The Most Common Surgical Errors

Medical and surgical errors occur at a surprising rate. According to a 2019 review in the British Medical Journal, approximately one in 20 patients are the victims of preventable harm from medical care. For a surgical error to constitute medical malpractice, two things must be true:

• The surgeon must fail to follow the appropriate standard of care
• The failure must be the actual and proximate cause of the harm suffered

If you have an upcoming surgery, or recently had surgery and are experiencing problems, you may be curious about the potential for medical and surgical errors, how they are defined, and what you as a patient can do to prevent surgical errors from occurring in the first place.

How Surgical Errors Are Defined

A surgical error is defined as an injury caused by a preventable error that occurs during surgery and is not an anticipated risk of the surgery.

By this definition, the error must cause some injury to the patient that's not an anticipated risk of the surgery. All surgeries involve some degree of risk, which is why the hospital likely will ask you to sign an informed consent document stating that you acknowledge and accept the risks involved with your upcoming surgery.

Also, the surgical error must have been caused by a preventable error. For example, perhaps the surgeon or accompanying medical team failed to do sufficient preoperative planning, resulting in a surgical error — the key here is that the error would have been prevented if standard operating procedures had been followed.

Common Medical Errors That Occur

While the list of medical errors that can occur during surgery is extensive, several errors recur relatively frequently, including:

• Anesthesia errors during surgery
• Surgeons leaving surgical equipment inside the patient
• Performing surgery on the wrong location
• Performing the wrong procedure 

Anesthesia Errors During Surgery

When an anesthesiologist makes a mistake, the results can be traumatic. For example, oxygen deprivation can occur if too much anesthesia is delivered. This can result in a traumatic brain injury, stroke, or even death.

On the other hand, if too little anesthesia is delivered, the patient can suffer from undue pain or accidental awareness during general anesthesia (AAGA). AAGA enables the patient to be aware of their surgery, remember it, and sometimes feel the associated pain. This experience can lead to post-traumatic stress disorder and anxiety.

Surgeons Leaving Surgical Equipment Inside the Patient

When a surgeon accidentally leaves surgical equipment inside the patient, it is considered a retained surgical instrument. An item is retained when discovered after the skin closure is complete, even if the patient is still under anesthesia in the operating room. In 2018, unintentionally retained foreign objects (URFOs) resulted in as many sentinel events — those which result in death, severe harm, or severe temporary harm — as falls.

The Open Access Macedonian Journal of Medical Sciences found that surgical instruments are retained in up to one out of every 1,000 abdominal surgeries. With over 28 million surgical operations performed in the U.S., they estimate roughly 1,500 cases of retained surgical instruments occur each year.

Performing Surgery on the Wrong Location

Performing surgery in the wrong location may mean that the surgeon did one of the following:

• Operated on the wrong body site, such as the wrong level of the spine
• Performed the wrong procedure, which a 2021 Joint Commission report rated as the fourth most frequently reviewed sentinel event
• Performed the operation on the wrong patient, such as this Massachusetts surgeon who removed a kidney from the wrong patient

Overall, it is estimated that wrong-site surgeries occur around 40 times per week in the U.S., or approximately 2,080 times per year. A 2020 study found that in Pennsylvania alone, wrong-site surgeries occur an average of 1.42 times per week.

Performing the Wrong Procedure

When a surgeon performs the wrong procedure on a patient, it can have devastating results.

To add insult to injury, the Centers for Medicare & Medicaid Services (CMS) made a statement that when a medical practitioner accidentally performs the wrong procedure on a Medicare beneficiary, CMS will not cover the costs of the erroneous operation.

What Can Lead to Errors During Surgical Procedures?

Knowing the prevalence of surgical errors in the U.S. healthcare system may lead you to wonder what causes these medical errors in the first place. Medical errors have many causes, from audio distractions to lack of training. However, three of the more common causes of surgical errors include:

• Poor communication
• Failure to follow surgical safety checklists
• The influence of drugs or alcohol
• The presence of any of these issues can greatly increase the chance of surgical errors.  

Poor Communication

Poor communication can be problematic when it comes to surgical errors. This communication breakdown could be between the surgeon, nurses, supporting medical staff, or the patient. A 2012 interview study found that preoperative lack of communication between anesthetists and surgeons was a common problem. The study suggests that communication failures across the entire spectrum of care could gravely impact patient safety.

Failure To Follow Surgical Safety Checklists

Surgical safety checklists exist to ensure that surgeons perform the correct procedures before, during, and after surgery. They help streamline the safety protocol. The World Health Organization offers a 19-point surgical safety checklist created in conjunction with the Harvard School of Public Health to increase surgical safety procedures for patients.

Influence of Drugs or Alcohol

If one of the supporting medical staff or the surgeon is under the influence of drugs or alcohol, the potential results could be tragic. According to a 2018 analysis of 157 patients potentially affected by medical malpractice, only 11 patients were aware of their doctor's intoxication, which suggests that many patients may not realize if their surgeon is under the influence of drugs or alcohol. 

According to Emergency Physicians Monthly, 15% of physicians will be impaired at some point in their careers. Addiction rates for physicians are higher than the national average of 13%, likely due to the stress and long hours common in the medical industry. However, their knowledge and access to medicinal drugs can make their substance issues challenging to detect.

How Can You as a Patient Prevent Surgical Errors?

Can a patient help prevent surgical errors? It may feel like the issue is out of your hands. However, there are certain steps you can take to help ensure your safety. One of the best things you can do is be an active participant in your medical treatment. Discuss your treatment or upcoming surgery with your medical practitioner. You should feel comfortable asking questions or voicing concerns — you have a right to question anyone involved in your medical care.

Before having surgery, be certain that you, your surgeon, and your doctor all agree on what operation will be performed, along with any minor details. Surgeons are supposed to use a special marker to initial on your body where the surgery will take place — you can verify they haven't placed their initials on the wrong area.

Another proactive action you can take is to choose a hospital that is experienced in performing the type of surgery you will be receiving. Hospitals that regularly perform a specific operation are generally less likely to make a grave mistake during that operation.

If you believe that you or a loved one has been the victim of a surgical error, you should speak with an experienced surgical errors attorney. Kennedy, Johnson, Schwab, and Roberge is a well-established legal firm with decades of experience representing injured people throughout Connecticut.

Contact us today to speak with an experienced surgical errors attorney.