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Eric G. Meinberg, MD and Peter J. Stern, MD
Journal of Bone and Joint Surgery, February 1,
2003
Investigation performed at the Department of Orthopaedic Surgery, University
of
Cincinnati College of Medicine, Cincinnati, Ohio
Eric G. Meinberg, MD Carolinas Medical
Center
1000 Blythe Boulevard, Charlotte, NC 28203
Peter J. Stern, MD Department of Orthopaedic Surgery
University of
Cincinnati College of Medicine
5508 Medical Sciences Building,
P.O. Box
670212,
Cincinnati, OH 45267-0212
The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Abstract
Background: Until recently, wrong-site surgery had received little attention
and had been considered a random, infrequent event. In 1997, the American
Academy of Orthopaedic Surgeons (AAOS) Task Force on Wrong-Site Surgery
was formed to determine the incidence of wrong-site surgery and to initiate
the "Sign Your Site" campaign. The purpose of our study was to
determine the incidence of wrong-site surgery among hand surgeons, elucidate
surgeons' practice habits and measures taken to prevent its occurrence,
and evaluate the effectiveness of the AAOS "Sign Your Site" campaign.
Methods: One thousand, five hundred and sixty active members of the American Society for Surgery of the Hand (ASSH) were polled by mail. Each member received a confidential twenty-nine-question survey. Nonrespondents were sent a second, identical survey. One thousand and fifty (67%) of the surgeons responded.
Results: One hundred and seventy-three surgeons (16%) reported that they had prepared to operate on the wrong site but then noticed the error prior to the incision, and 217 (21%) reported performing wrong-site surgery at least once. Of an estimated 6,700,000 surgical procedures, 242 were performed at the wrong site, an incidence of one in 27,686 procedures. The three most common locations of wrong-site surgery were the fingers (153), hands (twenty), and wrists (twenty-one). Permanent disability occurred in twenty-one patients (9%). Ninety-three cases (38%) led to legal action or monetary settlement. Seventy percent of the responding orthopaedic surgeons were aware of the "Sign Your Site" campaign, and 45% had changed their practice habits as a result.
Conclusions: Prior to the AAOS "Sign Your Site" campaign, the issue of wrong-site surgery by hand surgeons had not been addressed. Although wrong-site surgery is rare, 21% of hand surgeons reported performing it at least once during their careers. Since the institution of the "Sign Your Site" campaign, 45% of orthopaedic hand surgeons have changed their practice habits, and almost all routinely take some action to prevent wrong-site surgery.
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