This study evaluated the incidence of wrong-site surgery amongst active members of the American Academy of Orthopaedic Surgeons via a mail poll. 1050 (67%) of the surgeons responded. Sixteen percent reported that they had prepared to operate on the wrong surgical site but noticed the error prior to the incision. Twenty-one percent reported performing wrong-site surgery at least once. 18% reported one incident, 2% reported 2 incidents and 0.1% reported 3 incidents of wrong-site surgery. Among the respondents, 16,700,000 procedures were performed and 242 were performed at the wrong site for an incidence of 1 in 27, 686 procedures. The fingers were the most common location of wrong-site surgery, followed by the hand and wrist. Permanent disability occurred in 9% and 38% led to legal action and a monetary settlement. The rates of wrong-site surgery tended to increase with increasing surgeon age and years in practice, but were not statistically significant. There was a weak correlation between the rate of wrong-site surgery and the yearly case load. Seventy percent of the responding orthopaedic surgeons were aware of the AAOS “Sign Your Site” Campaign and 44% had changed their practice habits as a result.
This study indicates an alarmingly high incidence of wrong-site surgery reported amongst hand surgeons. Permanent disability occurred in less than 10%, but nearly 40% led to legal action or a monetary settlement. Previous studies reveal that only 2% of orthopaedic surgery claims related to wrong-site surgery but 84% of those claims resulted in a court award to the plaintiff. There appears to be an increased incidence of wrong-site surgery amongst experienced busy hand surgeons. It does appear that the AAOS “Sign Your Site” Campaign has been successful in educating its members with at least 70% of orthopaedic surgeons aware of this campaign compared to only 25% and 36% of plastic and general surgeons, respectively. Hand surgeons are encouraged to develop mechanisms to prevent wrong-site surgery, which is an indefensible error.
J Bone and Joint Surg