Surgical mistakes in US on the rise: report

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Surgical mistakes in US on the rise: report

NEW YORK, Dec 06 (Reuters Health) - Since 1998, the number of operations

performed on the wrong body site or the wrong patient has increased

dramatically, according to a report released Wednesday by the Joint

Commission on Accreditation of Healthcare Organizations (JCAHO).

The JCAHO is an independent commission that evaluates and accredits

about 18,000 healthcare organizations and programs in the US.

In 1998, the JCAHO issued a Sentinel Event Alert after 15 " wrong site "

surgery cases were reported to it. By the time the current report was

released, this number had skyrocketed to 150.

According to the new figures, orthopaedic/podiatric operations were the

most common procedures linked to errors, accounting for 41% of the 126

cases that were analyzed. General surgery procedures accounted for 20%

of the cases, neurosurgery operations for 14%, and urologic surgery

operations for 11%. The remaining cases involved other procedures such

as dental/oral operations.

Fifty-eight percent of cases occurred in an outpatient surgical setting,

29% in an inpatient operating room, and 13% in other inpatient settings.

Most of the errors involved operations on wrong body parts or sites, but

13% involved operations on the wrong patient and 11% involved the wrong

surgical procedure.

The JCAHO also identified a number of factors that seemed to increase

the risk of surgical mistakes. Among these, emergency cases and physical

characteristics of the patient--such as morbid obesity or physical

deformity--were the most commonly cited. In addition, most cases

involved a " breakdown in communication " between surgical team members

and the patient or the patient's family.

" Although the wrong site surgery problem has been addressed on a local

level in many areas of the country, there has been no organized national

effort to eliminate wrong site surgery, " Dr. S. Terry Canale, immediate

past president of the American Academy of Orthopaedic Surgeons, said in

a statement.

The JCAHO is also offering some advice to patients on avoiding surgical

errors:

-- Make sure you and the surgeon agree on exactly what will be done

during the procedure.

-- Ask to have the surgical site marked with a permanent marker and to

be involved in marking the site.

-- Ask questions and speak up about any concerns.

-- Have the surgery at a JCAHO-accredited facility. Consumers can find

out if a facility is accredited by going to the commission's Web site,

www.jcaho.org.