especially if pointed, will puncture internal organs, or in the case of swabs can rot inside the patient and cause infection. Not only that, the patient will also be experiencing emotional trauma and additional stress.
The surgical room is a busy place. There are many personalities involved with its own tasks and responsibilities, and still everyone is accountable for any event that occurs during the operation. The surgeon is the leader of the surgical team. He makes sure that the whole surgery would progress in a safe and orderly manner. The anaesthesiologist or anaesthetist is a professional trained in administering anaesthetics. He monitors the patient’s vital signs and maintains the degree of sedation of the patient throughout the procedure. The circulating nurse is the only member of the team who is not sterile. She is in charge of keeping and updating the patient’s medical chart and also to replenish supplies and to do errands while the surgery is in session. The scrub nurse, on the other hand, is included in the sterile field, and is in charge of assisting the surgeon and passing the instruments needed in the surgical procedure. It is also her job to keep track of the number of instruments used and make sure that no instrument, or swab, is left in a patient before the surgeon closes off the incision. With the different factors surrounding the team, such as inaccurate tool count, fatigue and the complexity of the procedure, tools can be inadvertently left in a patient.
Retained surgical instruments are a cause of legal action as it is a clear case of medical negligence on the part of the health team. Victims of these should discuss this issue with their lawyers and search for options for a compromise and compensation from the hospital.