Part 1
Despite recently-implemented policies and procedures to prevent it, reports of wrong-site surgery (e.g., amputating a right leg when a left leg should have been removed) still occur. The Joint Commission (JC) - a not-for-profit group that accredits the nation's hospitals - estimates that wrong-site surgeries occur around 40 times per week. The number of cases reported to the JC nearly doubled from 2004 to 2010. Please note that this number includes only reported cases, since approximately half of the states in the U.S. do not require hospitals to report cases of wrong-site surgery. Therefore, it is difficult to pin down the real number of cases.
A study noted that only one in three of these reported cases resulted in a medical malpractice case. There are a multitude of reasons for this, but - for starters - tort reform and damage caps make it difficult if not impossible to pursue cases where injuries are not severe enough to warrant the time and expense of litigation. It is often said that these reforms and caps are in place to drive down costs and help consumers, yet healthcare costs have continued to rise, as have reports of medical mishaps.
The Joint Commission approved a Universal Protocol for Preventing Wrong-Site, Wrong-Procedure, and Wrong-Person Surgery in July 2003, which became effective and mandatory for all accredited hospitals, ambulatory care centers, and office-based surgery facilities on July 1, 2004. The three principal components of the Universal Protocol are a pre-procedure verification, site marking, and a pre-incision "time-out."
Despite the implementation of the Universal Protocol, wrong-site, wrong-procedure, and wrong-person surgeries continue to occur in U.S. hospitals at alarming rates. Some reasons for this may include the increased time pressure put on physicians, as well as their lack of willingness to adhere to "protocols" and their underestimation of their fallibility. In addition, many of these errors are the result of simple oversights - failing to double-check imaging reports, not displaying imaging in the operating room, ensuring that x-rays are not flipped backwards, failing to double-check that the correct patient is on the operating table, or failing to take the required "time-out" or doing it halfheartedly or lackadaisically.
