Unintended Retention of a Foreign Body is Again Joint Commission’s Most Reported Sentinel Event

February 19, 2016 | Strategic Insights for Ambulatory Care


​Unintended retention of a foreign object was again the most frequently reviewed sentinel event by the Joint Commission in its review of sentinel-event statistics for 2015, with 116 occurrences, according to data for 2015 posted on its website. Wrong-patient or wrong-site procedure was the next-most reviewed, seeing a rise from 67 events in 2014 to 111 in 2015. For the second consecutive year, the most frequently identified causes of sentinel events were human factors, leadership, and communication. The majority of events were found to have multiple root causes.

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