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Risk factors for retained instruments and sponges after surgery. Classic icon
Gawande AA, Studdert DM, Orav EJ, Brennan TA, Zinner MJ. N Engl J Med. 2003;348:229-235.

This case-control study discovered that emergency surgeries, unplanned changes in a surgical procedure, and heavier patients all posed greater risk for suffering the complication of a retained foreign body. Investigators analyzed 54 cases where foreign bodies requiring reoperation occurred and drew comparisons to more than 230 control cases. Overall, the authors' findings suggest a rate of one such case or more each year at the typical large hospital, which may be an underestimation given the cases are captured through malpractice claims. They suggest routine intraoperative radiographic screening might serve as a cost-effective intervention to prevent these often costly events. The lead author of this article also wrote a book entitled Complications that explores the imperfect science of medicine. A case discussing an error of a retained sponge and a preventable death was discussed in an AHRQ WebM&M commentary.

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Related Resources
ORGANIZATIONAL POLICY/GUIDELINES
Statement on the prevention of retained foreign bodies after surgery.
Bulletin of the American College of Surgeons; October 2005.
STUDY
Retained foreign bodies after surgery.
Lincourt AE, Harrell A, Cristiano J, Sechrist C, Kercher K, Heniford BT. J Surg Res. 2007;138:170-174.
REVIEW
Preventable errors in the operating room: retained foreign bodies after surgery--part I.
Gibbs VC, Coakley FD, Reines HD. Curr Probl Surg. 2007;44:281-337.
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