The Scientific American and other publications, reported the other day, on a surgical checklist designed by the World Health Organization (WHO) to help minimize errors of miscommunication in the operating room. The checklist consists of items to be confirmed before anesthesia is administered, before the incision is made, and before the patient leaves the operating room. Examples are: pre-anesthesia – confirm patient identification, procedure to be performed; anesthesia safety check completed; pre-incision – team members have introduced themselves to each other by name and role; surgeon, anesthesiologist and nurse, verbally confirm patient, site of surgery to be performed, and procedure; review potential complications; pre-discharge from operating room – instrument and sponge count correct; concerns for post-operative recovery reviewed. There are several other items to be checked during each of the three surgical periods.

A WHO study found that following its checklist could reduce surgery complications by 30% and deaths by 40%. Proponents of the checklist are concerned that busy surgeons may believe that the time taken to do the checks are excessive or unnecessary. In my own experience, both as an attorney and a patient, the checklist or something like it should be followed in every surgical procedure. One of the saddest cases I’ve handled involved the death of a healthy 40 year old wife, and mother of four children, because of a deadly miscommunication between the surgeon and the anesthesiologist. The anesthesiologist gave surgery for a lesser procedure than the one actually performed. When the anesthesiology wore off mid-surgery, additional anesthesia was improperly administered, causing the patient to vomit into her lungs. She died several days later as a result. Had the surgeon and anesthesiologist followed a simple checklist, and confirmed the procedure to be done and anesthesia to be administered, my client's wife would have lived.

As to my own experience, I was to have a local anesthetic administered during outpatient surgery for a modest sports-related injury. When the anesthesiologist entered the room where I awaited the surgery, he insisted that I was to receive general anesthesia. Only when I refused to continue unless the surgeon came in and spoke to the anesthesiologist, was the situation corrected. It turned out that the anesthesiologist had grabbed another patient’s chart. I read a few months later that a jury had returned a multi-million dollar verdict against the same anesthesiologist for administering the wrong anesthesia that killed a woman undergoing routine surgery.

Patients who will undergo surgery need to be familiarize themselves with what they should expect, and need to make sure, to the extent they can, that every member of the medical team is informed and communicating with each other. For more on the subject of preventable medical mistakes, read my article on this web site, titled, Deadly Anesthesia Errors.