Retained Foreign Objects After Surgery in Georgia: Why These “Never Events” Are Almost Always Malpractice

No patient goes into an operating room expecting to leave with a surgical sponge, clamp, or needle still inside their body. Yet retained foreign objects after surgery remain one of the most preventable—and most harmful—errors in modern medicine. In the United States, an estimated 1 in every 7,700 surgeries results in a foreign item being left inside a patient, and surgical sponges account for roughly 70 percent of those cases. When it happens, the consequences can range from chronic pain and serious infection to organ damage and death.

If you or a family member discovered that a surgical instrument or sponge was left inside your body after an operation in Atlanta or anywhere in Georgia, you are not at fault. These incidents are classified as events that should never occur in a properly run operating room—and under Georgia law, they almost always support a viable malpractice claim.

What Is a Retained Surgical Sponge or Foreign Object?

A retained foreign object is any item unintentionally left inside a patient’s body after a surgical procedure. The most frequently retained items are laparotomy sponges—absorbent pads used to soak up blood and fluids during surgery. Because these sponges become saturated and can closely resemble surrounding tissue, they are easy to overlook when the incision is being closed.

Other commonly retained objects include clamps, retractors, scalpel tips, guidewires, suture needles, drain tips, and catheter fragments. While any of these can cause serious harm, sponges are by far the most common culprit. They can trigger a severe inflammatory response known as a gossypiboma—a mass that forms around the retained material and can mimic a tumor or abscess on imaging, further delaying correct diagnosis.

Why Retained Foreign Objects Are Called “Never Events”

The National Quality Forum classifies a retained foreign object as a “never event,” meaning it is an error so serious and so preventable that it should never occur when proper safety protocols are followed. The Joint Commission, which accredits hospitals nationwide, treats every confirmed retained object as a sentinel event—triggering a mandatory internal investigation.

The label matters because it reflects a medical consensus: there is no acceptable clinical reason for leaving a sponge or instrument inside a patient. Research published through the Agency for Healthcare Research and Quality confirms that approximately 40 percent of retained object incidents cause severe patient harm, and roughly 16 percent contribute to patient death. These are not freak accidents. They are system failures.

How Surgical Teams Are Supposed to Track Sponges and Instruments

Every hospital and surgical center is expected to follow standardized counting procedures designed to prevent a retained surgical sponge or instrument. Before the first incision, the scrub nurse and circulating nurse count every sponge, needle, blade, and instrument on the surgical tray. That count is recorded. The team repeats the count before the surgeon begins closing each internal cavity, and again before the final skin closure. If the numbers do not match, the team is supposed to stop and locate the missing item—sometimes using intraoperative imaging.

Many facilities also use radiopaque markers embedded in sponges. These markers are designed to appear on X-ray so that even if a sponge is visually missed, it can be detected by a scan before the patient leaves the operating room. Some hospitals have adopted barcode-scanning systems or radiofrequency identification (RFID) tagging to track surgical materials in real time.

What Goes Wrong During Counting

Despite these safeguards, retained objects still occur. The most common breakdowns include:

• Miscounts caused by fatigue, distraction, or shift changes during long procedures
• Emergency surgeries where time pressure leads the team to skip or rush the counting protocol
• Poor communication between the scrub nurse, circulating nurse, and surgeon—especially during complex procedures involving multiple surgical teams
• Understaffing in the operating room, which places the counting responsibility on fewer people
• Failure to perform a final reconciliation when counts are documented as correct but were actually incomplete

The risk rises sharply in operations that are longer than expected, involve a change in surgical plan mid-procedure, or require emergency intervention. Obese patients and those undergoing abdominal or pelvic surgery also face elevated risk, because the surgical field is larger and sponges are more easily obscured by tissue.

Symptoms of a Retained Foreign Object After Surgery

One of the most troubling aspects of a retained surgical sponge is that symptoms may not appear for weeks, months, or even years. When they do surface, they are often mistaken for unrelated conditions—leading to prolonged suffering and delayed treatment.

Common warning signs include:

• Persistent or worsening pain at or near the surgical site that does not improve with time
• Unexplained fever or recurrent low-grade fevers
• Swelling, redness, or drainage from the incision area
• Nausea, vomiting, or bloating—particularly after abdominal surgery
• Bowel obstruction or changes in bowel habits
• A palpable mass or lump near the operative area
• Chronic fatigue or general malaise without a clear cause

Because these symptoms overlap with common post-surgical complications, many patients are initially treated for suspected infections, adhesions, or inflammatory conditions. Some undergo rounds of antibiotics or additional testing without ever being evaluated for a retained object. The misdiagnosis can continue for years, during which the retained sponge or instrument causes progressive tissue damage.

Diagnosing a Retained Object: Imaging and Delays

When a retained foreign object is suspected, the primary diagnostic tools are X-ray and CT scan. If the retained item contains a radiopaque marker—as most surgical sponges do—it will typically appear on a standard X-ray. CT scans provide greater detail and can identify objects that are partially degraded, encapsulated in scar tissue, or located in areas where overlapping anatomy complicates a plain film.

The real problem is not the imaging technology itself. It is the failure to treat symptoms in a timely manner by ordering the right test. When a patient returns with post-operative pain or fever, clinicians may attribute the symptoms to normal healing, prescribe pain medication, or focus on other diagnoses before considering that a foreign object may have been left behind. Every week or month of delayed imaging allows the object to cause more tissue damage, more infection, and more scar formation—making eventual removal more difficult and more dangerous.

