July 18, 2006

ID chips keep sponges out of surgery patients

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - Radiofrequency ID (RFID) chips,
similar to those implanted in products to deter theft, may help
prevent sponges and other materials from being left in a
patient during surgery, the findings from a small study

Still, further research is needed to determine whether
placement of these chips in surgical sponges and other
operating room materials will be cost effective for a problem
that occurs once in every 10,000 procedures.

At most hospitals, the operating room staff counts the
number of sponges before the operation starts and then counts
them again at the conclusion to make sure none are been left
inside the patient. Still, according to lead author Dr. Alex
Macario, counting strategies are not perfect.

"A majority of retained sponges occur with normal counts,
perhaps falling outside human safeguards designed to prevent
these types of errors," Macario, from Stanford University in
California, told Reuters Health. "In fact, a...review of
malpractice claims related to retained foreign bodies found
that sponge counts had been falsely correct in 76 percent" of
non-gynecologic surgeries.

The present study, which is reported in the Archives of
Surgery, involved eight patients who underwent abdominal or
pelvic surgery. RFID-tagged or untagged sponges were placed by
one surgeon and then a second surgeon, who did not know the
sponge type, ran a wand over the patient's abdomen to look for
the sponges.

The wand identified all of the RFID-tagged sponges and
never reported the presence of a tagged sponge when, in fact,
there wasn't one. On average, it took just 3 seconds for the
wand to pick up the presence of an RFID-tagged sponge.

While surgeons and nurses reported that the RFID system was
easy to use, they also indicated a desire for a smaller wand
device. In addition, many believed that retained objects would
persist unless the system was made fail-safe.

"When we started, I was concerned about the technological
part of the problem," Dr. Macario noted, "but our study found
the device works 100 percent of the time. The real challenge is
how you incorporate a new device into the workflow of the
operating room. We need a system that is really fail-safe --
where, regardless, of how people use a counting system
technology, the patient doesn't leave the operating room with a
retained foreign body."

SOURCE: Archives of Surgery, July 2006.