Case Studies
What mistake was made in this surgery?: Sarah Thompson was diagnosed with gallstones and was scheduled to get her gallbladder removed. The surgeon accidentally cut her bile duct (carries bile from the liver to intestine) and hoped that this error would resolve itself.
What is her bile duct was cut
In what year was the NSPG found?
When is 2002
What percent of WSPE's are Operating on the wrong part of a patient’s body?
23%
What is the main goal of this section?
Prevent mistakes in surgery
What complications would John face from the surgeon's negligence in the following scenario: John Smith had knee replacement surgery. During the surgery the surgeon didn't properly align the prosthetic knee joint.
What is/are permanent mobility issues, constant pain, difficulty walking, limited ability to participate in ADL's (Activities of Daily Living)
Who founded the NSPG?
Who is the Joint Commission
What percent of WSPE's are wrong patient surgeries?
5%
What does WSPEs stand for?
wrong-site, wrong-procedure, wrong-patient errors
What did the surgeon do wrong in the following scenario: Michael Johnson had spinal surgery for a herniated disc. During the surgery, the surgeon misplaced a screw, but assured the family that the loss of sensation and movement afterwards was a natural part of the healing process.
What is/are misplacing a screw, refusing to acknowledge his error, and lying to the family about his recovery
In what year was the Joint Commission founded?
When is 1951
What is the most common surgical mistake?
Operating on the wrong side of the body
Are mistakes with anesthesia included in this section?
No, anesthesia is under medication safety or perioperative safety protocols
How do case studies serve as an example for the importance of preventing mistakes in surgery?
What is/are maintaining high standards of care, ensuring thorough surgical techniques, and adequate post-op monitoring
What year were the first NPSG's published?
1951
How many times a year does wrong site surgery happen?
4000+
How can a surgeon prevent wrong-site surgery?
Make sure they double check and mark the correct region (confirm with each other)
What is the name of the surgery mistake where a 42 year old male had surgery on the left knee instead of the right (intended) knee?
What is wrong-site procedure?
What year was the first medical malpractice documented?
When is 1794
What percent of WSPE's are performing the wrong surgical procedure?
14%
Fill in the blanks:
Make sure the correct ____ is done on the correct _____.
Surgery, patient