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Preoperative practices overhauled after surgical checklist failure.

1 Preoperative practices overhauled after surgical checklist failure Use of the World Health Organization’s surgical safety checklist has reduced surgical complications and mortality, but a narrow escape after a checklist failure at an Italian hospital suggests that more vigilant efforts are needed to avoid errors. In August 2012, an 81-year-old patient with vascular dementia was brought to the OR at G. Fracastoro Hospital, San Bonifacio (Verona), Italy, for left carotid artery surgery, as indicated on the sign-in sheet when his surgery was scheduled. In the preoperative area, the anesthetist obtained the patient’s consent, confirmed the surgical site, and asked a colleague to perform an ultrasound-guided cervical plexus block of the left carotid artery because he was not skilled in this technique. The surgeon was absent from the preoperative area while the anesthesia was being given. During the time-out prior to surgery, however, the surgeon realized that surgery should be performed on the right carotid artery, not the left. The patient was given general anesthesia, and the procedure was performed on the right carotid artery. Afterward, the patient was admitted to the ICU for postoperative monitoring for 24 hours.