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Message - December 19, 2001
Surgical Calamities on Rise, Group Says


By David Brown

Washington Post Staff Writer


The number of surgical calamities in which a doctor operates on the wrong part of a patient's body, and occasionally on the wrong patient, appears to be increasing, according to the organization that accredits U.S. hospitals.

Reports of "wrong-site surgery" have risen from 16 in 1998 to 58 this year, including 11 in the last month, according to the president of the Joint Commission on Accreditation of Healthcare Organizations.

"I think it's real," said Dennis S. O'Leary, a physician who heads JCAHO, which accredits about 95 percent of the hospital beds in the United States. "If you look at the trend line, you see an increase in every single year" since 1995.

"The preponderance of cases are in ambulatory surgery centers. I think patients are churning through these places," O'Leary said. "People are busy and patients are being put to sleep before there is an opportunity to verify who the patient is, what procedure is going to be performed and on what site."

The mistakes include operations on the wrong finger, replacement of the wrong hip joint, fusion of the wrong spinal disk, cataract removal from the wrong eye and biopsy of the wrong side of the brain.

A small number resulted in death. Some had serious consequences, such as the removal of a healthy kidney instead of a cancerous one. The subsequent need to remove the cancerous one forced the patient to use renal dialysis. But many of the mistakes produced no permanent disability.

O'Leary would not provide scenarios of individual errors, saying the reports are collected with the promise that details will be kept confidential.

In 1999, 41.3 million surgical procedures were performed, said a spokeswoman for the federal government's National Center for Health Statistics. The number of operations has fallen slightly in recent years, from 158 procedures per 100,000 in 1994 to 152 per 100,000 in 1999.

JCAHO's "sentinel event alert" report included three categories of mistake: operations on the wrong body part (76 percent of cases), operations on the wrong patient (13 percent) and the wrong operation on the right patient (11 percent).


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