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When a surgeon closes a patient’s incision while leaving behind a sponge, clamp, needle, or other object, the result is a retained surgical object (RSO). This is one of the most clear-cut examples of malpractice because the medical community considers it a “never event.” These errors should never happen when proper surgical counts, checklists, and technology are in place.
Though classified as rare, RSOs are not as uncommon as many believe. Studies estimate that retained objects occur in approximately 1 out of every 5,500 to 7,000 surgeries in the United States. That translates to several thousand preventable cases each year. Sponges account for the majority of RSOs, largely because they are small, easily concealed in cavities, and absorb blood.
The Agency for Healthcare Research and Quality (AHRQ) and The Joint Commission both classify RSOs as sentinel events—serious, reportable incidents that indicate major patient-safety failures.
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While any item used during surgery could theoretically be retained, the most common culprits include:
Sponges are particularly dangerous because they can remain undetected for weeks or months before causing infection or obstruction.
RSOs usually occur because of system failures and human error. Common causes include:
When hospitals cut corners or surgeons fail to enforce safety protocols, patients suffer the consequences.
Any deviation from these protocols that leads to an RSO is a breach of the standard of care and is legally considered malpractice.
The harm from RSOs varies but can be catastrophic. Patients may experience:
Even when corrected, patients are left with lasting trauma and financial burdens from entirely preventable errors.
Unlike many malpractice claims, retained object cases are relatively straightforward. Because RSOs are never events, plaintiffs do not need to prove that harm was unforeseeable—only that an object was left behind. Courts often apply the doctrine of res ipsa loquitur (“the thing speaks for itself”), meaning the very fact of a retained object is evidence of negligence.
Medical records, imaging, operative reports, and pathology from the removed object all serve as compelling proof.
At Snyder & Wenner, P.C., we have seen firsthand the devastation patients endure when something as basic as counting instruments goes wrong. These cases are egregious because they are 100% preventable.
Our attorneys meticulously review surgical records, nursing notes, hospital protocols, and technology usage to establish liability. We partner with top medical experts who confirm how the retained object violated every safety standard. With decades of malpractice litigation experience in Arizona and across the country, Snyder & Wenner is uniquely positioned to secure justice and compensation for victims of RSOs.
Responsibility may rest with multiple parties, including:
Surgeons, for failing to confirm complete counts before closure
Surgical nurses/technologists, for inaccurate counts or inadequate documentation
Hospitals/ASCs, for failing to implement or enforce prevention technology and protocols
Device manufacturers, in rare cases where detection equipment malfunctioned
Victims of RSOs may recover damages such as:
Medical expenses for removal surgeries, hospitalizations, and rehabilitation
Lost wages and diminished earning capacity
Pain and suffering, including chronic pain and emotional trauma
Loss of enjoyment of life
Wrongful death damages for families, including funeral costs and loss of support
Because these cases involve preventable harm, juries often view them as particularly egregious, which can increase awards.
Retained surgical objects are among the most shocking forms of malpractice because they betray the most basic duty of surgical safety. The medical community has the tools to prevent them—rigorous counts, radiopaque sponges, barcoding, and detection systems. Yet when protocols are ignored, patients pay the price with infections, repeat surgeries, or worse.
At Snyder & Wenner, P.C., we believe these errors are unacceptable. By representing patients harmed by RSOs, we not only fight for justice but also push hospitals to adopt stricter safeguards so that no other family has to endure the same preventable tragedy.
Absolutely. We specialize in high-stakes malpractice litigation, including RSO cases, and have the expertise to hold hospitals accountable.
