In the Courts: Retained Foreign Object: Court Applies Res Ipsa Loquitur, All Defendants Are Potentially Liable

November 25, 2015 | Strategic Insights for Health System


​A New York court interpreted the effect of res ipsa loquitur("the thing speaks for itself") after part of a catheter was left behind in a patient, and the court consequently declined to grant summary judgment to the defendant hospital, surgeon, and assisting resident physician. The patient underwent a thoracotomy to close an atrial septal defect. A physician, a resident in training in cardiovascular surgery, made chest incisions for drains, opened the pericardium, placed a retractor, and inserted a suction catheter to drain blood from the surgical field. The surgeon stopped the patient's heart, put the patient on bypass, sutured closed the surgical defect, and separated the patient from bypass. He left the operating room but remained in the hospital while the resident removed the drains and catheters and closed the patient. Four months later, the patient experienced chest pain. A computed tomography scan revealed a metallic object within her pericardium, adjacent to and anterior to the junction of the right inferior pulmonary vein and left atrium.

The surgeon and hospital determined that the object was a metallic ball at the tip of the suction catheter, a sump (known as a "floppy sucker") that acts to weigh the catheter down and keep it in place while draining the blood during the surgery. The entire catheter, including this part, was meant to be removed when the surgery ended. However, only the much larger tube was removed and discarded,...

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