Recommendations For Eliminating Wrong-Site Surgery Although the wrong-site surgery problem has been addressed on a local level in many areas of the country, there has been no organized national effort to eliminate wrong-site surgery. The Canadian Orthopaedic Association mounted a significant educational program from 1994 - 1996 to eliminate this problem and has reported that the number of known wrong-site orthopaedic surgery claims in Canada has subsequently dropped dramatically. The American Academy of Orthopaedic Surgeons believes that a unified effort among surgeons hospitals and other health care providers to initiate preoperative and other institutional regulations can effectively eliminate wrong-site surgery in the United States. Consequently, the AAOS urges other surgical and health care provider groups to join the effort in implementing effective controls to eliminate this system problem. Effective Methods of Eliminating Wrong-Site Surgery Wrong-site surgery is preventable by having the surgeon's initials placed on the operative site using a permanent marking pen and then operating through or adjacent to his or her initials. Spinal surgery done at the wrong level can be prevented with an intraoperative x-ray that marks the exact vertebral level (site) of surgery. Similarly, institutional protocols should include these recommendations and involve operating room nurses and technicians, hospital room committees, anesthesiologists, Residencys, and other preoperative allied health personnel. Consequently, eliminating wrong-site surgery means the surgeon's initials are placed on the operative site in a way that cannot be overlooked and in a manner that will be clearly incorrect if transferred onto another body area prior to surgery. The patient's records should also be available in the operating facility. In keeping with it Code of Ethics, the Academy believes that in any communication with the patient or patient's family regarding care rendered-particularly in relation to an untoward event such as wrong-site surgery-orthopaedic surgeons must be truthful in all circumstances. As indicated in the attached recommendations, particular circumstances of individual cases require specific and different actions on the part of the surgeon in the event that wrong-site surgery is discovered, but in all cases the patient's choice and the best interest of the patient should be the determining factors in decision making. Return to the IOS Newsletter Archive Educational Meetings and Program | Board of Directors | Residency | Find a Surgeon | Membership | Allied Association Links | Newsletter | Governmental Affairs | IAOS Main Page All material Copyright from the Illinois Association of Orthopaedic Surgeons, all rights reserved.