In medical terms, a “never event,” is exactly what it sounds like: a medical mistake so egregious that it should never occur. Wrong site surgery, or when a surgeon performs a procedure on the wrong part of the patient’s body, is a never event. Unfortunately, according to some cited statistics, surgical errors classified as never events – including wrong site as well as operating on the wrong patient or performing the wrong surgery – happen up to 40 times per week in this country.
These potentially fatal mistakes are preventable. That’s why the Joint Commission, an independent, not-for-profit organization that accredits and certifies more than 20,000 health care organizations and programs in this country, developed a universal set of protocols for medical professionals to follow in avoiding mistakes in the operating room. First established in 2003, they were revised in 2010.
Steps Medical Care Providers Should Take to Prevent Surgical Mistakes
The Joint Commission’s guidelines for preventing wrong site, wrong procedure, and wrong person surgery include:
- Conducting a thorough verification process prior to the surgery to confirm the correct procedure, the correct site and the correct patient. This encompasses all relevant written documentation on the patient and properly labeled test results displayed in the OR.
- Clearly mark the surgical procedure site, preferably at least by a licensed independent practitioner who will be in the OR while the surgery is performed.
- Just prior to surgery, the entire operating team should conduct a standardized “time out” to one last time verify the patient’s identity, the correct site for the surgery, and that the correct procedure has been scheduled.
Patients who are undergoing surgery should have confidence in their medical team. However, patients can play a role in helping to prevent surgical mistakes by doing any or all of the following:
- Ask your surgeon what steps are in place to ensure that he or she does not operate on the wrong site
- Confirm with the operating team your name and birth date several times prior to entering the OR
- Make sure that your surgeon marks the surgical site as directed in the Joint Commission’s Universal Protocols
- Take the time to understand what is in the consent form you sign prior to surgery. The consent form outlines what will be done in the procedure and the risks involved.
The ultimate responsibility for avoiding “never events,” however, belongs to health care providers. When preventable medical mistakes are made by a negligent hospital and/or medical professionals, legal action can provide compensation for the victim and help prevent a similar mistake and patient harm from happening again.