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Tools in the Body

They call it a counting error. The technical term from the Center for Medicare and Medicaid Services is retained foreign bodies or a retained surgical item, and they won’t pay for it because they are listed as Never Events… because they never should have happened. I think you know where this is going.

When a doctor does surgery, they are supposed to do a count of all the sponges and instruments used during surgery, before closing the patient up. Sometimes, they don’t do the appropriate mathematical standard of care and they leave something in the patient.


Maybe when the pain medication wears off, the patient begins to complain of pain and they discover the foreign body. Other times, it’s days or weeks when the person has gone home. Then, they begin to experience pain “inside” and head to the doctor because they complain of an unusual pain or upset stomach. When the x-ray is performed… there is the foreign body.  The single most left behind item is a sponge.

In an average surgery,  there are between 250-300 surgical tools used for the surgery. In a study done in 2008 and reported in the Annals of Surgery, it is estimated that mistakes in tools and sponge counts occur in 12.5% of surgeries. It’s unclear how many of these end up being left in the patient. This 2014 Washington Post article titled When your surgeon accidentally leaves something inside you, does a good summary of the risks, injuries, pain, infection and ultimate costs of surgery to remove the items. They estimate that removal surgery costs about $64,000.

The medical watchdog group The Joint Commission states that there have been a reported 770 foreign objects left in patients in the last 7 years. Of these, 16 resulted in death. A 2012 report from Johns Hopkins University found that 80,000 of the never events have occurred between the years of 1990 and 2010. Big discrepancy there in that math between those two reports!

This is an example where a doctor is not intentionally doing wrong, but it’s bad medicine because it’s bad math. And yes, these are medical malpractice claims.

After writing that, it causes me want to post a pic o’ day that makes me smile:




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