Surgical errors accounted for about 22% of medical malpractice claims last year in the United States according to a major medical malpractice services provider. A number of those errors, it appears, involve the kidneys.
- An Iowa woman, Dena Knapp, is suing her surgeon, Dr. Scott Baker, after he allegedly removed her kidney, when he was supposed to be removing her adrenal gland, which is an endocrine gland that produce adrenaline and cortisol. The surgeon is said to have removed the right kidney instead of the adrenal gland along with a mass that had formed on top of the gland. A week later, Dr. Baker called Ms. Knapp and told her that he “did not get everything” according to the lawsuit. He told her that she would require a second surgery. She went to another health care facility to have the adrenal gland and the mass removed.
- A Florida woman went into the hospital for back surgery, and her surgeon removed what he thought to be a cancerous tumor. The “tumor” turned out to be a perfectly functioning pelvic kidney, which was in an unexpected location. The case was settled without the doctor admitting fault.
- An Idaho man had a life-threatening, softball-sized tumor near his kidney, but instead his surgeon mistakenly removed his healthy left kidney. He has filed a lawsuit against the physician and the hospital.
There are many cases of congenital disorders of the genitourinary system, which result in the kidneys being found in unexpected places in the body. A pelvic kidney (ectopic kidney) can be located in the pelvis, or both kidneys can fuse into a single kidney; there are countless other variations when it comes to a kidney being located in an unexpected place in the anatomy of a human body.
Still, one might expect his or her doctor to know the difference between a tumor and a kidney.
Wrong site surgeries are “never events”
The Agency for Healthcare Research and Quality (AHRQ) classifies operating on or removing the wrong kidney as a wrong-site surgical error. A wrong-site surgical mistake is surgery performed on the wrong site, any procedure performed on the wrong patient, or performing the wrong procedure. Wrong-site surgery is considered a sentinel event, “an unexpected occurrence involving death or serious physical or psychological injuries, or the risk thereof.” It is also a “never event,” meaning it never should have happened.
Wrong-site surgical errors are supposed to be reported to the Joint Commission, which is an independent, nonprofit organization which accredits and certifies health care organizations and programs in the United States. The Joint Commission has found the top three root causes for wrong-site surgical mistakes to be: leadership, communication and human factors. There is even a “Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery,” which went into effect in 2004. The protocol includes many recommended steps including:
- Procedure verification
- Site marking
- A time out prior to making the incision
The Joint Commission reports that there were 1,196 sentinel events (wrong-site, wrong-side, wrong procedure surgical errors) reported through September 2015.
When a patient survives a wrong-site surgical error, such as the removal of the wrong organ, it usually means that he or she must undergo another surgery so that the correct procedure can be performed. In the case of kidneys, if the wrong kidney is a healthy kidney and the one that must now be removed is the diseased kidney, the patient will now require dialysis treatments because both kidneys have been removed. Patients deserve better than this.