Retained Foreign Objects Following Caesarean Section
A retained foreign object following surgery is a preventable occurrence. The 2002 National Quality Forum listed retained surgical items among a group of completely preventable medical errors that should never happen to patients, i.e., so-called “never events.” There are myriad measures that can and must be taken to prevent leaving a foreign object inside a patient during a surgery. These measures are known and required for any surgery, including a Caesarean section. The measures include counts of all surgical tools or aids, including gauze and sponges, before, during, and after surgery to ensure they are all accounted for (not retained in the patient). Responsibility for surgical counts lies with the surgical team. The doctor performing the surgery is ultimately responsible to ensure the counts are performed and are accurate. Other measures include visual and manual inspection of the patient prior to closure of each layer in a Caesarean section. When a count does not match or when a preoperative count is not performed, it is common and the preferred practice of surgeons to use x-ray before surgery is completed to ensure no foreign objects are retained in the patient. Surgical instruments, such as gauze or surgical sponges, contain radiopaque markers that make it easy to see these objects on imaging. This imaging needs to be promptly read by the surgeon and/or radiologist. If read by a radiologist, the results need to be promptly reported to the surgeon.