RFID at UC Irvine Spots Sponges Inside Patients After Surgery

The University of California at Irvine is using ClearCount's RFID technology to track sponges during surgery and prevent foreign objects from being left inside patients.

Radio-frequency identification technology is not only a way to track goods through the supply chain or the environmental conditions of food or medicine, but it may even save you from having foreign objects left inside of you after surgery.

The University of California's Irvine Medical Center in Orange, Calif., has adopted SmartSponge RFID technology from medical device vendor ClearCount Medical Solutions to spot retained surgical items, or objects such as sponges left inside a patient following a medical procedure. The hospital has implemented SmartSponge in all operating rooms as well as the labor and delivery facilities.

One in every 1,500 open abdominal or chest procedures involves a retained surgical item, according to a 2009 report in the Journal of Robotic Surgery. This medical error leads to additional surgery, added medical costs, malpractice suits and possibly infections and death, ClearCount reported.

The number of retained surgical items grew more than 40 percent from 2010 to 2011, according to the Joint Commission, a nonprofit organization that accredits U.S. health care programs.

Tracking these items has proven a lot safer for patients than when only manual checking is used, according to Dr. William Barron, UC Irvine's chief medical officer.

The manual procedure must be followed in addition to using RFID, said Barron. This standard approach involves nurses counting the sponges at the beginning and end of an operation. This process of counting is called a "device reconcile count," noted Jim Sweeney, ClearCount's vice president of marketing, in an email to eWEEK.

Towels and sponges used during surgery have a unique RFID chip sewn into them. The tag allows doctors to track how many sponges are being used, said Barron.

"After the surgery, as we remove each sponge, the technology identifies each sponge, and counts it and displays to operating room personnel that those sponges have been counted," Barron explained. "If there are any sponges that have not been removed from the patient, that is made clear to the OR staff, the surgeons and the nurses."

Items are matched according to their RFID numbers as they're removed from the "sterile area," said Sweeney.

"This direct verification of each item both before and after use is a true closed-loop reconciliation of the sponge count," Sweeney explained. If a sponge is unaccounted for, the surgeon waves a plastic circular wand, called the SmartWand-DTX, over the patient to locate the sponge that may need to be removed from inside the individual.

When the wand spots a sponge, a red LED light activates and an alarm sounds. A monitor then shows the number of sponges that may be retained in the patient.

The success rate as far as not leaving sponges in patients has been pretty high when using the SmartSponge RFID system, Barron suggested.

"We have never inadvertently left in a sponge that subsequently had to be removed since implementing the ClearCount technology," said Barron.

"On occasion, we leave in a sponge when a patient's medical condition requires it€”for example, when a patient has massive injuries to the abdomen," Barron added.

Still, a potential problem could result if a patient is transferred from surgery in another hospital that doesn't use RFID-tagged sponges, said Barron. If the sponges don't have RFID tags, ClearCount can't detect it.

SmartSponge conforms to international standards regarding long-term exposure to radiation for patients and staff, said Sweeney.

In addition to using RFID, this year UC Irvine plans to use wireless technology to connect the bar codes of infusion pumps with electronic health records (EHRs), said Barron.