Operating Room: Needle Count Should Have Included Hypodermic Used As Marker

Legal Eagle Eye Newsletter for the Nursing Profession

March 1998

  Quick Summary: A hypodermic needle used by the surgeon as an intra-operative radiopaque metallic marker was not an item to be counted, and it was left the patient.

  The lawsuit alleged the circulating nurse and the surgical tech were negligent for failing to maintain a proper needle count and for failing to ensure the removal of the needle after surgery.   SUPREME COURT OF VIRGINIA, 1997.

   Right after an anterior cervical diskectomy the patient was still having severe pain in her right hand, arm and neck. The neurosurgeon sent her to an orthopedist. He took x-rays but could not find the problem.

   Twenty months later a general surgeon discovered an 18-gauge hypodermic needle and an attached plastic syringe in the patient’s neck and removed it. The patient sued the neurosurgeon, his professional corporation, the circulating nurse, the scrub tech and the hospital.

   The Supreme Court of Virginia stated it could not rule one way or the other for or against the nurse, the tech and the hospital, although there was no doubt for the court the neurosurgeon was negligent for relying on the needle count being complete without knowing if the count included the marker needle. The court sent the case back to a lower court to get expert testimony about standards and practices for O.R. nurses and O.R. techs to see if they also were negligent under these circumstances. Dickerson vs. Fatehi, 484 S.E. 2d 880 (Va., 1997).