A new study is casting a harsh light on so-called “never events” in the surgical sphere, finding that such adverse events, which can include leaving a sponge inside a patient or operating on the wrong side of the body, led to malpractice litigation in more than 4,000 instances every year, and cost healthcare professionals at least $1.3 billion in malpractice payouts between 1990 and 2010.

In an article entitled “Surgical Never Events in the United States,” published by Winta T. Mehtsun, M.D., M.P.H., Andrew M. Ibrahim, M.D., Marie Diener-West, Ph.D., Peter J. Pronovost, M.D., Ph.D., and Martin A. Makary, M.D., M.P.H, and published online on Dec. 18 in the journal Surgery, the authors found ample evidence of the very high cost of surgical never events on surgeons and other clinicians. Mehtsun and his colleagues used the National Practitioner Data Bank to identify malpractice settlements and judgments for surgical never events, “including retained foreign bodies, wrong-site, wrong-patient, and wrong procedure surgery,” they note in the article. “Payment amounts, patient outcomes, and provider characteristics were evaluated.”

Examining a total of 9,744 paid malpractice settlements and judgments for surgical never events occurring during that 20-year period, the researchers discovered that malpractice payments for such events totaled $1.3 billion, or more than $65 million a year. As the authors note in their article, “Mortality occurred in 6.6 percent of patients, permanent injury in 32.9 percent, and temporary injury in 59.2 percent. Based on literature rates of surgical adverse events resulting in paid malpractice claims,” they add, “we estimated that 4,082 surgical never event claims occur each year in the United States. Increased payments were associated with severe patient outcomes and claims involving a physician with multiple malpractice reports,” they conclude, adding that, “Of physicians named in a surgical never event claim, 12.4 percent were later named in at least one future surgical never event claim.”