Bar Codes Keep Surgical Objects Outside Patients 269
Reservoir Hill writes "Every year about 1,500 people in the US have surgical objects accidentally left inside them after surgery, according to medical studies. To prevent this potentially deadly problem, Loyola University Medical Center is utilizing a new technology that is helping its surgical teams keep track of all sponges used during a surgical procedure. Each sponge has a unique bar code affixed to it that is scanned by a high-tech device to obtain a count. Before a procedure begins, the identification number of the patient and the badge of the surgical team member maintaining the count are scanned into the counter. When a sponge is removed from a patient, it is scanned back into the system. A surgical procedure cannot end until all sponges are accounted for."
Somehow I find this unlikely... (Score:2, Interesting)
Somehow I can't totally believe that. True, it will obviously remind them and stop them from leaving them accidentally, but what if the doctor just leaves? Does it lock the door?
</sadattemptandhumor>
Seriously though, what if there's a fire or something and not all the sponges can be accounted for? What if a doctor accidentally walks out with one? I agree that this will be useful a lot of the time, but it looks to me like their plan may not be 100% effective, and I sure wouldn't want to be left in the hospital to die because one sponge fell under the bed.
Re:High Tech Barcode Scanner? (Score:2, Interesting)
Well, to be fair, the person who wrote the article was George H. W. Bush. (1992) [pqarchiver.com]
Re:Surgeon accountability? (Score:5, Interesting)
We do all make mistakes, and surgeons are no exception.
I had a laproscopic procedure done a few years back and in the end I developed and abdominal infection. The surgeon had done his work, as had the hospital, but bacteria are microscopic. And, sometimes, the procedure just has a mistake.
As best as the surgeon could guess, there must have been some bacteria on one of the instruments despite all of the precautions. Shortly afterwards, though he didn't say so, I could tell that he was worried. Once I made it clear that I had no intentions of suing him, he became far more relaxed.
I don't blame him, and told him as much. Sometimes, even when you follow all of the proper procedures, things don't turn out right. It's unfortunate, but it doesn't mean he did it through incompetence or malice. Perhaps I would feel differently if it hadn't turned out well enough in the end, but given the amount of medical procedures I've been through, I expect I would have felt this way regardless.
We had (or have?) this problem in Mexico... (Score:2, Interesting)
Re:Anything. (Score:1, Interesting)
Re:Surgeon accountability? (Score:4, Interesting)
It always amazes me how resistant people are to this idea. Think about how many times it takes you to get some code working. Sure, you're not as worried about it working the first compile as a surgeon but we all know that little mistakes are inevitable. It's human nature. These kinds of systems are very sensible because they provide a mechanical way for staff to avoid a common medical error. It shouldn't even cost all that much once widely used.
I recently read a pretty interesting book called "Complications," sort of a blog style book about medical errors, mysterious ailments, etc. The author, who is a surgeon, recounts a list of medical errors that sound horrible...metal instruments left in a patient after surgery, incorrect dosages of medication given, etc. In some cases the patient in question died. The source of the mistakes? An informal survey of mistakes made in the past couple of months by his colleagues at Harvard.
Even cream of the crop doctors will screw up occasionally, and they see dozens of patients daily. One of the interesting points of the book was that there is very little scientific study on medical errors and how to best avoid them.
Re:RFID? (Score:3, Interesting)
Re:Surgeon accountability? (Score:4, Interesting)
Happened to me too (Score:2, Interesting)
Yeah. I was pissed.
Re:Anything. (Score:3, Interesting)
Re:A 39 cent solution (Score:5, Interesting)
I was a Navy operating room tech. As a junior enlisted, I yelled at an officer exactly one time: when a new anesthesiology resident saw a sponge on the floor and helpfully threw it away in his own trashcan (which the nurses and techs aren't responsible for). At the end of the case when the count was off, the surgeon proceeded to pitch a royal conniption - and justifiably so. We tore the room apart, went through the trash, went through the biohazard trash (filled with bloody stuff), dismantled every piece of equipment that it could possibly have fallen into, and generally panicked. After about 20 minutes of frantic searching, the new guy walked in and asked us very sympathetically what was wrong. He went white as we told him and ran to fetch his garbage, thus rescuing us from The Wratch Of The Surgeon.
We asked him to please not do that again.
But this barcode scheme wouldn't have helped. We already knew we were missing exactly one sponge, and it wouldn't have told us that it had been taken from the surgical suite. As much as I hate to say it, this is well beyond the point of diminishing returns and may even be more dangerous than the current system. This will require more labor, and thus either cause surgeries to take longer (exposing patients to risks of longer anesthesia) or raise surgical headount and costs and thereby make medical care even harder to get for some people. At some point, you have to say "the current level of risk is just about as good as we can get it" and move on.
You can get risk levels arbitrarily low given an infinite amount of resources. We don't have infinite resources.
Re:A 39 cent solution (Score:3, Interesting)
This is one reason that the whining of people about tort reform doesn't carry too much weight with me. If you can charge someone 6 figures to perform a surgery, why should you be surprised that juries are willing to hand out awards in the same range? If I walk into Best Buy and buy a DVD player, only to find that there's a huge gouge on the front of the machine, I'd be able to return it and get a refund. It doesn't matter that there are no "long term consequences" on the operation of the player: a large gouge on the front of the machine is still a major defect. It also wouldn't matter if such defects are rare (even 1 in 20,000).
I'd say that a sponge sewed up inside a person is a pretty large defect in the purchased surgery. However, if the doctor/hospital isn't willing to issue a refund, the only other option is legal recourse. I don't like the privatized health care system, mainly because it's not a market in any definition of the term, but I digress. This is just the logical consequence of it.
Simple Count. (Score:3, Interesting)
And that's how it works here in Geneva (Switzerland). In addition of the count, there's a mandatory X-Ray done after each operation, which gives a couple of critical information about the results of the surgery...
Bar code are a technical overkill and are plagued by the same kind of errors as the counting method :
- failing to count material at beginning of surgery vs. failing to swipe barcodes of material before using it.
The only kind of high tech stuff that could be useful would be RFID identifications in addition to counting.
Thus RFID signal could be used to interrogate "Are there any material still left and responding to the signal" ? Thus helping identify material that was missed during the initial count / barcode swipe.
But that would increase the cost of the material (which is disposable).