Potential Causes of Wrong-Site Surgery

Some surgical sessions involve multiple procedures. The number of procedures affects the complexity and duration of the surgery. Both things increase the risk of a surgical error.

Consider a complex case where a patient needs:

• A hepatectomy (removal of a liver section)
• An appendectomy (removal of the appendix)
• A lobectomy (removal of one lobe of the lung)

For this patient, the risk of wrong-site surgery is higher than a patient only needs a hepatectomy.

Although surgeons are well trained and skilled, they can make mistakes if they rush. A surgeon team might rush their procedure because:

• Their facility is understaffed, and they need to work on another patient
• They are fatigued due to long work hours
• They work in multiple facilities and must shuttle between them to handle their cases

Rushing can cause multiple problems that can lead to wrong-site surgery. For example, the surgeon might rush through the surgical checklist and fail to realize that the marking is erroneous.

Marking the surgical site is a necessary preoperative procedure. The marked area represents the site of the incision. Thus, poor or mismarking increases the risk of wrong-site surgery. Consider a case of breast reduction surgery with improper marking. The patient can easily end up with improper nipple placement or abnormally small breasts.

Most surgical procedures are team efforts. The number and nature of professionals in the team depend on the surgery. Team members include:

• Anesthesiologist
• Surgeon
• Nurses
• Physician assistant
• Surgical technician

For example, every member of the team should be aware of the surgical site. Otherwise, the responsible person might mark the wrong part and trigger wrong-site surgery.

Miscommunication arises in various ways. For example, some of the team members might not get the information they need if they don't attend the relevant meetings. Note that communication with the patient is just as important as communication between the surgical team members.

The surgical team must have a time out just before the surgery. During this period, the entire team pauses to confirm critical information before proceeding. For example, the team must confirm that:

• They have the right patient
• The marking is correct
• The procedure is correct

A bungled time out can easily lead to wrong-site surgery. For example, the surgical team might bungle the process if:

• They rush
• Some of the team members are not present
• Some team members interrupt the process

Say the surgical team holds their time out when the surgeon is not ready. The surgeon might make a wrong incision since they didn't participate in the confirmation.

Lastly, many healthcare facilities have staffing problems that can lead to surgical mistakes. For example, staff members of an understaffed facility are likely to be tired most of the time. Fatigue can induce sleepiness and increase the risk of an error.

Another problem arises if, due to staff shortage, the wrong professional performs a procedure. For example, a nurse might mark the surgical site instead of the surgeon. The nurse might make a mistake if they don't have the relevant skill and experience.

You deserve adequate compensation for all the consequences of wrong-site surgery. However, medical malpractice cases tend to be complicated and require legal expertise and experience. Wegner & Associates has both of these and can help with your case. Contact us for a free initial consultation to review your case and advise you on the way forward.