Medics in Spain have been fined more than $11,000 after leaving forceps in a patient’s abdomen during an operation, Central European News (CEN) reported. 

The patient, who was identified only as a 44-year-old female, had undergone a minor surgery at the San Camilo private clinic in Madrid. During a follow-up appointment two days later, doctors saw on an X-ray that the forceps, a surgical instrument similar to tongs, had been left inside of the woman. Doctors reportedly feared the forceps had been left inside her because they couldn’t find the instrument in the clinic, according to CEN.

The woman underwent a second operation to remove the tool, and she successfully sued the hospital for damages, which she attributed to an extended stay and distress. A court ruled the woman didn’t suffer additional injuries due to the error.

According to CEN, hospital mistakes such as these may be on the rise in Spain due to a shortage of doctors and nurses in the country.

In a similar case, Spanish surgeons left a surgical swab inside a patient, and only located and removed it three years later, after the woman suffered from severe abdominal pain. She was left with a scar when the infected swab was finally extricated.

CEN reported that the number of doctors in Spain is dwindling: Compared to last year, when there were 40 doctors per 10,000 people in Spain, there are now only 37 per 10,000 people. Last year, there were also over 80 nurses per 10,000 people in the country, while this year there only 51.