▪︎ New Malpractice Case – Old Problem
If you work in healthcare you know that retained foreign objects are a common source of malpractice cases against physicians who do surgery. But did you know nurses who perform the “sponge count” may also be named as a defendant in these cases.
A lawsuit filed against Northwestern Medicine McHenry Hospital recently alleges a surgical sponge was negligently left inside a patient after surgery.
The plaintiff was being treated for cancer, underwent surgical left neck exploration, excision of a cervical mass and lymph node dissection on Jan. 31, 2023.
In the weeks and months following the surgery, the patient “continued to have significant unexplained swelling in his neck and drainage from his surgical wound,” according to his attorneys. P_laintiff sought the opinion of a different surgeon, and on May 31, underwent a second surgery to determine the cause of his symptoms.
The surgeon performing that procedure found and removed a surgical sponge from the initial surgery. The medical malpractice lawsuit alleges the surgical “technologist”, nurse Elizabeth. R. (omitted) and the doctor who performed the surgery, failed to ensure all sponges were accounted for – and didn’t follow procedures and protocol pertaining to a sponge count.
My recommendations:
Surgical nurses can take several precautions to avoid lawsuits related to inaccurate sponge counts. Here are key strategies:
1. Follow Standardized Counting Protocols
Perform sponge counts at designated times:
Before the procedure begins (initial count).
Before wound closure (final count).
Any time a new set of sponges is added.
Use a count sheet or electronic tracking system to document all counts.
Ensure two-person verification (usually a scrub nurse and circulator) when counting.
2. Use Technology for Sponge Tracking
Consider using radiofrequency (RFID) or barcode-tracking systems to track sponges and reduce human error.
Some hospitals use radiopaque sponges, which can be detected via X-ray before closure.
3. Communicate Clearly and Assertively
Speak up if a count discrepancy occurs—never ignore a miscount.
Inform the surgeon immediately so corrective action (e.g., rechecking the field, using an X-ray) can be taken. Ensure team members listen and respect concerns about missing sponges.
4. Conduct a Thorough Visual and Manual Search
Check under drapes, in surgical wounds, on the floor, and in disposal bins before concluding the count. Use a systematic approach for searching when a discrepancy is found.
5. Document Accurately and Completely
Record all counts, discrepancies, and resolutions in the patient’s medical record.
If an incorrect count occurs, document what actions were taken to resolve it (e.g., additional searches, use of X-ray).
Avoid falsifying or guessing counts—integrity is key to legal protection.
To learn more about these legal topics check out our courses on demand (with extensive written materials):
➡️ The Nurse’s Law School – A Practical Legal Guide for Nurses (7.6 CE Hours)
➡️ Legal Issues in Perioperative Nursing
➡️ Legal Issues in Perinatal/OB Nursing
Sincerely,
Laurie Elston JD BSN
www.NursingLawCenter.com
Law Office of Laurie R. Elston Inc.
📞 T: (805) 481-1001
📧 Email: [email protected]
