SAS Ordered to Pay €67,000 After Kirschner Needle Fragment Left in Patient’s Wrist

The High Court of Justice of Andalucía (TSJA) has ordered the Andalusian public health service (SAS) to pay €67,000 in compensation to a Málaga woman. The court ruling, delivered in September 2025, came after nearly a decade of medical and legal battles. The woman, a 63-year-old doctor, suffered lasting wrist damage when part of a surgical needle was not removed during a 2014 operation at Hospital Virgen de la Victoria in Málaga, Spain.

According to the court, “part of a needle used in a previous operation was not removed,” and this failure directly contributed to the patient’s pain, joint injuries, and the need for further surgery.

The Initial Surgery

The patient, a 63-year-old doctor, had sustained a wrist injury in 2012. To restore stability, surgeons performed a wrist arthrodesis in 2014. This procedure fuses bones in the wrist to relieve pain and improve function.

A Kirschner needle (K-wire) was inserted during the operation. These thin stainless steel pins are common in orthopedic surgery for holding bones in place. Two months later, the cast and the needle were removed, and the patient began physiotherapy at home.

Despite treatment, the woman’s pain worsened. An MRI scan in October 2014 revealed “a metallic object, likely from a previous surgical procedure” still embedded in her wrist at the site of the fusion. The scan also showed serious complications:

• A dorsal radioulnar subluxation (partial dislocation of the joint between the radius and ulna)

• Ruptured ligaments

• A torn joint capsule

• Bone erosion

In November 2015, under private care, the woman underwent a second surgery. Doctors confirmed that the object was a fragment of the original Kirschner needle that had not been fully extracted during the first operation.

The Legal Debate

The case centered on whether the damage was linked to her pre-existing polyarthritis or the retained surgical fragment. Polyarthritis affected only her feet, not her wrist. Expert testimony played a key role. A rheumatologist concluded that her injuries were “post-traumatic” and unrelated to her rheumatic condition.

The judgment stated that the K-needle was “not completely removed due to a lack of skill on the part of the doctor and failure to notice it… or because, if she was aware of it, she did not report it.”

SAS, in its defense, argued that leaving part of the needle was “over-information and not essential information.” The court dismissed this, calling it “an insult to intelligence” and “an absolute lack of respect for patients.”

Retained surgical fragments are rare but well-documented complications. Kirschner needles, while effective for temporary bone fixation, can break or migrate if not properly handled. Failure to detect such fragments can lead to ongoing pain, ligament damage, instability, and erosion of surrounding bone.

Radiological imaging such as X-rays or MRIs is vital when post-operative pain does not resolve, as it helps identify hidden foreign bodies. Surgical safety protocols, including instrument counts, imaging checks before discharge, and detailed post-operative follow-up, remain essential to preventing such incidents.

The Outcome

The court upheld that there was a clear causal link between the retained fragment and the patient’s injuries. It concluded that SAS bore direct responsibility for negligence in the 2014 operation. SAS was ordered to pay €67,000 plus interest for the pain, corrective surgery, and complications caused by the oversight.

(Rh/Eth/SS/MSM)