Failure to Remove Medical Tools Before Closing

A number of clinical negligence claims arise as a result of 'retained surgical items'. Surgical items such as sponges, sharps and instruments can be retained in patients' bodies following surgery and lead to serious patient harm. Retained surgical items occur because of problems with multi-stakeholder operating room practices and problems in communication between Medical Practitioners during surgery. Such foreign bodies that are left in patients after surgery can cause serious harm to surgical patients. Commonly, surgical instruments such as sponges and small gauze and packs are left inside patients. These missed instruments can cause dangerous complications. A missed instrument remains silent and is discovered accidentally because it is sterile and inert whilst a sponge can produce infection.

The causes of the failure to remove medical tools can be as a result of:-

  • Difficult surgery, especially emergency surgery at night;
  • Surgery for obese patients;
  • Excision of a big abdominal tumour;
  • Necessity to arrest massive intro-abdominal bleeding using multiple instruments and packs;
  • Bad general condition of the patient during general anaesthetic and the need to cut short an operation;
  • The presence of an untrained or newly trained Nurse;
  • Absence of the circulating Nurse;
  • Absence of a swab and instrument counting system;
  • Many teams sharing in the surgical operation;
  • Improper lighting in the theatre with a bad surgical theatre environment.

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