Operating Room Mishaps: A Troubling Increase in Surgical Accidents in Hospitals
In a worrying development, reports indicate that incomplete surgical checklists are becoming a frequent problem in hospitals managed by the Assistance Publique - Hôpitaux de Paris (AP-HP) in the Île-de-France region.
According to a confidential report obtained by Le Canard Enchaîné, nearly one-third of patients treated in AP-HP hospitals did not benefit from a complete checklist. The rise in serious adverse events reported to the Haute Autorité de Santé (French Health Authority) in 2024, with 4,630 incidents, a 13% increase compared to 2023, further underscores this issue.
The checklist process, designed to ensure safety and accuracy, is often hurried. In some cases, the surgeon and the nurse complete it in as little as three and a half minutes. An anonymous operating room nurse admitted to checking off the checklist even when it has not been fully completed, often due to lack of time.
The incomplete checklists could potentially contribute to surgical errors, as highlighted by a recent incident at Henri Mondor Hospital in Créteil, Val-de-Marne. On July 31, a 77-year-old patient's healthy kidney was removed instead of the one with a cancerous tumor. The patient had confirmed his identity and specified the kidney to be operated on, yet the mistake still occurred.
Éric Vibert, a hepatic surgeon at Paul-Brousse Hospital (AP-HP) and director of the Bopa innovation chair, stated that the postoperative checklist may be less well filled out compared to the preoperative one. He also emphasised that the underestimation of serious adverse events is a general opinion.
To prevent such errors, a checklist should be completed before anesthesia, during, and after surgery, with simple verifications such as the patient's identity. This ensures that all necessary steps are taken to minimise the risk of surgical errors and maintain patient safety.
It is worth noting that the Haute Autorité de Santé reported 4 serious adverse events related to treatment in French healthcare institutions in 2024. However, this number appears very low and may indicate massive underreporting, with no specific number reported for AP-HP hospitals in Île-de-France.
In light of these concerns, it is crucial for hospitals to prioritise the completion of checklists and ensure that all steps are taken to maintain patient safety. The checklist is a vital tool in the prevention of surgical errors, and its importance cannot be overstated.
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