A physician operating on the wrong body part – which is known as a wrong site surgery – is a “never event” in the medical world. A never event is a patient safety incident that is considered preventable and should never happen. There is a wide range of estimates on how often a wrong site surgery occurs – which can be anywhere from .09 to 4.5 times per 10,000 surgeries performed.
Common surgeries to the hand can include tendon repair, nerve repair, carpal tunnel release surgery, trigger finger release surgery, fasciotomy, joint replacement, and skin grafting. Common surgeries to the elbow include total elbow replacement, surgery for tennis elbow, total elbow replacement cubital tunnel release surgery (when a nerve in your arm becomes entrapped causing pain and numbness in the arm), elbow arthroscopy, elbow fracture repair, and UCL reconstruction. If the procedure is to be done on both sides of your body it will be called a bilateral procedure, and if one a unilateral procedure. For example, a person can undergo carpal tunnel release to both hands – a bilateral carpal tunnel release. Or they may only need it for one hand – a unilateral carpal tunnel release.
How do hospitals make sure they know whether they are operating on the right hand or elbow?
The Joint Commission (an organization that certifies and accredits health care organizations such as hospitals and surgery centers) has introduced a “Universal Protocol” to help reduce the incidence of surgeries to the wrong area of the body. The Universal Protocol calls for surgeons and the medical staff assisting in the operation to conduct a pre-procedure verification process. This process includes verifying the correct procedure, for the correct patient, at the correct site. If possible, the Universal Protocol calls for involving the patient in the verification process.
For the surgery itself, the Universal Protocol notes at a minimum the surgery site should be marked when there is more than one possible surgical site, and operating at the wrong surgical site could cause harm to the patient. The marking of the surgical site should be done before the surgery is started, and the patient should be involved in the marking of the site if possible. The person to mark the surgical site should be the medical practitioner (doctor) who is accountable for the surgery and will be present when the surgery or procedure is performed. In some limited circumstances residents, physician assistants, or advanced practice registered nurses can mark the surgical site. According to the Universal Protocol the doctor performing the surgery is still responsible to make sure the right site was marked even if that doctor is delegating this responsibility.
The mark used for the surgical site must be a well understood and universal sign that the mark represents where the surgery is to be done. The mark must also be visible after the surgical site is prepped and draped. Adhesive markers should not be the only means of marking the surgical site.
Another step that should happen is what is known as a “time out”. During this time out session all immediate members of the team to do the surgery must be present. These surgical team members must communicate with each other during the time out period and all must agree that they have the correct patient, agree on the procedure to be done on the patient, and agree on the correct surgical site. If there are two surgeries that are going to be performed on the same patient, and a new surgeon is doing the second procedure, a second time out must be performed for that second surgery.
A doctor or surgical team can perform a wrong-site hand or elbow surgery for many reasons. There may be poorly trained staff who drape and prep the wrong surgical site because they miss the marking of the correct site. The staff may rush through the time-out procedure and not perform an adequate one. Or they may negligently not perform one. The doctor may also delegate the marking of the surgical site to staff who are unqualified to do so and not later confirm that the correct surgical site was marked off.
In order to prove negligence in wrong-site hand or elbow surgeries, you will need medical experts board certified in the same area of medicine as the doctor who operated on you to discuss that. You may also need nursing or hospitalist experts to discuss any negligence on the part of the surgical staff.
How can a wrong-site surgery on your hand or elbow cause damages to you?
A wrong-site surgery on your hand or elbow can have wide-ranging effects on you. It can lead to a build-up of scar tissue and functional limitations with your formerly healthy hand or elbow. If you have total elbow replacement, you could now have an elbow that is less than 100% functional and have your healthy joints unnecessarily replaced with implants. The same goes for joint replacement surgery in your hand.
In some instances, you can suffer complications from the wrong site hand or elbow surgery. Here, not only did you have unnecessary surgery on the wrong body part, but you suffered nerve damage or other injuries during the surgery. These complications could leave you with a permanently disabled hand or elbow that was not supposed to be operated on in the first place. An example of this would be suffering median nerve damage during carpal tunnel release performed on the wrong hand. Or suffering ulnar or radial nerve damage during tennis elbow surgery performed on the wrong elbow.
You could also suffer psychological impacts and economic damages due to the wrong site hand or elbow surgery. The psychological impacts could be a loss of confidence in healthcare providers and delaying routine procedures, you need for fear of something similar happening again. If complications from the wrong site hand or elbow surgery prevent you from working, you will also have a lost wage claim. Depending on your health insurance, you may have a right to recover any bills related to the medical treatment due to negligence in operating on the wrong hand or elbow. You may also have a future medical cost claim if you require more surgery and therapy in the future due to the wrong site hand or elbow surgery.
The Thistle Law Firm is experienced at handling wrong-site surgery to your hand or elbow cases. If a doctor or other healthcare provider performed surgery or a procedure on the wrong hand or elbow, the attorneys at The Thistle Law Firm are here to take your call and answer your questions at 215-568-6800.