By David Brown
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"
"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