A middle-aged man had a HeartMate-2 left ventricular assist device inserted, but faced declining health from more than his heart after he developed a critical infection. He was discharged the same day the insertion was completed, but returned to the hospital two months later to treat his infection, which was done with the use of a vacuum-assisted wound sealing application (VAC). He returned to the hospital yet again, however, for mediastinal bleeding and required surgery for a chest wall infection. After multiple other hospitalizations, his ventricular assist device was removed, and the surgeon found a wound VAC sponge inside him, which was removed along with copious amount of dead tissue which had grown into the sponge. The surgeon who performed the initial wound VAC was consequently sued, and an expert in hospital procedural guidelines was needed to testify in the trial.
Question(s) For Expert Witness
1. Do you routinely treat patients similar to the one described in the case?
2. Have you ever had a patient develop the outcome described in the case?
Expert Witness Response E-007335
I have a 25 year career in Cardiothoracic Surgery, and am Chief of Cardiothoracic Surgery and Interim Chair of Surgery at my institution. Retained sponges are designated as "Never Events" by Centers for Medicare and Medicaid Services - as in, they should never happen and there is no defense for their occurrence. I routinely treat patients with LVAD devices like the one in this case. We have had patients with pocket infections, but never a retained sponge.
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