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Articles Posted in Surgical Errors & Complications

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Surgical errors and complications occurring during robotic laparoscopic surgery have to be reported by hospitals to the robot manufacturers. The manufacturers will then report them to the U.S. Food and Drug Administration. Because of the financial interests at stake hospitals and manufacturers tend to keep complaints quiet. An independent and transparent reporting system may provide a more accurate picture of the actual level of safety of robotic surgery.

According to a study led by Martin A. Makary, M.D., M.P.H., an associate professor of surgery at the Johns Hopkins University School of Medicine, more than one million robotic surgeries have been performed in 12 years but only 245 complications including 71 deaths were reported to the FDA. For a new and complex technology these numbers seemed too low to Dr. Makary and his team. To prove their assumption, the researchers compared the incidents reported to the FDA between 2000 and 2012 with legal judgments and adverse events using LexisNexis to scan news media, and PACER to scan court records. They found that 8 cases were not properly reported. Among them some were never filed and other were filed after the media talked about them.

The study also reveals that out of the 71 deaths, 22 were related to gynecologic procedures, 15 happened during urologic surgery and 12 during cardiothoracic surgery. The most common cause of death was excessive bleeding. When patients survived, hysterectomy was the robotic surgical procedure that had the most complications with 43% of all injuries.

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New data from New York DOH unveil mortality rates for cardiac surgery by hospitals and by type of procedure. Even though some procedures are by nature riskier than others, New Yorkers suffering from heart conditions should understand that not every hospital offers the same level of safety.

Based on the data provided by The New York State Health Department here are some of the findings:

Valve surgery is the riskiest type of cardiac surgery with a mortality rate of 4.59% for New York State between 2008 and 2010. PCI or Percutaneous Coronary Intervention, sometimes also called coronary angioplasty or coronary stenting is the less risky of all types of cardiac surgeries as long as it is a planned surgery. It becomes riskier when it is an emergency procedure.

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The following graphs show the mortality rate by hospital for the various type of procedures. Because some hospitals may deal with riskier cases than others the graphs show 3 types of mortality rates:
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Complications during or after surgery are happening too often at New York City, St Luke’s Hospital. The Hospital scored a low overall surgery rating on the new Consumer Reports surgery safety rating. The safest hospitals in the city to have surgery are Mount Sinai, NYU Langone Medical Center and New York Presbyterian Hospital.

Consumer Reports looked at medicare claims data from 2009 through 2011 for patients undergoing 27 categories of common scheduled surgeries. For each hospital, the results for all procedures are combined into an overall surgery rating.The global ranking is based on who died in the hospital or stayed longer than expected for their procedure. More detail by type of surgery as well as a hospital ranking by state can be found on the Consumer Reports website.

Most common surgery complications are bad reaction to anesthesia, heart problems or surgeon nicking a blood vessel, leaving an instrument inside, or even operating on the wrong body part. Complications can also happen after the surgery. Nationally, 30 percent of patients suffer infections, heart attacks, strokes, or other complications after surgery and sometimes even die as a result.

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Methicillin-resistant Staphylococcus aureus (MRSA) infection is caused by a specific staph bacteria that is resistant to antibiotics and therefore very difficult to treat. If not diagnosed on time MRSA can be life threatening. MRSA is a major concern for hospitals where the superbug can attack older patients or those suffering from weakened immune system. Patients necessitating medical tubing such as intravenous line or catheters are also at risk as well as patients staying in nursing homes. MRSA is also an issue in child care centers, military camps and jails.

There is an urgent need to find therapeutic ways to fight this superbug. In research appearing in the Journal PLOS ONE , Shelley Haydel, a researcher at Arizona State University’s Biodesign Institute demonstrate that particular metal ions attached to the clay may have the potential to kill MRSA as well as a range of other dangerous pathogens including E-coli. Medical property of clay has been recognized since antiquity when it was used for its wound healing property.

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Percutaneous nephrolithotomy, or PCNL, is a minimally invasive urological surgery during which a surgeon removes medium to large kidney stones through a small incision in the back using a hollow scope. The use of PCNL is increasing especially among women and complications are on the rise particularly blood infections. Patients are at risk of developing complications if they are older, sicker and treated in more recent years. Age is significantly associated with increased odds of mortality according to a research from from Khurshid R. Ghani, M.D., of Henry Ford Hospital’s Vattikuti Urology Institute, which was published in the Journal of Urology.