Retained foreign bodies.
OBJECTIVE
To evaluate the frequency of occurrence and outcome of patients having retained foreign bodies after treatment in an urgent-care setting.


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.


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.
Kaiser
C W
CW
Department of Veterans Affairs Medical Center, Manchester, New Hampshire 03104, USA. cwkaiser@ix.netcom.com
Slowick
T
T
Spurling
K P
KP
Friedman
S
S
D003951:Diagnostic Errors; D005547:Foreign Bodies / Q000175:diagnosis* / Q000191:economics / Q000628:therapy; D006801:Humans; D008318:Malpractice / Q000191:economics