Surgeon left needle tip inside baby during operation

[anonymouse007]

Hi everyone,

I'm hoping someone can advise me on my current situation. I'll avoid sharing too many 'outy' details but hopefully it'll be understandable.

My daughter was born with DDH (hip dysplasia). When she was 1 month old, we used a harness and fixed one hip. Her doctor decided she would need surgery to fix the second hip.

At 10 months old, she underwent an 'open reduction' surgery which involved making a cut, sorting out the hip socket and pushing her hip into the correct position.

My problem is this...
After the op, I was told the following by her surgeon--
When the stitches were done, my daughter's hip was x-rayed to make sure the positioning was correct. In the x-ray, a foreign object was noted in the hip joint. Doctors checked medical equipment and realised the tip of a suturing needle had broken off. They said it was "less than 1mm long." They re-opened her stitches but apparently couldn't find the piece and decided to leave it because it was "only in the tissue, not near the bone or muscle."
They said the piece will either "disintegrate" over many years or "be ejected from the skin as a foreign body" but it won't be harmful.

Honestly speaking, I feel like the issue was downplayed. The incident was not even mentioned on the discharge notes. I actually had to ask them to add it in (which they did) so that I would have it on record.
I also asked the nurses if an Incident Report had been filled out and if I could view it but I didn't get a straight answer. They told me to request my daughter's health records under the data protection act to find out more.
The surgeon did mention that they "will be contacting the needle manufacturers to ensure it doesn't happen again." That's all.

I just want to know...
Will my baby be OK?
Has anyone had a similar experience?
For other medics: have you heard of this happening? How serious would you say it is? Did the doctors/nurses act appropriately?
Should I seek legal advice?
What should I do?

I have many more appointments at the same hospital so hopefully I can ask questions next time I'm there. I'm just not sure where to start. Honestly, I just don't want this to affect my child's health or make her suffer in the future.

Thanks for reading my essay! Looking forward to hearing your opinions.

Whilst I would agree that technically this wasn't a never event I would argue that this may still represent a failure of normal checking procedures and is probably a "near miss". The discovery on x-ray was incidental to the reason for the x-ray (checking joint positioning) otherwise the broken suture would not have been noticed until after the operation. The scrub nurse possibly should have noticed that the tip of the suture needle was damaged when doing the swab and instrument counts unless it was a very, very tiny suture.

Having said that, as others have said, it's extremely unlikely to cause any further problems.

Shocking - yes, accidents happen but the follow on and lack of transparency was piss poor

First off I don’t think this would ever cause an issue for your child. There are hundreds of people walking round with much bigger pieces without causing any issues.

I’m afraid reallybadidea I disagree. A tiny fragment off the top of the needle would be extremely difficult to spot by scrub staff or surgeon. It’s not a never event as detailed above as seen on intra-operative imaging. Drill bits especially fatigue and snap and very often it would cause more harm to try and find it than leaving it alone.

Can you still see it on the XR out of interest? No orthopod is going to leave a bit of metal in a joint space so I’d trust him when he says that he is not concerned.

I'd be worried the metal made its way into the joint and caused arthritis later on in life. I'd ask about that.

*A tiny fragment off the top of the needle would be extremely difficult to spot by scrub staff"

I said "possibly" it should have been noticed. I'm an ex-scrub nurse. Some really tiny sutures don't even show up on x-ray. We don't know how big this fragment was, but it was big enough to show up on x-ray and it was big enough for them to work out where it came from when they went back to check.

Swab, needle and instrument counts aren't just about counting numbers; as far as is reasonably possible, the integrity of these items should be checked as well.

I'm not saying that the nurse definitely should have noticed, but I think at the very least it doesn't hurt to ensure that staff are aware that needles can break sometimes.

Just to add as well, there are many people in a theatre team as well as the surgeons so don't worry about them 'not investigating' as there is no way that the whole team would just not do anything. It will definitely be reported and if the surgeons I work with are anything to go by, they will be contacting the company and reporting to them as it is likely a manufacturing issue and the whole batch will need to be checked and possibly recalled.

