c. Malpractice. Negligence is the failure to exercise due care. Due care is
further defined as the action that a reasonable and prudent person would perform under
the same or similar circumstances. Due care takes into consideration the training,
experience, education, and capabilities of each person. Negligence of professionals,
such as medical professionals, is termed malpractice.
d. Prevention of Lawsuits. Most mistakes or accidents are preventable.
Some are so slight that the patients are never aware of them; others can prove fatal.
Even if a patient himself is at fault, those caring for him suffer great remorse. You
should be cognizant of many hazards and know the safeguards.
2-24. POTENTIAL LEGAL INVOLVEMENTS
a. Loss of Sponges. Loss of sponges is a frequent cause of lawsuits. In a few
states, the responsibility for accounting for all sponges before closure rests with the
surgeon. However, the law in most states is that each member of the surgical team is
responsible for his specific duties. Therefore, in a case where the surgeon has
performed correctly but a sponge is left in the incision, the circulator or scrub may be
b. Burns. Burns are another frequent cause of lawsuits. A burn may occur
from the use of a hot instrument such as a mouth gag or a heavy retractor. The scrub
should have available a basin of cold saline solution for cooling instruments and should
cool the instruments when necessary before handing them to the surgeon. A burn may
also occur from a light, a thermal blanket, or an electro surgical inactive electrode.
c. Falling. Falls are another frequent cause of lawsuits. Observe the usual
safeguards for children or disoriented or sedated persons, whether in wheelchairs, in
bed, or on the operating table. Use special care when patients are moved from bed to
table and back to bed again, as well as those being moved about on litters or
d. Patient Identity. Many serious situations may arise in the hospital as the
result of carelessness in checking patient identity. The right medication or treatment for
the wrong patient may or may not be serious, but sometimes takes on great proportions.
Be sure of the patient's identity.
e. Unconscious Patients. Since a great number of patients in the OR
receive a general anesthetic and are therefore unconscious, great vigilance is
needed. If the patient is injured while unconscious, negligence may be presumed, which
may require those caring for the patient to show that due care was followed during the
entire period of unconsciousness.