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How Common Is It for Doctors to Confuse Left and Right?

Left-right confusion during surgery can have severe consequences for patients.

Key points

  • Left-right confusion is mostly harmless in everyday life, but it can be fatal during surgery.
  • About 14.7% of medical students report to frequently confuse left and right.
  • Marking the side to operate on before surgery can be used to prevent left-right confusion.

Most of us have, at one point in our life, confused left and right. Some even may do it frequently.

A common situation for left-right confusion is driving in a car and the person in the passenger seat says, “Make a left turn here!” but the driver turns to the right. This is especially common when the driver is stressed out or under time pressure.

Left-right confusion in everyday life is mostly harmless. However, there are situations in which left-right confusion can have severe or even fatal consequences. For example, if a doctor confuses left and right during surgery this can have severe consequences for the patient. This can happen during a lot of different surgeries, most commonly during amputations of arms or legs. For example, if someone is scheduled to get an amputation of their left leg and the surgeon confuses left and right, the healthy right leg may get taken off instead of the left. Other surgeries during which left-right confusion can have severe consequences for the patient are surgeries on paired sensory organs like eyes and ears, or surgeries on paired internal organs such as kidneys, ovaries, and lungs wings. For example, if someone suffers from lung cancer and has a malignant tumor in the left lung wing and the surgeon confuses the left and right and takes out the healthy right lung wing, this can have fatal consequences for the patient. Thus, it is vital to conduct psychological research to get a better understanding of left-right confusion by doctors!

Here are some scientific insights on left-right confusion in medical professionals.

1. Left-right confusion during surgery can be deadly

If a doctor confuses left and right during surgery, it can have fatal consequences for the patient. According to a publication from 2004, a patient's healthy left kidney was mistakenly removed instead of the unhealthy right kidney (Dyer, 2004). The patient died five weeks after the procedure due to the consequences of not having a healthy kidney anymore.

2. Left-right confusion during surgery happens more often than you may think

There are not a lot of scientific publications on left-right confusion in the surgery room, but there is a larger study that analyzed data from the National Health Service in England (Omar et al., 2021). The scientists analyzed data on so-called “Never Events” (e.g., medical mistakes that should never happen, such as accidentally killing a patient by giving the wrong medication) in English hospitals. Between 2012 and 2020, 797 such horrible events were reported. Overall, a total of 427 of these events (53.8%) were surgeries on the wrong part of the body. Of these, a total of 84 were left-right confusions.

3. About 14.7% of medical students frequently confuse left and right

A study of 636 medical students at Mutah University in Jordan found that about 14.7% of medical students report that they frequently confused left and right – not the best prerequisite for becoming a doctor (Amnsour et al., 2023).

4. Marking the correct side before surgery is highly important

Because left-right confusion by doctors can have severe consequences for the patients, it is a common practice nowadays to mark the side on which surgery should be performed beforehand. This way, it is clear to the surgeon whether the left or the right limb or organ should be removed.

That this precaution is important was shown in a 2014 study of eye surgeons from Israel (Pikkel et al., 2014). In the study, doctors were asked to recognize the side of the operation by the patient’s name and by looking at the patient’s face from a two-meter distance. The results were astonishing: The doctors were able to recognize the side of the eye that was to be operated on in only 73% of cases based on the patient’s name, and in 83% of cases by looking at the patient’s face. They made more wrong judgments the longer the time between the examination before surgery and the surgery itself. Thus, if the doctors had operated without the information from side markings on the patients, the probability of surgery on the wrong eye, at least in a few patients, was quite high.

While such side markings therefore seem to be a good measure, they do not completely solve the issue of left-right confusion in hospitals. After all, the person who marks the patient also can confuse left and right!

References

Dyer O. Doctors suspended for removing wrong kidney. BMJ. 2004 Jan 31;328(7434):246. doi: 10.1136/bmj.328.7434.246-a. PMID: 14751886; PMCID: PMC1143788.

Mansour S, Mwafi N, Al-Tawarah N, Masoud B, Abu-Tapanjeh H, Alkhawaldeh I, Qawaqzeh M, Amro R, Mazahreh S. PREVALENCE OF LEFT/RIGHT CONFUSION AMONG MEDICAL STUDENTS IN MUTAH UNIVERSITY- JORDAN. Georgian Med News. 2023 Nov;(344):85-89.

Omar I, Singhal R, Wilson M, Parmar C, Khan O, Mahawar K. Common general surgical never events: analysis of NHS England never event data. Int J Qual Health Care. 2021 Mar 17;33(1):mzab045. doi: 10.1093/intqhc/mzab045. PMID: 33693752.

Pikkel D, Sharabi-Nov A, Pikkel J. "It is the left eye, right?". Risk Manag Healthc Policy. 2014 Apr 8;7:77-80. doi: 10.2147/RMHP.S60728. PMID: 24748828; PMCID: PMC3986280.

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