{"id":"209761db-9a26-4987-9a5f-261fef7202a0","slug":"retained-foreign-bodies-in-spine-surgery-never-events-near-never-events-but-not-just-adverse-events","title":"Retained foreign bodies in spine surgery: Never events, near never events, but not just adverse events","authors":["Nancy E. Epstein","Marc A. Agulnick"],"abstract":"Background: Retained foreign bodies (RFB), or those left behind following spine surgery, are considered “Never Events (NE /= 1/100).” The vast majority of NE/NNE are due to cotton sponges, cottonoids, or residual cotton strands (i.e., collectively called Textilomas or Gossypibomas). However, RFB additionally included; fractured needles, guidewires, fractured screws/implants/drains, and/or broken instruments (i.e., scalpels). Notably, the spine surgeon of record, as captain of the ship, is primarily liable for RFB and is central to ensuing medicolegal suits. However, secondarily liable are the adjunctive surgical/medical personnel, (i.e., physicians, Physician Assistants, Nurses, Nurse Practitioners, Physical Therapists, Occupational Therapists), and others who are independent or work full-time for hospitals. Methods: Patients with RFB may present with acute, subacute, or chronic/delayed pain and suffering. Additional complaints include; lost wages, sustained physical disability and/or injury attributed to these objects. Most RFB are diagnosed on plain X-rays, followed by MR and/or CT studies. Results: RBS’s may include; retained drain fragments, broken needles, fractured guidewires, broken scalpel blades, fractured screws, and/or instruments. Retrieval procedures warrant a wide variety of different techniques, some of which fail. Notably, RFB’s largely occur due to the performance of; emergent procedures, doing an unfamiliar operation, encountering anatomical variants, or operating on patients with elevated body mass indexes (BMI). Additionally these include; surgeons’ failure to order and/or radiologists’ failure to correctly read intraoperative X-rays/fluoroscopic images, and/or nurses’ failures to correctly perform end of surgery counts. Conclusion: RFBs, or foreign bodies left behind following spine surgery, are considered “Never Events ( 1/100)”. When they do occur, the operating surgeon bears primary responsibility, but the nursing/adjunctive staff and hospital are also liable.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/209761db-9a26-4987-9a5f-261fef7202a0/featured/hero-cropped-1781557433692.jpg","publishDate":"2026-06-05T00:00:00.000Z","doi":"10.25259/SNI_593_2026","categories":["Spine","Review Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2026/06/14602/SNI-17-338.pdf"}