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Brooks Schuelke
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Standard of Care For Avoidance of Wrong Site, Wrong Side, Wrong Patient, Wrong Procedure Problems, Part 1

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This is the second part of our series on wrong site, wrong side, wrong patient, wrong procedure surgeries. Today we’re looking at the history of the standard of care and the first element that each surgical provider must follow. You can view the first post in the series here.

The irony of the wrong site, wrong side, wrong patient, wrong procedure problem is that, unlike many problems, there is an almost universally accepted protocol or standard of care to avoid the problem.

The Joint Commission on Accreditation of Healthcare Organizations is a non-profit that accredits and certifies health care organizations around the country. After receiving numerous reports of wrong site, wrong side, wrong patient, wrong procedure surgeries, the Joint Commission decided to adopt a universal protocol to address the problem. In May 2003, the Joint Commission hosted a Wrong Site summit that included numerous health care organizations, including the American Medical Association, the American Hospital Association, and the American College of Surgeons. Out of that summit came the first Universal Protocol, which was effective as of July 1, 2004.

The adoption of the Universal Protocol essentially set the standard of care for surgical procedures. Its use was mandatory for all facilities accredited by the Joint Commission and the protocol has been endorsed by over fifty independent medical organizations.

The current protocol has three key steps. The first step, the focus of the rest of today’s post, is the pre-operative verification process. In any event, the Joint Commission has mandated that each institution adopt an ongoing process of information gathering and verification, beginning at the time the patient and/or physician decide to conduct the procedure until the procedure itself.

So what does this look like? Unfortunately, this is the least precise of the three steps so it can look different from provider to provider. But generally, each physician and facility must have a procedure in place to verify the proper procedure (1) at the time the parties decide to do the procedure; (2) when the patient is admitted into the facility; (3) any time the responsibility for the patient’s care is transferred from one care-giver to another; and (4) before the patient leaves the pre-operation area.

This standard could include checklists to make sure various documents are in place (medical records, images, etc), to make sure that all of the Universal Protocol is followed, etc. It could also take other forms.

Tomorrow, we’ll look at the second, and first specific, element of the standard of care.

As mentioned in my last post, several Injuryboard members are dedicating August to awareness of wrong-site surgeries. The good part about this is that most of us have different angles on the story so you can learn different things from each set of attorneys. If you have any further interest in this topic, I suggest you read the following posts:

From Des Moines personal injury lawyer Steve Lombardi:

Wrong Site Surgery – The Board of Medicine – The Surgeon

Wrong Site Surgery – The Surgeon Doctor’s Clinic

From Lansing, Michigan personal injury lawyers at Church Wyble:

Surgery Gone Wrong: When a Surgeon Refuses to Stop And Ask For Direction

The Frightening Reality of Wrong-Site Surgery