Surgical errors are often preventable. Clearly, wrong side surgeries are preventable. In 2002, the National Quality Forum published a list of 28 Serious Reportable Events (SREs) “to increase public accountability and consumer access to critical information about healthcare performance.” The list includes a number of common preventable surgical errors, including wrong site surgery (e.g., an operation performed on the wrong knee, wrong level of the spine, etc.).
The NQF publication makes clear that wrong site surgery is medical malpractice. Medical malpractice, also called medical negligence, occurs when a surgeon falls below accepted standards of care and, as a result, causes injury to a patient. Not all bad surgical outcomes mean that there was negligence. For instance, continued back pain after a spine surgery does not mean that the operation was negligent. However, when a surgeon mistakenly operates on the wrong body part, and harm occurs, that is clearly avoidable, preventable and totally unnecessary.
Per the NRQ, surgical SREs include the following:
- Surgery performed on the wrong body part;
- Surgery performed on the wrong patient;
- Wrong surgical procedure performed on a patient;
- Retained foreign object after surgery;
- Death of certain low risk patients.
In an effort to eradicate wrong site surgeries, hospitals have adopted “universal precautions.” These include a “timeout,” where the patient is asked to confirm their identity and what type of procedure is to be performed. Careful surgeons will also mark the surgical side to assure that an x-ray or other imaging has not been transposed.
A friend of mine who is an orthopedic surgeon told me a story about an operation that he performed on a local lawyer. The lawyer was upset when he woke from anesthesia and found a large “L” on his backside. He thought that “L” stood for “lawyer” and the surgical staff was having fun at his expense while he was knocked out. My friend explained that the “L” actually stood for “left,” the side where the surgery was meant to be performed. He was being cautious to avoid surgical errors, as all surgeons should be when taking their patient’s life and well-being into their hands.