past President of the yankee Academy of Orthopedic Surgeons

Wrong Site Surgery Persists Despite safety measures

It’s hard to believe that operations at the inproperbody part or at the inproperpatient still happen. Yet, in line with the Joint Commission on Accreditation of fitnessCare Organizations (“JCAHO”), surgeons have operated at the inproperleg Tiffany Heart Pendants, eye, kidney or other body part 150 times since 1996. more often than not these cases are quietly settled, but usuallythey become headline news.

a couple of notorious examples are illustrative of this point. A patient admitted to a Tampa Cheap Tiffany, Florida, hospital in 199fivefor an amputation of a gangrenous foot had the inproperfoot removed. In ny, a patient had surgery at the inproperside of his brain at Sloan-Kettering Cancer Center. A surgeon, nationally recognized for his figure with breast cancer patients, confused two patients and performed a mastectomy at the inproperpatient in November 1998.

JCAHO, alarmed on the ongoing topincidence of surgical mistakes, issued a sentinel alert advising patients to beare availableterested in ensuring thon the surgical site is easily marked before undergoing surgery. This alert, issued in December 2001, is the second one sentinel alert at the similar form of medical error. the basicalert interested in wrong site surgery was issued in 1998, and that included a review of onefivecases that were reported to JCAHO. Of the150 reported cases within the curhiredatabase, operations at the inproperbody part accounted for 76% of the cases, at the same time asoperations at the inproperpatient accounted for 13% of the cases. the inpropersurgical operation was interested in 11% of the cases.

what's far more alarming is that JCAHO’s figure may very well understate the real incidence of wrong site surgery. fitnesscare providers don't seem to be required to report sentinel events to JCAHO. They report these events voluntarily. if truth be told, of the 150 cases, only 81% were self-reported by providers. The Physician’s Insurance Association of America discovered 331 claims for wrong site surgery within the ten year period from 198fiveto one99fiveonce It reviewed claims from 22 malpractice carriers representing 110,000 physicians. And, even this number may well be too low because not eachcase ends up in a claim.

Wrong site surgery will have serious consequences for both patients and fitnesscare providers. according to the basicalert in 1998, the yankee Academy of Orthopedic Surgeons adopted the “Sign your Site” program of preoperative surgical site identification. Surgeons were encouraged to initial the intended operative site employingan enduring marker. in line with Dr. Terry Canale, past President of the yankee Academy of Orthopedic Surgeons, the Academy discovered that once a two year period of this campaign only 60% of surgeons were marking their operative sites.


JCAHO isn't anyw encouraging patients to take an active role in assuring that surgeons functionat the right sortsite. in line with JCAHO Tiffany Necklace, patients should do two things: (1)talkin particularwhat is going to be done through the surgery with both the surgeon and anesthesiologist, and (2) have the surgical site marked with an enduring marker within the presence in their surgeon, then have the surgeon initial the location.

The alert also givesconcrete steps for professionalviders to scale back the danger of wrong site surgery. The JCAHO recommends providers:

*require thon the surgical site be marked.
*develop verification checklists.
*require each member of the surgical team to orally checkthe identity of the patient, the planned surgical operation and the location, with the patient Tiffany Charm Bracelet, after the patient arrives within the operating room.
*call a “day out” for the surgical team before the real surgery begins to make sure the patient, procedure and location.

In 1975, the Louisiana legislature limited damage awards in medical malpractice actions to $500,000, exclusive of future medical expenses and legal interest. Despite multiple challenges to this limit on constitutional grounds, the medical malpractice cap remains in effect. But providers need to beware. Wrong site surgery is obviously avoidable and should end up in devastating consequences for patients. Thus, it's imperative that fitnesscare providers quickly adopt effective safety measures designed to eradicate wrong site surgery, or face the actual chanceof losing the medical malpractice cap. Continued wrong site surgery errors may sourceopponents of the cap with enough ammunitidirectly to finally eliminate it, leaving providers at risk of unlimited damage awards. Whon the legislature giveth, the legislature can taketh away.

By focemployingnational attention on that issue, JCAHO hopes to eliminate these avoidable mistakes. shall wehope third sentinel alert in this subject may not be necessary.

Tiffany Earrings。