What Are Foreign Object Errors?
Foreign object errors, also known as retained foreign objects, occur when a surgeon or surgical team fails to remove all the items used during a procedure. The National Institutes of Health (NIH) characterizes a retained foreign object as anything used in a surgical procedure but unintentionally left inside the patient's body.
Examples of foreign objects left behind include the following:
- Needles and sharps - Small items like needles or fragments of broken instruments can be overlooked, especially during complex procedures. Their small size increases the risk of being overlooked, especially if surgical counts are inaccurate.
- Surgical instruments - Although less common, larger instruments such as clamps or forceps can be retained, particularly in emergency surgeries where time constraints may lead to lapses in standard protocols.
- Broken fragments - Pieces of surgical devices or instruments that break off during a procedure can remain inside the patient if not identified and removed promptly. This includes parts of catheters, guidewires, or screws.
- Surgical drains and tubes - Portions of drains or tubes used during surgery may be unintentionally left behind, especially if they become dislodged or severed during removal.
- Guides and markers - Tools used for navigation or marking during surgery may not be accounted for before closing.
- Surgical sponges - According to the cases reported to the Joint Commission (TJC), sponges are the most frequently reported retained items used to absorb blood and maintain a clear surgical field. Their soft texture and ability to blend with bodily tissues make them difficult to detect if not properly accounted for.
These errors can have severe consequences, from immediate health risks to long-term complications that affect the patient’s quality of life. However, they are entirely preventable with proper protocols and attention to detail.
