Pittsburgh Medical Malpractice Blog

An international research team has shown that death and complication rates from surgery can be dramatically improved by using simple checklists to make sure that safety measures are taken before, during, and after each operation.

The research project involved nearly 8,000 patients at eight hospitals around the world and was done as part of the World Health Organization’s program called Safe Surgery Saves Lives. The results were published in January 2009 in the New England Journal of Medicine.

The surgical teams using checklists found that death rates were cut in half and non-fatal complications by one-third.

Items on the surgical safety checklist included basic items like verifying that the team has the correct patient and the correct surgical site, making sure the pulse oximeter (which measures oxygen in the blood) is working, making sure antibiotics have been given within one hour before the start of the surgery to prevent infection, and confirming that x-rays needed for the case are on display in the operating room. Another item on the checklist is to have all members of the surgical team introduce themselves by name and role; this is intended to give permission to lower-status team members to speak up at a later time if they notice something is wrong.

Listed below is the entire nineteen-item checklist from the World Health Organization:

Before Induction of Anesthesia:


1. Patient has confirmed
   
   
   
   • Identity
   
   
   • Site
   
   
   • Procedure
   
   
   • Consent
   
   


2. Site Marked


3. Anesthesia safety check completed


4. Pulse oximeter on patient and functioning


Does Patient have a:


5. Known Allergy?


6. Difficult airway/aspiration risk?


7. Risk of more than 500 ML blood loss (7 ML/KG in children)?


Before skin incision:


8. Confirm all team members have introduced themselves by name and role


9. Surgeon, anesthesia professional, and nurse verbally confirm:
   
   
   
   • Patient
   
   
   • Site
   
   
   • Procedure


10. Surgeon reviews: What are the critical or unexpected steps, operative duration, anticipated blood loss?


11. Anesthesia team reviews: Are there any patient-specific concerns?


12. Nursing team reviews: Has stability (including indicator results) been confirmed? Are there equipment issues or any concerns?


13. Has antibiotic prophylaxis been given within the last 60 minutes?


14. Is essential imaging displayed?


Before Patient Leaves Operating Room

Nurse verbally confirms with the team:


15. The name of the procedure recorded


16. The instrument, sponge and needle counts are correct (or not applicable)


17. How the specimen is labeled


18. Whether there are any equipment problems to be addressed


19. Surgeon, anesthesia professional, and nurse review the key concerns for recovery and management of this patient.

Contact the medical malpractice lawyers at Rosen Louik & Perry, P.C. to obtain your free consultation. Our lawyers are experts in dealing with cases involving surgical accidents. There will be no fee for unless a recovery is made.

A recent study published in the journal of Health Services Research found that preventable medical errors occurring during or after surgery cost employers nearly $1.5 billion dollars a year. In addition, these preventable medical errors account for almost 10 percent of surgery related deaths. The report went on to state that 1 out of every 10 patients who dies within 90 days of surgery died because of a preventable error, and one-third of the deaths occurred after the patient was discharged. The researchers conducting this study analyzed data on more than 161,000 patients in employer-based health plans who underwent surgery between 2001 and 2002.

Listed below are examples of some of the costs associated with patients who experienced preventable surgical errors, compared to other patients who did not:

- Nursing care associated with medical errors, including pressure ulcers and hip fractures - $12,196 (33 percent more).

- Metabolic problems associated with medical errors, including kidney failure or uncontrolled blood sugar - $11,797 (32 percent more).

- Blood clots or other vascular or pulmonary problems associated with medical errors - $7,838 (25 percent more).

- Wound opening associated with medical errors - $1,426 (6 percent more).

If you or a loved one has been the victim of a surgical or medical error, then perhaps you should seek the opinion of a law firm that is devoted to medical malpractice cases. The lawyers at Rosen Louik & Perry, P.C. devote their time and efforts to medical malpractice cases throughout Pennsylvania. We obtain and evalute your medical records with our full-time doctors on staff. Please contact us today for your free consultation.

Surgical errors can be the most serious forms of medical errors. The majority of surgical errors are known as “wrong site” operations, where the surgeon operates on the wrong organ, limb or other area of the body. Other times a surgeon performs the wrong procedure and at times operates on the wrong patient.