These things do happen unfortunately although rare but trust your daughter's surgeon. He wouldn't say it would be ok and cause no bother if he wasn't 100% sure. If he was at all concerned they would bring her back in for further x-rays to check position.

If you think about the size being less than 1mm that is as small as a grain of sand and although she's your baby and I can completely understand, I am sure she will be just fine.

Do speak with PALs to make sure you get any information from the investigation and have a chat with your surgeon next time you see them for a bit more reassurance.

I am sure they were only downplaying it as they are so unconcerned that this will cause as issue and just didn't want to cause upset where it was not warranted.

Hope your baby is making a good recovery. My girl is 10 months too and can't imagine her having surgery! Little darling!

This is not a never event.
This is a rare occurrence that was discovered on an x-ray and you were informed about it .It is unlikely to cause a problem and trying to remove something so small would.
You have it in writing that it occured,everyone will be vigilant incase there seems an issue in the future.But really it is so unlikely.
I am sorry that your child's surgeon has not made everything clear to you.What you want now depends on what you do.
If you want to complain then write a complaint letter to the Hospital,there will be help on how to do this on the website.
If you want a fuller explanation about what happened and how that could affect you child then talking to the consultant would be better and you could arrange that through their secretary.They would also he able to tell you about the hospitals reporting procedure and the progress of any investigation.
That we tell you that this kind of accident is rare and unlikely to cause a problem is irrelevant unless you talk to the right people who were there and get their understanding of events. Time makes it easier to ask the right question too.
I hope you get answers that help you come to terms with what has happened and that you child has overall benefited from the surgery.

I don’t know much about your original question OP but just to reassure you - some of the needles used are really tiny and very fine. Surgeons use needle holders to hold onto the needle when placing sutures and some of these have can be clamped onto the needle. It is possible to damage the needle when placing sutures, especially when they are fine and especially after repeated clamping on the same spot. The needle could easily have been damaged without anyone being remotely rough with her.

How awful for you. Hopefully your daughter remains well.

Hi OP,
You could raise a concern with CQC as they have a duty to investigate- especially after the Staffordshire enquiry ...however no claim as far as medical negligence

Me again, sorry...just spoken to dh!
The fact that the needle broke , means it is unlikely that it amounts to medical negligence. Assuming this is a one off incident with the needle ( ie no recall notice from manufacturer) , it is therefore unlikely that this would give rise to a potential claim under the consumer protection act as it would probably not amount to the definition of 'defect' within that act
However, the conduct of the nurses does appear to be inconsistent with 'the culture of openness ' adopted by NHS England, following the Francis report....on that basis, while you do not appear to have a legal claim, you do have grounds for a complaint to the Care Quality commission

I used to work in a risk team for an nhs hospital and don't think this would be classed as a never event. A missed needle, swab, instrument, etc definetely would be.

If it was half of a large suture needle which should have been visually obvious then probably. But something 1mm in size which could be reasonably argued wouldn't be visible that it had snapped off then no.

Years ago I had some metal fragment come out my foot. I have no idea how they got there and certainly don't remember standing on anything sharp but felt that my foot was sore. Skin seemed unbroken but over the next few days I got a lump. A&e pulled out quite a bit of metal, very thin but some bits were 4-5cm in length. I'm guessing they'd been there a bit and worked their way out. So until the last minute I was unaware of them. I'd guess something even smaller would be even less noticeable. Don't some people have bullets, etc left in them because it's too dangerous in some cases for them to be taken out?

Hi OP,

Not the same but similar....When I was 15 I jumped onto a sewing needle in bare feet, by accident. It was buried into my foot up to the eye. When I pulled it out about 1cm broke off and remained in my foot.

An X-ray showed the tip deep in the ball of my foot. There was talk by the doctors about surgery to remove it but it was decided in the end that an operation may cause more damage than leaving the needle.
They said that it would disintegrate in my body over time. I was sceptical, so were my parents.

5 years later I needed an X-ray on the same foot as it had been crushed in an accident. There was no evidence of the needle. After the initial swelling had gone down, I was fine, no I’ll affects.

I hope your baby is as unaffected as I was.