The latest story in the news is of a three-year-old boy who was supposed to have surgery to correct a lazy eye, but whose surgeon accidentally operated on his other, good eye. Now he has to have the surgery again, to correct the work done wrong and to correct the lazy eye that wasn’t corrected in the first place.
This type of mistake is more common than you’d like to think. Studies estimate that as many as 2,700 serious surgical errors, like operating on the wrong side of the body or on the wrong body part, are committed each year. That amounts to about seven a day.
The term “never events” is used to describe medical errors that should absolutely never happen, no matter what. Operating on the wrong body part is one of them.
[Dr. Kenneth] Kizer is the former CEO of the safety advocacy group National Quality Forum and the man who helped coin the term "never events," a list of 28 adverse events — such as operating on the wrong body part or giving a patient the wrong medication — that happen in the health care system and put patients at serious risk.
"People underestimate how complex the system is and the number of ways that errors can happen," he said. "There are dozens of doctors that will be involved in a case that goes to an operating room. Every time someone new sees a patient, there’s the potential that they’ll miss something or get a detail wrong." –CNN
As a patient, obviously you don’t have a whole lot of control over the system. But there are certain steps you can take to help reduce the risk that a “never event” will happen with your surgery.
1. State your name and your birth date to everyone who gives you a medication or treatment.
2. Ask the surgeon and surgical nurses specifically what they will be doing to ensure that your surgery is performed on the correct side and body part.
3. If you are having general anesthesia, request that the operating team take a “time-out” before you go under, to agree about all the details of your surgery while you are coherent and able to detect any confusion.
4. Thoroughly read your informed consent form, and ask questions if you read anything you don’t understand or are worried about.
5. Have your surgeon initial your surgical site (and check the initials) before you go into the operating room.
6. Trust your intuition, and speak out. If you sense confusion or otherwise feel like someone in your medical team is missing something, don’t hesitate to ask questions.