Other types of surgical errors can occur during plastic or cosmetic surgeries such as breast implantation or reduction, as well as some facial related surgeries. Although the surgical mistakes may not threaten the health of the patient, such errors may produce results far worse than the condition that the plastic surgery intended to repair.

Solid statistics on the number of surgical errors that occur each year are hard to obtain because most states don’t require doctors to report surgical errors. Here are some measures you can take to prevent a possible surgical error from happening to you or a loved one:

1. Check out your doctor and hospital. Ask lots of questions . . . such as how many times your doctor has performed the intended procedure and compare that number with other physicians. The U.S. Department of Health and Human Services offers detailed information about procedures performed at different hospitals.

2. Make sure your doctor initials your surgical site.

3. Confirm the surgery site with the surgeon before the procedure.

Mistakes do happen with even the most skilled surgeon. Cases involving surgical errors are very complicated and should only be handled by experienced medical malpractice attorneys. Our Pittsburgh, Pennsylvania medical malpractice law firm is one of the only law firms in Pittsburgh with medical doctors on staff to evaluate and consult on our medical malpractice and personal injury cases. The medical malpractice lawyers of Rosen Louik & Perry, P.C. offer free, no-obligation initial consultations, and there is no fee unless recovery is made. Contact us today for your free consultation.

With the increasing number of surgical procedures being performed in the United States, it’s not surprising to also see an increase in surgical errors. Errors occurring during surgery can take many forms, including:

Drug errors or medication overdoses
Anesthesia overdoses
Wrong surgical procedure, such as the removal of the wrong tissue, limb, or organ
Accidentally leaving a surgical instrument in the patient's body (including sponges, retractors,
surgical towels). The CDC says that in the last few years, this type of medical error has injured
almost 15,000 patients
Misreading a medical chart or medical history
Scalpel slips that cut into nearby organs, perforating bowels, a uterus, a bladder or a ureter
Improper medical clearance for surgery
Failure to diagnose and treat a post-operative infection
Wrong surgery for the correct diagnosis
Damage caused by a scheduled surgery, which can occur when a physician fails to inform a patient
before the surgery about the risk of damage

Even the most experienced and skilled surgeons can commit a surgical error. While every case is unique and results can vary, our law firm’s thorough investigation and dedication to provide the best legal service has contributed to our success in representing vicitims of surgical accidents. If you or someone you love has been the victim of a surgical accident, please contact the Pittsburgh, PA law firm of Rosen Louik & Perry, P.C. for your FREE consultation.

Dr. Lisa Marcucci, a trauma surgeon formerly associated with Geisinger Medical Center, has written a book entitled “Avoiding Common Surgical Errors.” In it, she identified 186 medical mistakes, some of which could involve serious consequences to patients. Dr. Marcucci’s stated goal—to help prevent such errors in the future.

In an interview with the Times Leader, a Wilkes Barre online newspaper, Dr. Marcucci stated that she was motivated to write on this subject because of numerous surgical errors that she has both seen and heard about. She related that, as a second-year resident, she attended a conference about medical errors and learned of two mistakes made by other second-year residents. One patient died after the resident removed a chest catheter while the patient was sitting upright. Another patient lost a hand after a resident attempted to draw blood from two large arteries in the same arm at the same time. Despite attending a top medical school and having completed a year of residency, Dr. Marcucci had never been taught that the actions of the two residents constituted mistakes.

Dr. Marcucci noted that doctors often confer to review errors and how to avoid them. She noted, however, that the results of such conferences fail to reach a broad enough audience, particularly medical residents (including approximately 2,300 new surgical trainees annually), interns, and young attending doctors. This latter group, as well as physician assistants and nurse practitioners, are the primary target audience of Dr. Marcucci's book. Twenty-six other physicians contributed to the book.

In the future, Dr. Marcucci plans to write a series of book on medical errors in a number of different areas of medicine. She is also developing a web site for patients planning to undergo surgery and their families. Dr. Marcucci finally noted that even though doctors in this country practice the best and safest medicine in the world, room for improvement exists and she hopes her efforts will lead to such improvement.

Source: The Time Leader