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Monday, February 25, 2008

Wrong Eye Surgery: Could It Happen to You?
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Medical treatment can be dangerous, even fatal: errors, wrong medication, wrong dosage, surgery performed on the wrong patient or the wrong body part.

Ophthalmologists are not immune to this problem. Take a good look at the photo. Once the patient is prepped and draped the only thing the surgeon sees is the eyeball. Since the OR crew usually handles the prep and drape chores the surgeon has to trust others not to make any mistakes. Memo to all: mistakes happen!

A recent review of 106 eye surgery errors (dating back 23 years) were analyzed in the prestigious Archives of Ophthalmology. The authors wanted to know the outcomes if the so-called Universal Protocol was applied to these cases. The records were obtained from one malpractice insurer and one state health agency. The actual nationwide number of mistakes is much, much larger.

The Universal Protocol is a series of safety steps designed to prevent operative mistakes. This protocol includes consistent preoperative verification (patient and O.R. team agree which eye needs surgery), site marking to identify the surgical eye, and a mandatory time-out before making the first incision.

Those 106 cases included incorrect intraocular lens implantations, wrong-eye surgery performed, wrong-eye preoperative anesthetic block, wrong patient in the operating room (?!?), even wrong-eye corneal transplantation (duh, the eye that needed it didn't get it!)

Careful reconstruction of the details in these 106 lawyer-friendly disasters revealed that 85% of these mishaps would never have happened if the Universal Protocol was in effect at that time.

This is wonderful news so long as surgeons and hospital staff observe the rules.

If you are scheduled for surgery don't hesitate to ask if the Universal Protocol is practiced. Make sure the non-operated eye is covered with a shield before entering the operating room. Finally, make no apologies for repeatedly announcing a statement like, "Dr. Brown is operating on my left eye!" Let others think what they want, you'll be able to see their smiles afterwards.

REFERENCE: Archives of Ophthalmology Nov 2007; 1515-1522.

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Posted by: Dr. Lloyd at 2:45 PM

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