In some cases, a retained object is discovered incidentally during imaging for a completely unrelated issue. A patient may break a rib, have a routine scan, and learn for the first time that a sponge has been sitting inside their abdomen since a surgery years earlier. By that point, the damage may be extensive.

Who Is Legally Responsible—Surgeon, Nurse, or Hospital?

Retained foreign object cases often involve multiple parties who may share liability. In Georgia, the question of who can be held accountable depends on the specific facts of the case, the employment relationships within the operating room, and how the counting protocols were managed.

The surgeon bears primary responsibility for the procedure and for confirming that the operative site is clear before closure. Georgia courts have historically recognized the “captain of the ship” concept, which holds the lead surgeon accountable for events that occur during the operation—even if the surgeon relied on nursing staff to perform the sponge count.

Scrub nurses and circulating nurses who performed or documented inaccurate counts may also be individually liable. If an assisting surgeon or resident participated in the procedure and contributed to the error, they can be named as well.

The hospital itself may face liability under a theory of corporate negligence—for instance, if it failed to implement adequate counting protocols, understaffed the operating room, or did not properly train its surgical teams. When nurses and technicians are hospital employees, the hospital may also be responsible for their actions under the legal principle of respondeat superior.

A malpractice attorney can review the operative report, nursing notes, and staffing records to determine which parties should be held accountable.

How Georgia Law Treats Retained Foreign Object Cases

Under Georgia law, leaving a surgical instrument or sponge inside a patient is treated as strong evidence of negligence. While Georgia malpractice claims generally require expert testimony to establish that a healthcare provider deviated from the accepted standard of care, retained object cases carry a built-in presumption: a competent surgical team following proper protocols would not leave a foreign body behind. The Georgia Code, Title 51, Section 51-1-27, addresses the doctrine of res ipsa loquitur, which can apply in foreign object cases where the negligence is self-evident from the facts.

This does not mean the case is automatic. The defense may argue that the patient’s anatomy, the complexity of the procedure, or an emergency situation created circumstances beyond the team’s control. A qualified medical expert is still needed to explain how the standard of care was breached. But the factual foundation in these cases—a sponge or clamp found inside a body where none should be—is powerful.

The Discovery Rule and Statute of Limitations

Georgia’s general statute of limitations for medical malpractice is two years from the date of injury, with a five-year statute of repose. However, retained foreign object cases are treated differently because patients often have no way to know about the error until long after surgery.

Georgia law provides a discovery rule for these situations: a patient has one year from the date they discover (or reasonably should have discovered) the retained object to file a lawsuit. This means that even if the original surgery took place a decade ago, a claim may still be viable if the foreign object was only recently found. The discovery rule does not shorten the standard two-year period—so if a patient discovers a retained sponge within days of surgery, they still have the full two years to file.

Because the discovery rule involves factual questions about when the patient knew or should have known about the object, it is important to consult with an attorney as soon as a retained item is identified. Waiting too long can put the claim at risk.

How Damages Are Calculated in These Cases

The harm caused by a retained surgical sponge or instrument goes well beyond the initial error. Patients frequently require one or more additional surgeries to remove the object and repair the surrounding tissue. During that time, they may develop infections—including sepsis in severe cases—that demand hospitalization, IV antibiotics, and extended recovery.

Damages in retained foreign object malpractice claims typically include:

• Medical expenses for additional surgeries, hospital stays, diagnostic imaging, medication, and rehabilitation
• Lost wages and reduced earning capacity from time away from work during recovery
• Pain and suffering, including the physical pain of living with a foreign object and the emotional distress of learning it was left behind
• Long-term disability or chronic conditions resulting from infection, organ damage, or adhesions caused by the retained object
• Loss of enjoyment of life when ongoing complications limit a patient’s daily activities and quality of life

Georgia does not cap compensatory damages in most medical malpractice cases, which means the full scope of a patient’s losses can be pursued. In cases where the conduct was especially reckless—such as falsifying count records or ignoring a known discrepancy—punitive damages may also be available.

Practical Steps to Protect Your Rights After a Suspected Retained Object

If you suspect or have confirmed that a foreign object was left inside your body after surgery, taking certain steps early can strengthen a potential claim:

First, seek prompt medical attention. Your health comes first. If a retained object is causing symptoms, you need proper diagnosis and treatment. Ask your physician to order imaging—an X-ray or CT scan—to confirm the presence and location of the item.

Second, request copies of your operative report, anesthesia records, nursing notes (including sponge and instrument count documentation), radiology studies, and pathology findings from both the original surgery and any follow-up procedures. These records form the backbone of any malpractice investigation.

Third, keep a record of your symptoms, including when they started, how they have changed over time, and how they have affected your daily life and ability to work.

Fourth, speak with a medical malpractice attorney before discussing the situation in detail with the hospital or its representatives. Anything you say may be used later to minimize your claim.

Time matters in these cases. While the discovery rule provides important protection, the sooner an attorney can review your records and begin preserving evidence, the stronger your position will be.

Talk to a Georgia Medical Malpractice Lawyer

A retained surgical sponge or instrument is not something you caused, and it is not something you should have to absorb alone. These cases involve preventable errors with real, lasting consequences—and Georgia law recognizes that.

If you or someone you love is dealing with complications from a foreign object left behind during surgery, we can help you understand what happened and what options may be available. Davis Adams represents patients across Georgia in medical malpractice claims involving surgical errors, retained objects, and delayed treatment. Request a confidential consultation to discuss your situation with an experienced Atlanta medical malpractice lawyer.

This article is for general informational purposes only and is not legal advice. Every case depends on its own facts, medical records, and expert review.