While performing the last safety checks on pressure points of our anaesthetised patient for a major procedure requiring complex positioning, the anaesthetist noticed a small object tucked underneath the patient's compression stockings. Initially it looked like a portable flash drive, but closer inspection revealed tiny printed letters spelling “mic”, a small red light, and a tiny switch which was turned on. It took a few moments for the realisation of what this device was and its intended purpose to dawn on us.

Putting aside the inappropriateness of a concealed recording device in this setting, this situation raised several major concerns. First, there is the paramount issue of patient safety, with potential for pressure sore development, diathermy burns, and interference with monitoring equipment. Second, the equally key issue of patient confidentiality, because the device might have inadvertently recorded medical staff discussions regarding other patients, making the circumstances in theatre distinct from doctor–patient consultations in the clinic. The third point of concern is that comments made by theatre staff might be misinterpreted and taken out of context, or in the worse-case scenario, be used to instigate proceedings for damages or even for a claim of awareness during anaesthesia.

1 Jackman T Man who recorded doctors mocking him during an operation sues anesthesiologist and practice for $500,000. The Independent. June 24, 2015. We will never know the real intention of a covert recording. We refer to the recent court case in Virginia, USA, where a patient accidentally recorded on his smart phone derogatory remarks made by his anaesthesiologist and medical-care team while he was anaesthetised for his colonoscopy.The patient was awarded US$500 000 for defamation and medical malpractice. A simple internet search shows that a plethora of sophisticated recording devices are widely available.

The overwhelming feeling in the theatre room after the discovery was of violation and sadness with the acknowledgment that the sanctity of the doctor–patient relationship is threatened and weakened by rare incidences such as these.

So it is a sign of the times, and having reflected on the circumstances around this event, we would like to advise all our colleagues to exercise caution; to ask patients at the pre-op check to, not only remove jewellery and metal, but also recording devices, and to explain the rationale behind the request, and finally, to be very careful what you say in the operating room.

We declare no competing interests.

Reference 1. Jackman T Man who recorded doctors mocking him during an operation sues anesthesiologist and practice for $500,000. The Independent. June 24, 2015. http://www.independent.co.uk/news/world/americas/man-who-recorded-doctors-mocking-him-during-operation-sues-anesthesiologist-and-practice-for-500000-10341565.html View in Article Google Scholar