Could surgical ‘black box’ help prevent operating room errors?

Canadian researchers are developing a surgical “black box” to monitor operating room procedures, with the hope of identifying and reducing surgical errors.

A 2012 study found that surgical "never events," or mistakes that should not occur under any circumstances, happen at least 4,000 times yearly, according to a Johns Hopkins press release. These dramatic errors often make headlines, but smaller mistakes can also cause serious injuries. While New York City doctors can often prevent "never events" through simple protocols, other errors can be harder to address.

Fortunately, new technology being developed in Canada could help prevent these errors. "Black box" monitoring devices could keep surgeons safely on track during procedures, reducing the risk of adverse outcomes, according to CNN. Surgeons could also use the data collected to identify mistakes and improve their future performance.

Detailed feedback

In early research, the surgeon who developed the black box found that surgeons are often oblivious to the mistakes they make. The average surgeon studied made 20 mistakes during each procedure. In this case, mistakes were simply defined as deviations from standard procedure, so every mistake didn't necessarily cause permanent harm.

The black box could help surgeons identify - and eventually prevent - mistakes ranging from minor to consequential. The device is still under development, according to the Toronto Star, but it currently consists of the following components:

  • Three microphones positioned in the operating room
  • Two cameras that monitor the operating room
  • One camera that monitors the laparoscopic surgery inside the patient's body

A team analyzes all of the recorded data to evaluate the surgical techniques, the team's dynamic and the operating room itself, looking for errors and potential hazards. In the future, the black box will include analytical software, which will detect when surgeons are using potentially risky techniques or otherwise deviating from best practices.

At present, the box only provides surgeons with feedback after the procedure. Still, this marks a significant improvement over traditional recording methods, such as audio transcripts. These forms of recording could make it difficult for surgeons to go back after surgery and identify why a complication developed.

Since April 2014, the black box has been used to record roughly 80 gastric bypass surgeries performed in one Toronto hospital. The data gathered has already been used to identify two stages of the surgery in which 86 percent of observed errors were made. The surgical team is now taking steps to address the most common sources of error.

The inventor of the black box hopes the device will promote a shift in operating room culture, in which mistakes could be readily acknowledged and addressed, rather than ignored or denied. This could lead to safer procedures and better outcomes for patients.

Future of the technology

The black box has received mixed responses; some surgeons welcome the chance to improve their techniques, while others worry the device could lead to more malpractice claims. The box will soon be tested in various countries, potentially including the U.S., according to CNN. The same source notes that, in the future, black boxes could be implemented quickly here; since the technology is not a medical device, it will not require FDA approval.

In the meantime, preventable surgical mistakes may affect many people. Anyone who has been hurt by one of these errors should meet with an attorney to discuss pursuing compensation.

Keywords: medical malpractice, surgery, error