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Publication Type: Risk Alert
Single or Multiple Incident: Single
Date: 7/1/2021 12:00:00 AM
Country: Hong Kong

This alert describes a near miss where a patient was to have a cataract procedure performed on the right eye but the retrobulbar block was nearly performed on the left eye. A contributing factor was that time out was conducted at the patient’s left side. A recommendation to prevent similar incidents is provided.

Wrong Patient / Part -- Retrobulbar block performed on the incorrect eye