Wrong Site Surgery: Is the Standard of Care Enough?

Brooks Schuelke

Contributor

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We have devoted the month of August to Wrong Site Surgeries. Our series started out by looking at the Universal Protocol, the standard of care on how to avoid wrong site surgeries. The standard was adopted several years ago, but now the question arises, "Is it enough?"

At least one commentator (and the results since the adoption of the protocol) suggest that it isn't enough. Steve Sanford, of the Preferred Physicians Medical Risk Retention Group, contends that the Universal Protocol has several flaws that prevent it from being effective. First, he argues against the shared responsibility advocated by the protocol. Shared responsibility is, in essence, no responsibility. When participants to a surgery think other participants are going to check the proper site, the responsibility goes unfulfilled. Instead, Sanford argues that the surgeon should have the sole responsibility and should know that he or she will be held accountable for the errors --- no more suggesting that someone else should have handled it.

Sanford also argues that the protocol is not specific enough and leaves too much interpretation up to individual institutions. If the standard was more concrete and accepted between institutions, it might be easier to follow.

Statistics suggest that Sanford's assertion that the Universal Protocol is ineffective is right. PPM's statistics show that the number of wrong site surgeries actually increased following the adoption of the Universal Protocol. Other studies made similar findings.

Given this, it is more important than ever for the patient to be an active participant in the process.