• Laparoscopic Complications
• Wrong Site Surgery

How To Prevent Wrong Site Surgery

Whenever someone undergoes surgery, there are many issues to consider, and many things that could potentially go disastrously wrong. Even under the best of circumstances, an oversight by the surgeon or hospital nursing staff could have dire consequences for the patient.

According to the Washington University School of Medicine in St. Louis, 4,000 wrong-site surgeries occur annually in the United States. This equates to one in 17,000 surgeries being performed on the wrong site. By definition, wrong site surgery encompasses surgeries done on the wrong organ or limb, at the wrong level of the spine, or even on the wrong patient.

The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) reports that of all the reported wrong site surgery incidences:

• 19 percent were emergency cases
• 16 percent involved morbid obesity or physical deformity
• 13 percent included unusual time pressures to start or complete the surgical procedure
• 13 percent required unusual equipment or unusual setup in the operating room
• 13 percent involved multiple surgeons
• 10 percent had multiple procedures performed during a single surgery

The JCAHO also identifies the following as root causes for wrong-site surgeries:

• Communication breakdown between the surgical team and the patient
• Inadequate policy with the surgical institution involving properly marking and verifying the surgical site prior to surgery
• No hospital policy to verify surgical site in the operating room
• Inadequate patient assessment
• Incomplete pre-operative assessment
• Inadequate surgical team staffing
• Hospital organizational failures

What can the patient do to prevent a wrong site surgery?
Once the patient is under general anesthesia, he or she is no longer able to monitor or voice any thoughts or concerns. Patients must proactively be involved in all aspects of his health and medical decision-making; especially when surgery is involved. Studies have shown that patients who are actively involved in the decision-making process relating to their care are more likely to have a favorable outcome. Some things a patient facing a surgery should remember:

• Make sure you have spoken to your surgeon and you understand and agree to the surgery to be performed.
• Make sure the surgery site is clearly marked with a permanent marker. The markings should be clear and should remove all doubt as to where the surgery will be performed. If you have any doubt or concern that the surgery site is not clear, be sure to speak up and address it with the surgeon before your surgery.
• If any x-rays are used to identify the surgery site, make sure the x-rays films are yours and do not belong to another patient.
• Ask for your surgery to be performed at a facility accredited by the JCAHO. This accreditation means that the facility has undergone rigorous on-site evaluation and is committed to national quality and safety standards.

Regardless of how rare a wrong-site surgery may be, if it happens to you, it is devastating and can have long term ramifications.

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