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a retained surgical item is referred to as a never event by the joint commission and despite considerable efforts these events still occur more than 10 years ago as a group of hospitals insured by a single medical malpractice carrier we began to develop strategies to reduce negative surgical outcomes which accounted for more than a quarter of medical malpractice payouts retained surgical items are estimated to occur in about one in every 10 000 operations negative patient outcomes include re-operation sepsis visceral perforation and even death the care for patients after a retained surgical item is expensive and is often not reimbursed legal fees and liability settlements can be substantial traditionally prevention relied upon performing cavity sweeps and manual counting both of which are prone to human error reported to be about 10 to 15 percent in addition sporadic radiographic screening is insufficient and routine postoperative x-rays are inefficient the most common root causes of a
