GITNUXREPORT 2025

Retained Surgical Items Statistics

Retained surgical items pose significant health, legal, and financial risks globally.

Jannik Linder

Co-Founder of Gitnux, specialized in content and tech since 2016.

First published: April 29, 2025

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Statistic 1

Retained surgical sponges can cause granulomas, fistulas, and infections, which can delay treatment and increase morbidity

Statistic 2

Retained surgical items can cause significant psychological distress for patients, with about 23% experiencing prolonged anxiety or depression

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Approximately 1 in 5 retained surgical items go unreported annually

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The incidence rate of retained surgical items is estimated at 1 in 5,000 to 1 in 18,700 surgeries

Statistic 5

Surgeries involving emergency procedures are at a higher risk of RSI, with an estimated risk ratio of 2.5

Statistic 6

Approximately 85% of RSI incidents are discovered intraoperatively

Statistic 7

Surgical sponges are the most frequently retained surgical items, representing about 78% of cases

Statistic 8

The mortality rate associated with RSI can be as high as 24%

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Over 26% of all surgical claims related to RSI involve a delay in diagnosis

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Up to 64% of RSI cases involve a breakdown in communication among surgical team members

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About 30% of RSI cases are identified only after wound closure, often following postoperative imaging

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Retained surgical items are more common in patients with higher BMI due to surgical complexity

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Retained surgical items account for roughly 10% of all surgical adverse events reported to hospital incident reporting systems

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The risk of RSI increases with multiple surgeries within a short time frame, due to fatigue and protocol lapses

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The incidence of RSI in pediatric surgeries is lower but still significant, accounting for approximately 3.2% of all RSI cases

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RSI is more likely in surgeries involving foreign body implantation, such as prostheses or mesh, due to increased complexity

Statistic 17

The number of reported RSI cases has increased modestly over the past decade, likely due to improved detection and reporting practices

Statistic 18

Surgical teams with higher experience levels have a statistically lower RSI incidence, with a reduction of about 28%

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Retained surgical items are more common in surgeries performed during off-hours, with some studies indicating rates up to 2.5 times higher

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The annual cost associated with RSI-related legal claims is estimated to be over $1.7 billion in the US

Statistic 21

Retained surgical items are responsible for 72% of surgical malpractice claims involving foreign bodies

Statistic 22

The average legal settlement for RSI cases in the U.S. is approximately $2.5 million

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Medical liability for RSI can include wrongful death suits and severe physical impairment claims, with settlements reaching over $10 million

Statistic 24

The average increased hospital stay associated with RSI is about 5 days, significantly increasing healthcare costs

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About 25% of RSI cases involve failure to document and communicate the removal of foreign bodies post-surgery, increasing legal risks

Statistic 26

The use of surgical counts and radiography reduces missed items by up to 50%

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Hospitals that implement radio-frequency detection systems report a 50% reduction in RSI incidents

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The risk of RSI is higher when surgical teams do not adhere strictly to standardized counting protocols

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Implementation of intraoperative radiography can identify retained items in up to 2% of cases where counts are correct

Statistic 30

The median time to detection of RSI varies from immediate intraoperative discovery to up to 10 years postoperative

Statistic 31

Surgical team training and protocols significantly reduce the incidence of RSI by approximately 40%

Statistic 32

The use of barcode scanning systems during surgical counts reduces the likelihood of RSI by approximately 86%

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Only around 40% of hospital systems globally have comprehensive protocols specifically addressing RSI prevention

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The use of RFID technology in surgeries can decrease RSI incidents by up to 70%, according to recent studies

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The utilization of checklists during surgeries can reduce RSI incidents by approximately 35%, according to WHO recommendations

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The most effective RSI prevention strategies include surgical counting protocols, imaging, and technology-assisted detection, but combined implementation yields the best results

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Textiles are the most commonly retained items, accounting for roughly 79%

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The most common anatomical locations for RSI are the abdominal cavity (58%), pelvis (22%), and chest (20%)

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The most common types of retained surgical items are non-absorbable surgical sponges and textiles

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Key Highlights

Approximately 1 in 5 retained surgical items go unreported annually
The incidence rate of retained surgical items is estimated at 1 in 5,000 to 1 in 18,700 surgeries
Surgeries involving emergency procedures are at a higher risk of RSI, with an estimated risk ratio of 2.5
Textiles are the most commonly retained items, accounting for roughly 79%
The annual cost associated with RSI-related legal claims is estimated to be over $1.7 billion in the US
Approximately 85% of RSI incidents are discovered intraoperatively
The most common anatomical locations for RSI are the abdominal cavity (58%), pelvis (22%), and chest (20%)
Surgical sponges are the most frequently retained surgical items, representing about 78% of cases
The use of surgical counts and radiography reduces missed items by up to 50%
Retained surgical items are responsible for 72% of surgical malpractice claims involving foreign bodies
The mortality rate associated with RSI can be as high as 24%
Over 26% of all surgical claims related to RSI involve a delay in diagnosis
Retained surgical sponges can cause granulomas, fistulas, and infections, which can delay treatment and increase morbidity

Did you know that despite advances in medical technology, approximately 1 in 5 retained surgical items go unreported each year—posing serious risks to patient safety and costing the healthcare system over $1.7 billion annually?

