The Mount Holly news. [volume] (Mount Holly, Burlington Co., N.J.) 1891-1942, 1908-03-31
SURGICAL TRAGEDIES,
Mishaps That Follow In the
! Wake Of Operations.
OBJECTS LEFT IN THE BODY.
Recorded Cases Show That Tubes,
Clamps, sponges, Towels and seis-
sors Have Been Forgotten or Over
looked Until Disclosed by Autopsy.

Clamps Sponges, Towels ana Scis-
sors Have Been Forgotten or Over
looked Until Disclosed by Autopsy.
Accidents VIII happen in the best reg
alated of operations. Foreign bodies, :
such as forceps, sponges, towels and
gauze pads, are more frequently left In
the human body after operations than
the public Is aware Of To be sure, the
number of operations in which this
happens is small. 1t occurs perhaps
once or twice in the course of 1000
operations. Like an eruption of Vesu-
Wins, however, it is likely at any time
and has marked the operations of some
of the best known surgeons OF this
city. They say 1t may occur again not
withstanding the number OF schemes
which have been devised to prevent It
No one knows the number OF these
mishaps, as only in relatively few cases
is death followed by an autopsy. The
announcement that "the operation was
success, but the patient died., may
cover a multitude of sins Of omission
and commission SO far as any one can
tell. One may find In the files of the
ANNALS Of Surgery" the reports OF be-
tween 100 and 200 cases In which OBJ
jects used In operations have been left
In the body. These objects include
tubes, clamps, sponges, towels, forceps,
scissors and finger rings. Usually 1t
is piece of gauze or sponge that Is
left In the wound. In 100 cases re-
ported from Europe thirty-one sponges
and thirty three pieces of gauze were
left In wounds. In forty-three cases
death resulted In the other sixty-six
cases the articles worked their way out
after remaining In the body for months
and sometimes years or were discover
ed and removed by operations perform
ed to relieve the pain caused Dy the
movements of these objects
In one case a surgeon lost his seal
ring. 1t finally pushed its way to the
surface of the body of person on
whom he had operated and was re-
turned to its owner. In another pair
of forceps circulated about the abdom-
anal cavity Of a lease" for four years
before being recovered. Pieces OF
vauze Eve feet long and a yard wide
have been removed from persons on
whom operations had been performed
It seems strange to the layman that
anything should be able to escape the
surgeon In such small cavity as Is
likely to be created in the body In tne
course of an operation. Especially does
it seem impossible that anything should
be lost In view of the extreme care
taken to prevent it. Many surgeons
have worked out methods Of proce-
dure for operations with the intention
Of eliminating the possibility OF the loss
of anything used. Unfortunately even
these have never proved infallible.
The most usual method is TO have ev-
erything counted by a nurse Defore
the operation begins. Before the wound
Ia closed each article is accounted for
BY recount. Some surgeons have hao
experiences which led them to triple
the number of persons responsible Tor
the appliances, each to check the counts
of all the others. Other surgeons have
the gauze pads in packages OF halr a
dozen or q dozen. Only one package
Is opened at time, and its contents
must be accounted for before the next
is opened. Tying tapes to each gauze,
mad or instrument inserted In wound
Is another precaution. A prominent
Brooklyn surgeon devised check sys-
TEN similar to that used by baggage
men. A quantity of glass checks were
numbered, there being two OF eacn
number, and to each set of duplicates
was attached a tape. To every article
used In the operation one of these
tapes with the check attached was fas-
tened. Whenever, for instance, a piece
of gauze was taken from basin Tor
use one of the checks was removed
and placed in the basin. Before the
wound was stitched each article rep
resented by these detached checks had
to be accounted for.
Notwithstanding such precautions, In
four recorded cases large sponges were
torn in half while the operation was
in progress and one Of the halves
placed in the wound and lost sight OF.
When the count was made there was
the same number of sponges as at the
beginning of the operation. The miss
ing half was forgotten and the wound
closed.
A surgeon in describing one Of these
mishaps says:
"a young surgeon, assisted by an
older surgeon, performed the operation
The older one tore sponge in half and
tucked half Of it in without saying any
thing about it. The woman died Of
shock, and the sponge was removed at
the postmortem examination, much to
the surgeons surprise, as count Of
sponges gave the number with which
the operation had been begun"
Another way in which reputable
surgeon may be made the victim OF
this kind of an accident is illustrated
In this settlement, made by an Ameri-
can practitioner:
81 have had two unfortunate expert
ences in regard to foreign bodies re-
manning In the abdominal cavity, one
occurring a few years ago when using
the old fashioned sponges, the patient
dying from general peritonitis. One
occurred about three years ago in which
: small gauze sponge was left, the pa
t1ent making a good recovery, but on a
temperance of the disease year
after the sponge was found on explora-
ton. This is an accident to be regret
ted. I have always been fortunate in
reference to forceps and instrumentr.
ana in the nrst case to which referred
/ had trusted entirely TO my assistant,
who assured me all the sponges were
accounted for. After the death of the
patient and on making an autopsy, you
can imagine my sorrow and chagrin in
finding a small sponge in the abdom-
inal cavity"
Even when the count does not tally
and it is evident that something is
missing the accident which may cost
a life happens.
ut was sponge about the size of a
small hens egg, lost in the abdominal
cavity, thanks to the assistance of a
visiting surgeon" said one surgeon in
reporting his experience. "A prominent
operator from one of the large east
ern cities being present, asked him
to assist me, as was then so frequently
the custom. did not feel at liberty to
speak to him quite as l should have
done to my usual assistant Before
closing the wound the customary
sponge count was called for and show
ed one missing A thorough search of
the room failed to reveal it. then
searched the cavity. as / thought, most
carefully. In the meantime every as
sistant-and there were many, as was
then the custom-expressed his views,
and 1t was decided that the missing
sponge was one which had been drop