Why surgical mistakes often involve more than the operating room

Surgical mistakes go beyond errors committed inside the operating room, as comprehensive surgical care is a multi-step journey. With surgeries consisting of many steps, surgical teams, including surgeons, anesthesiologists, and surgical assistants, can commit errors before or after, not just during. 

Understanding pre-op, post-op, and operating room errors is vital, as medical mistakes are common. A StatPearls article published in the National Library of Medicine notes that recent studies estimate 200,000 to 400,000 patient deaths result from preventable medical errors in the U.S. alone each year.

What Are Examples of Surgical Mistakes? 

Retained foreign objects are common examples of surgical mistakes. Wrong-site surgeries are also prevalent.

The Joint Commission found that unintended retention of foreign objects and wrong surgeries are among the second most common sentinel events (8%) in 2024. Falls lead the way (49%).

Sentinel events refer to unexpected occurrences in healthcare settings affecting patient safety. They involve and cause patients:

• Severe temporary harm
• Permanent harm
• Death 

Are Surgeons Liable for Mistakes?  

Yes.

Surgeons and other members of the surgical team can be liable for failing to adhere to the codes and standards for patient safety in surgery. If the surgical errors they’ve committed caused the patient harm, the victim can sue them for medical malpractice. 

Likewise, surgeons and surgical team members can be liable for mistakes if they fail to implement strategies that would have otherwise allowed for surgical error prevention.

Why Do Surgical Mistakes Often Involve More Than the Operating Room?

Surgical mistakes can extend beyond the operating room because of the numerous steps involved in these medical procedures.

Aside from the sensitive nature of surgeries themselves, they often require extensive pre-op preparation and post-op care. Failing to account for either is a mistake in itself and can result in increased surgical risk factors and a higher likelihood of patient harm. 

Pre-Operative Errors (Before Operation) 

One of the potential causes of surgical mistakes is inadequate planning, something that can occur in the administrative or staging phase. An example is if a surgical team fails to review a patient’s:

• Comprehensive medical and family health history
• Current medications
• Existing allergies

Incorrect patient charting is another mistake that can occur pre-op. It can result from administrative disorganization or miscommunication, leading to wrong-patient or wrong-site surgical error. 

Post-Operative Errors (After the Operation)

Even if surgeons and their other team members perform a flawless procedure, they can still commit errors after the surgery, such as delivering poor post-operative care. Inadequate monitoring, for example, may result in missed signs of medication errors or infections. 

Lapses during patient hand-offs can also lead to devastating post-operative consequences. An example is if there’s no proper communication between attending physicians or nurses during shift changes. In this case, they may fail to share vital patient information, leading to post-op complications.

Patient Safety Must Always Be the Priority

If patients recognize the potential for surgical mistakes and that these errors can occur before or after the operation, they can make more informed decisions. They can seek second opinions, for instance, and ensure they choose a surgeon known for their excellence. 

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