Retained foreign bodies

Abstract

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.