Impact on Patients and Healthcare Systems

Retained surgical sponges can cause granulomas, fistulas, and infections, which can delay treatment and increase morbidity
Retained surgical items can cause significant psychological distress for patients, with about 23% experiencing prolonged anxiety or depression

Impact on Patients and Healthcare Systems Interpretation

Retained surgical items not only pose serious health risks like granulomas and infections but also leave patients emotionally scarred, with nearly a quarter experiencing ongoing anxiety or depression, highlighting the critical need for meticulous surgical accountability.

Incidence and Epidemiology of RSI

Approximately 1 in 5 retained surgical items go unreported annually
The incidence rate of retained surgical items is estimated at 1 in 5,000 to 1 in 18,700 surgeries
Surgeries involving emergency procedures are at a higher risk of RSI, with an estimated risk ratio of 2.5
Approximately 85% of RSI incidents are discovered intraoperatively
Surgical sponges are the most frequently retained surgical items, representing about 78% of cases
The mortality rate associated with RSI can be as high as 24%
Over 26% of all surgical claims related to RSI involve a delay in diagnosis
Up to 64% of RSI cases involve a breakdown in communication among surgical team members
About 30% of RSI cases are identified only after wound closure, often following postoperative imaging
Retained surgical items are more common in patients with higher BMI due to surgical complexity
Retained surgical items account for roughly 10% of all surgical adverse events reported to hospital incident reporting systems
The risk of RSI increases with multiple surgeries within a short time frame, due to fatigue and protocol lapses
The incidence of RSI in pediatric surgeries is lower but still significant, accounting for approximately 3.2% of all RSI cases
RSI is more likely in surgeries involving foreign body implantation, such as prostheses or mesh, due to increased complexity
The number of reported RSI cases has increased modestly over the past decade, likely due to improved detection and reporting practices
Surgical teams with higher experience levels have a statistically lower RSI incidence, with a reduction of about 28%
Retained surgical items are more common in surgeries performed during off-hours, with some studies indicating rates up to 2.5 times higher

Incidence and Epidemiology of RSI Interpretation

Despite advancements and increased vigilance, the startling reality remains that nearly one in five retained surgical items go unreported annually, underscoring the persistent risks of surgical oversight, especially during emergency, complex, or off-hour procedures, where communication breakdowns and fatigue can make even experienced teams overlook the tiny yet deadly errors lurking behind wound closures.

Legal and Financial Implications

The annual cost associated with RSI-related legal claims is estimated to be over $1.7 billion in the US
Retained surgical items are responsible for 72% of surgical malpractice claims involving foreign bodies
The average legal settlement for RSI cases in the U.S. is approximately $2.5 million
Medical liability for RSI can include wrongful death suits and severe physical impairment claims, with settlements reaching over $10 million
The average increased hospital stay associated with RSI is about 5 days, significantly increasing healthcare costs
About 25% of RSI cases involve failure to document and communicate the removal of foreign bodies post-surgery, increasing legal risks

Legal and Financial Implications Interpretation

With over $1.7 billion annually in legal costs, a 72% share in malpractice claims, and settlements soaring to over $10 million, retained surgical items highlight that the true cost of a lost sponge goes far beyond patient safety—it’s a costly reminder that meticulous documentation and vigilance are essential to prevent preventable tragedies and financial disasters.

Prevention and Detection Methods

The use of surgical counts and radiography reduces missed items by up to 50%
Hospitals that implement radio-frequency detection systems report a 50% reduction in RSI incidents
The risk of RSI is higher when surgical teams do not adhere strictly to standardized counting protocols
Implementation of intraoperative radiography can identify retained items in up to 2% of cases where counts are correct
The median time to detection of RSI varies from immediate intraoperative discovery to up to 10 years postoperative
Surgical team training and protocols significantly reduce the incidence of RSI by approximately 40%
The use of barcode scanning systems during surgical counts reduces the likelihood of RSI by approximately 86%
Only around 40% of hospital systems globally have comprehensive protocols specifically addressing RSI prevention
The use of RFID technology in surgeries can decrease RSI incidents by up to 70%, according to recent studies
The utilization of checklists during surgeries can reduce RSI incidents by approximately 35%, according to WHO recommendations
The most effective RSI prevention strategies include surgical counting protocols, imaging, and technology-assisted detection, but combined implementation yields the best results

Prevention and Detection Methods Interpretation

While diligent counting protocols, radiography, and cutting-edge detection systems can halve or even eliminate retained surgical items, the grim reality remains—only 40% of hospitals employ comprehensive RSI prevention strategies, highlighting that in the complex theatre of surgery,, missing items often lurk in the shadows of complacency and inconsistent implementation.

Types and Locations of Retained Items

Textiles are the most commonly retained items, accounting for roughly 79%
The most common anatomical locations for RSI are the abdominal cavity (58%), pelvis (22%), and chest (20%)
The most common types of retained surgical items are non-absorbable surgical sponges and textiles

Types and Locations of Retained Items Interpretation

With textiles comprising nearly 80% of retained surgical items—primarily lurking in the abdomen, pelvis, and chest—the persistent challenge of RSI underscores the need for sharper vigilance and innovative solutions to keep our surgical wards — and their linens — where they belong.