HOUSTON – What goes in, must come out. At least, that is what is supposed to happen with equipment and instruments, such as scalpels, needles, clamps and sponges, used during surgeries.
However, we found on occasion things do get left behind.
While checking the consumer version of "Facility-Specific Health Care Safety Reports" on the Texas Department of Health Services website, we noticed a small section at the bottom of the report called "Preventable Adverse Events."
In reports for the second half of 2016, the most recent on the site, we saw more than a dozen local hospitals spread over three of our area's largest counties reported leaving objects in patients.
The medical community calls such incidents "retained foreign objects." The reports simply said, "Object left in patient after surgery."
No matter what you call it, it means something got left in the patient during their surgery.
Looking for more information, we found these cases are usually settled out of court and have confidentiality clauses.
Dr. William Cramer is General Surgeon in Houston. He's also an expert witness who has reviewed and testified in these kinds of cases for both hospitals and patients.
Cramer told Channel 2 Investigates these incidents most often happen during emergency surgeries or during very long surgeries where members of the surgical team rotate in and out.
According to Cramer, to prevent incidents, almost all hospitals have policies requiring a count of all instruments and sponges before the surgery starts and again toward the end.
"They're also required to be counted as the surgeon is preparing to close the abdomen or the pelvis or whatever part of the body they're working on, and also a third sponge count, instrument count and needle count when the abdomen or surgical location is completely closed," Cramer said. "And that has to occur with what's referred to as a "correct count" meaning hopefully an accurate count ... that those that were present before the surgical procedure have been removed and are present at the end of the procedure as well."
The items most often left in patients are sponges. Surgical sponges are soft pieces of gauzy material used to sop up blood during procedures. Wadded up bloody sponges can look a lot like tissue that belongs in the body. If a sponge gets left behind, it can become infected.
To lessen the chances of a sponge being left inside a body, nearly all now have a blue thread or tab that shows up on x-rays. If there is doubt about the sponge count, an x-ray can be taken before the patient is closed up to find it and remove it.
Before anyone has a surgery, ask if the hospital has a policy requiring sponge and instrument counts during procedures. Medicaid and Medicare have a tough policy when it comes to leaving things in patients, according to Cramer.
"They describe these things as 'never acts,' which meant it should never happen," Cramer said. "So in the case of someone who is on Medicare or Medicaid that has a retained foreign object left behind, either a sponge, instrument, Medicare will not reimburse for any subsequent care that that patient is required to have."