Tracking Surgical Sponges Prevents Errors

A radio frequency identification (RFID) tracking system registers the history of every sponge or towel during a procedure, guaranteeing that none are left in the patient.

The SmartSponge System and the SmartWand-DTX can read and record the unique identification (ID) number of each sponge as it comes out of its packaging in the operating room (OR), as it is used in the patient, and as it is removed and disposed. Both the SmartSponge and SmartWand-DTX count multiple sponges and read through blood and tissue, and they can locate a missing tagged sponge using radio waves to signal the RFID tag to identify itself. Both systems also use the same RFID-tagged consumables, providing hospitals with a choice of devices to best address the unique conditions of each OR.


Using the system, nurses scan packages of sponges before an operation. The technology verifies and counts each sponge's internal chip, recording the total in an "in" column on a display monitor. Used sponges are tossed into an attached SmartBucket with a built-in sensing device, which verifies each chip and tallies the "outs.” Ideally, the figures in the two columns match, termed reconciliation; if not, the number of missing sponges appears in a third column, titled "find", a signal to use the SmartWand, which digitally locates sponges still inside the patient.

Among the advantages of the system are that no line of sight is required for RFID tags to be read; intuitive graphical interface provides quick reconciliation views; and reduced handling of soiled sponges is needed, which minimizes biohazard exposure. The system allows different sponge types and towels to be tracked and counted at the same time, and uniquely identified sponges prevent the system from ever counting the same sponge twice. The data can be exported to a hospital information system (HIS) in standard HL7 format, and a printer option is available for case documentation. The SmartWand-DTX and SmartSponge System are products of ClearCount Medical Solutions (Pittsburgh, PA, USA), and have been approved by the U.S. Food and Drug Administration (FDA).

"Our SmartSponge System technology was invented by an operating room nurse to improve OR safety through improved counting and detection of surgical sponges,” said David Palmer, president and CEO of ClearCount. "Our device automates a manual, error-prone process.”

Studies indicate that one in every 1,000 to 1,500 abdominal surgeries results in a sponge being left behind. A sponge mistakenly sewn into a patient can lead to serious complications, such as a bloodstream infection, unnecessary X-rays to find the missing gauze, a need for repeat surgery, and even death.

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