Fool Proof Technology For Retained Surgical Objects?

According to an article published the other day by the Chicago Tribune, RF Surgical Systems of Bellevue, Washington, has developed technology that allows surgeons to easily determine whether tagged surgical sponges, gauze or towels remain in the body prior to closing at the conclusion of a surgical procedure. According to the firm’s website, here is how the system works:

By preventing the occurrence and risk of retained surgical sponges, the RF Surgical Detection System™ raises the standard of patient care and safety in the OR.

Three key components make up the system: a handheld scanning wand connected to a compact, self-calibrating console and a micro RF tag which is embedded in a variety of surgical gauze, sponges and towels. When the system is activated and the wand is passed over a patient prior to closing procedures, an audible and visual alarm would immediately signal the presence of any retained object(s) fitted with a tag.

In addition to detecting sponges left inside patients, the system can be used to locate missing sponges elsewhere in the OR to help rectify counts.

And here are the descriptions of the three main components:

RF Tag Embedded in Sponges, Gauze and Towels

• Small, hybrid RF tag (4mm x 12mm) for unobtrusive use in gauze and sponges, including those used in minimally invasive and OB procedures
• Low cost passive tag allows cost-effective use—even in multiple sponge cases
• Unique and reproducible signal strength optimizes detection
• Low frequency tag signal passes through tissue, fluids and bone
• No signal interference from pacemakers or other medical devices

Blair-Port Wand®

• Reusable wand brings average per case cost under $15
• Disposable wand cover for easy transfer to sterile field
• Lightweight for ease of use
• Highly accurate reading depth and range
• Self check for accuracy and circuit integrity
• 9 foot cord for easy connection to console

RF Surgical Detection Console [Model #100A]

• Console provided at no cost to hospitals
• Case and circuitry designed to shield from OR electronic interference
• Intuitive steps for power cord and wand connections
• Self check for accuracy and circuit integrity
• One button push starts scanning
• Visual and audible alarms

More than 100 hospitals are currently using the system which adds about $15.00 to the cost of a surgery. According to the company, not one surgical object has been left behind since the hospitals implemented the system.

RF Surgical Systems is now working to expand its detection system to surgical devices beyond sponges, gauze and towels. Here is their blurb on this development work:

RF Surgical Systems, Inc. is actively engaged in development work that will allow surgical instruments to be tagged for both detection and counting in the OR.

Scanning will detect tagged instruments inadvertently left behind in patients undergoing surgery or misplaced elsewhere in the OR. The new instrument tag application will also assist in counting and inventory for improved instrument management.

The technology is an extension of the company’s RF Surgical Detection System™ that uses a scanning wand attached to a self-calibrating console to detect and prevent retained RF tagged sponges, gauze and towels in OR patients.

Bill Blair, an electrical engineer and one of the two co-founders of the company, has been working with RF Surgical’s technical engineers in the company’s R & D division in San Diego, California to develop a tag for instruments that will withstand durability and permanence tests in autoclave environments.

The small size of the proprietary tag makes for unobtrusive application to surgical instruments, just as the size of the RF tag has allowed its use in surgical sponges—even those for minimally invasive and OB procedures.

As a technology leader in preventing surgical errors, the newest extension of RF Surgical’s product line, when launched, will give hospitals a three-fold advantage:

• Tagged surgical instruments can be detected inside patients prior to closing to allow their removal, thereby averting a dangerous medical error and patient safety breach.
• After patients are cleared and the instrument count is still off, the scanning wand can be used to locate misplaced or lost tagged instruments elsewhere in the OR to rectify counts.
• Tagged surgical instruments will also assist in counting and inventory for improved instrument management.

If they are able to succeed with these technological developments and can implement them at reasonable costs per procedure, the future of surgical device management seems quite bright. That said, there still seems to be opportunities for human error to intervene. Each device will have to be tagged correctly for the system to work properly. This will require consistent diligence on the part of those doing the tagging and proper use of the monitoring equipment by surgeons. Let’s hope this technology keeps moving in the right direction.