ClearCount Medical Solutions

Items that have been unintentionally left behind in patients following surgery are referred to as retained foreign bodies. While surgical sponges account for the majority of incidents, needles, knife blades, and other surgical instruments have been reported as well. Recent studies have estimated that cases of retained foreign bodies occur between 1 out of every 100 to 1 out of every 5000 surgical procedures. Gossypiboma is the technical term for a retained surgical sponge. It is derived from the Latin "gossypium" (cotton) and the Swahili "boma" (place of concealment). Studies have shown that 2/3 of all retained foreign bodies are surgical sponges.

Economics of the problem

A closer look at the problem reveals three separate contributing factors amounting to $1.5 billion in costs:

Manual counting is currently the accepted method, but it comes with an enormous price. In over 10 million procedures each year in the U.S., registered nurses spend at least 15-30 minutes accounting for surgical sponges and instruments. With high overhead costs in the O.R., it is not surprising that accounting for sponges and instruments costs U.S. healthcare institutions more than $1 billion annually.

X-Rays are the last line of defense against retained bodies when manual counts do not match. Over 1.5 million x-rays are taken each year to detect retained bodies. A typical x-ray costs over $200, wastes valuable time, and is subject to a false negative error rate of up to 20%. X-rays used to check for retained objects represent a cost of $375 million each year in the U.S.

Medical malpractice lawsuits resulting from the 20,000 mistakes which still occur annually in the U.S. represent a significant expense in addition to the immeasurable damage to the reputation of medical institutions and professionals. The costs of litigation, as well as the costs to remove retained objects, amount to $125 million each year in the U.S. alone.

Articles:

Reducing the Risk of Unintentionally Retained Foreign Bodies
By the Joint Commission International Center for Patient Safety
http://www.jcipatientsafety.org/15199/

Statement on the prevention of retained foreign bodies after surgery
by the American College of Surgeons
http://www.facs.org/fellows_info/statements/st-51.html

"Recommended Practices for Sponge, Sharp, and Instrument Counts," in AORN Standards, Recommended Practices & Guidelines (Denver, AORN, Inc., 2004) 229-234

Images:

Imaging of Retained Surgical Objects in the Abdomen and Pelvis
By University of California San Francisco, Department of Radiology
http://www.radiology.ucsf.edu/instruction/abdominal/ret_objects3.shtml

View the Clinical Studies