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Retained foreign bodies
C W Kaiser1, T Slowick, K P Spurling
1Department of Veterans Affairs Medical Center, Manchester, New Hampshire 03104, USA. cwkaiser@ix.netcom.com
Objective:
To evaluate the frequency of occurrence and outcome of patients having retained foreign bodies after treatment in an urgent-care setting.
Materials And Methods:
Closed case records from the files of the Medical Professional Mutual Insurance Company involving claims of retained foreign body were reviewed for a 7-year period.
Main Results:
Thirty-two patients filed 54 claims against 32 physicians and 22 health care institutions. Defense costs were $298,906, and indemnity payments were $1,279,171. Glass was the most frequent retained foreign body, constituting 53% of claims. Despite the fact that glass is radiopaque, x-ray films were ordered for only 35% of these patients. Retention of glass fragments when no radiologic study was obtained resulted in unsuccessful defense of 60% of the claims and higher indemnity payments. Radiologic studies were ordered for only 31% of all patients.
Conclusions:
All wounds should be considered to be at risk for foreign body entry. Documentation in the medical record of wound exploration and patient follow-up, and ordering of plain films and other diagnostic imaging studies should be used more frequently toward this end.
