Can a Black Box Prevent Surgical Errors?

Posted on Aug 6, 2014 | 0 comments

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When an airplane crashes, the rush is on to find the black box. This is a recording device that can help investigators piece together what happened to cause the accident. A similar device recently was developed for use in the operating room. The researchers behind the device hope it prevents medical malpractice and improves patient outcomes much in the same way it aids in airline safety and accident investigations.

Reducing the rate of surgical errors is an important cause. A 2012 study from Johns Hopkins University found that such mistakes, known as “never events”, happen at least 4,000 times each year. These mistakes include wrong site surgeries, performing the wrong procedure and leaving foreign objects behind in a patient. By helping medical professionals to understand why these seemingly simple mistakes happen, a black box could help surgeons reduce their occurrence.

Black Box Prototype Tested at Three Hospitals reports that Dr. Teodor Grancharov, who specializes in minimally invasive surgical procedures, developed the box where he works at St. Michael’s Hospital in Toronto. Up to this point, the device has been tested at the facility and two additional hospitals in Denmark.

It is about the size of a cable box. The device records everything that goes on in the operating room much like a black box on an airplane records everything that goes on in the cockpit.

The device captures any video from scopes inserted into the body. It also captures the room temperature, patient vitals, decibel levels and conversations among different healthcare workers in the operating room.

For now, the device works only for minimally invasive procedures such as those using small laparoscopic incisions. However, the hope is that its use will be expanded to a wider range of surgical procedures.

The goal is to have a documented account of everything that takes place during a surgery. Understanding where errors happen can help doctors and hospitals prevent additional mistakes and develop training and education.

Dr. Grantcharov says that developers of the black box are looking for performance issues. For example, did a surgeon apply an incorrect technique during an operation? They are also looking at “less tangible” factors that can contribute to surgical errors such as miscommunication between members of the operating team.

In addition to providing surgeons and hospital officials with information on how to improve patient safety, such devices could give medical malpractice victims important evidence of negligence if a mistake results in serious personal harm.

Your Role in Preventing Surgical Errors

While the development of a black box for surgical procedures is a promising advance in patient safety, it may be a long time before such a device is widely used and its benefits are realized in terms of preventing surgical errors.

For now, if you are undergoing surgery, you can take steps to help protect yourself. The Joint Commission (pdf), an organization that accredits healthcare agencies and promotes patient safety, offers the following tips for patients:

  • Ask your doctor detailed questions about the surgery before it occurs.
  • Ask for detailed pre-op instructions regarding meals, water, medications, make-up, nail trimming and other preparations you should make before the day of surgery.
  • Write down any questions you may have as you prepare for surgery.
  • Bring someone you trust with you on your operation day and tell them your concerns as they will be your advocate if you are unable to speak or communicate.
  • Make sure all information on consent forms is correct before signing them. Ask questions if you have any before you sign the forms.
  • Make sure markings put on your body for the surgery are in the right place.
  • Ask your surgeon if the team will take a “time out” before your operation.

The outcome of a surgery may not be your responsibility but rather that of the surgeon and team attending to you. Still, speak up if you have questions and hold your healthcare providers accountable for any errors or problems you may experience.

Submitted by Powers & Santola, LLP

Robert Gordon (71 Posts)

Robert Gordon is the editor of, a health fanatic and avid Kayaker. He spends most of his time reading medical blogs and searching for new content to engage his readership.

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