believe - This could have multiple reasons, but the fact that it has happened several times is interesting. It could be the same staff member in each case, but that should be obvious and they should have been relieved of their duties by now, plus they are very different surgeries, so that is unlikely but still possible. They could be putting so much pressure on the staff to turn cases around that they are not following all the counting protocols - very bad. Sometimes the surgeons will not stop, even when they are informed that there is a problem - not much the staff can do except report him, but a general surgeon would not be doing brain surgery, so that isn't it either most likely. That is a pretty rash step to tell them they have to put video cameras in all the operating theaters. I would think that would be a violation of patient confidentiality. The broken off drill bit could happen easily, but if it remained in place (sometimes it can be more risky to try to remove it than leave it in place), the patient should have been notified and notes made in the operative record that the drill bit broke during the procedure and was left in-situ, which seemingly didn't happen. The forceps in the abdomen is a big no-no. Very bad. I don't really see a review of funding being necessary in this case. They need to look at their operating room staff, the number of cases they are performing daily, and their counting procedures....IMHO.
http://www1.whdh.com/news/articles/...pital-fined-for-leaving-drill-bit-in-patient/
RI Hospital fined for leaving drill bit in patient
"We have made aggressive efforts to put the strongest, most effective policies in place to eliminate medical errors. But if we fail to adhere to these policies 100 percent of the time, we are falling short. And that is unacceptable and frustrating," Babineau said in a written statement.
Health department spokeswoman Annemarie Beardsworth said operating room staff violated hospital procedure in leaving a drill bit in the patient's head. The policies require staff to conduct an X-ray of a patient if surgical tools or devices can't be found after a surgery. No X-ray was taken.
If the bit
broke, they weren't short when they counted - thus no X-ray.
Part of the bit was there, and it was counted would be my guess. The doctor had to know the bit broke, it would have been in his hand when it happened. He should have notified the nurse and scrub nurse/tech. The scrub should have noticed the bit came back broken and questioned where the other piece was. If they
had to leave it, that should have been documented in the record.
http://www.rhodeislandhospital.org/rih/about/stats.htm
According to their statistics here, they performed 24,399 surgeries in 2009, which works out to 67 procedures per day (365 days) or 96 procedures per day (253 work days - I don't know if they run on weekends.) Dunno how many rooms they have, but that could be as few as 6-7 or as many as 9-10 procedures per day per room. That is alot, more than one per hour. Those nurses and techs (if they have them) are hustling. An 8 hour day, 7 hours with breaks, that is alot of cases, to do a case per hour, depending upon the procedure is an awful lot to keep up with.
"We have made aggressive efforts to put the strongest, most effective policies in place to eliminate medical errors. But if we fail to adhere to these policies 100 percent of the time, we are falling short. And that is unacceptable and frustrating," Babineau said in a written statement.
Health department spokeswoman Annemarie Beardsworth said operating room staff violated hospital procedure in leaving a drill bit in the patient's head. The policies require staff to conduct an X-ray of a patient if surgical tools or devices can't be found after a surgery. No X-ray was taken.
Ugggghh. They do alot of complicated procedures. Those take more than an hour to perform. They also do trauma. Wonder if any of these cases were trauma cases. The rules with those are a little different.
http://www.rhodeislandhospital.org/rih/services/Surgery/default.htm
The bottom line to my rambling post is that it can certainly be more than staff ineptitude that can cause this and cutting funding will not fix it.....
