Wrong-Site Surgeries Persist, Despite Hospital Safety Measures

Nearly half of neurosurgeons who specialize in spinal procedures admitted to performing at least one wrong-site surgery in their career, according to a survey in the November edition of Neurosurgery Focus.

Wesley Hsu, neurologist at Wake Forest Baptist Medical Center in Winston-Salem, N.C. and lead author of the study, said he and colleagues are now looking into developing custom-tailored checklists for spinal surgeons to prevent wrong-site surgeries.

There are so many things that occur - like on an airplane flight - that have to go right, Hsu said. The more honest you are that it can happen, to more likely you are to be able to prevent it from occurring it from happening. I'll do everything in my power to prevent a mistake from happening.

Surgeons in the U.S. perform an estimated 35 accidental procedures on incorrect body parts each week, according to survey data. Getting the wrong operation by mistake is statistically rare, experts say, but the results can be potentially devastating for patients and lucrative for medical malpractice lawyers.

The Joint Commission, an organization that accredits hospitals and sets health care standards, began investigating the rate of wrong-site surgeries in 2009.

The commission found that between October 2009 and October 2010, surgeons performed 48 wrong-site operations in Minnesota and 58 botched surgeries in Pennsylvania.

Using the data from the two states, The Joint Commission estimated that across the entire U.S., including Washington, D.C. and Puerto Rico, surgeons perform 1,839 wrong-site surgeries per year.

While wrong-site surgery is not an everyday occurrence, all facilities and physicians who perform invasive procedures are at some degree of risk, Joint Commission President Mark R. Chassin said in a statement. Unless an organization has taken a systematic approach to studying its own processes, it is flying blind.

The Joint Commission, along with professional organizations that represent surgeons strongly promote a universal safety protocol. The Joint Commission approved the protocol in 2003 that took effect July 1, 2004.

Patients, nurses and staff all play a role in safe surgery, Hsu said. The Joint Commission published a brochure available online to teach patients what to ask and do before a surgical procedure.