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Surgery on Wrong Patients, Surgical Sites Persists, Study Finds
Date:10/19/2010

istakes, Stahel's group found diagnostic errors accounted for 56 percent of the operations on the wrong patient, and 100 percent -- including one in which the wrong child was called to the operating room -- were due to poor communication.

Among operations on the wrong part of the body, 85 percent were due to errors in judgment and 72 percent were due to not performing a "time-out" as required by the universal protocol. Time-out is a common occurrence before an operation begins, when all those in the operating room check that they have the right patient and that they know what part of the body they are operating on.

But a safety system alone cannot solve the problem, Stahel noted.

"Once we were fully responsible for our actions -- now we hide behind a safety system that should cover the problem. The time-out is performed, but people are not mentally involved -- the system alone cannot protect you from wrong-site surgery," he said.

The blame for these mistakes falls across the medical profession, the researchers noted. The groups most frequently involved in operations on the wrong patient were internal medicine specialists, who were responsible for 24 percent of such mistakes, and clinicians involved in family or general medicine, pathology, urology, obstetrics-gynecology, and pediatrics, who were each responsible for 8 percent, according to the study.

The study also found that specialists in orthopedic surgery were responsible for 22.4 percent of the operations on the wrong surgical site, general surgeons for 16.8 percent, and anesthesiologists for 12.1 percent.

Stahel said doctors should take more personal responsibility for their errors. "We are going from a culture of blame to a culture of system safety, and we should move on to a culture of patient safety and accountability," he said.

Dr. Martin A. Makary, an associate professor of surgery at Johns Hopkins University and author of an accompanying journal editorial, said
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