CASE STUDIES
CONSENT MATTERS
Let’s have a look at some cases where the medical practitioners were caught up in some litigations due to various trivial reasons
Mrs. X attended her GP with the complaint of back pain and was prescribed simple analgesia. After a month she couldn’t see her condition improving and hence contacted a neurosurgeon. She was advised conservative measures which did no good to Mrs. X.
Over a month Mrs. X informed the neurosurgeon that she has developed left-sided sciatica as confirmed by her GP through an MRI scan. Overall her condition worsened over time.
She was advised to go for a microdiscectomy by her surgeon and various options were discussed with her over the phone. The surgeon did state the phone call but didn’t exactly quote what was discussed.
Mrs. X was quite comfortable regarding the process and she happily gave her consent. Operation and surgical proceedings were arranged. A letter carrying the details of this procedure and plan was sent to the GP as well.
Mrs. X was happy to go ahead and had no doubts about the operations and signed the consent form. The pros and cons of this operation were not listed on this consent form. The operation was carried out without any complications. However, two months after this operation Mrs. X’s pain worsened and she developed genital numbness and urinary symptoms. The urodynamic investigations were found normal but she was numb in the S3 dermatome.
Mrs. X claimed that the neurosurgeon had taken inadequate consent and he never informed her about the pros and cons of this operation. She also alleged that the operation was not performed effectively and there was gross negligence while doing the same which damaged the left L5 root and S2, S3 roots bilaterally.
OBSERVATIONS AND EXPERT OPINION
- It was observed that the consent form was inadequate and the phone calls along with verbal discussions were no taken into consideration.
- Also, it was observed that there was no proof of nerve damage in the immediate post-operative period.
- The experts suggested that deterioration occurring two months after the operation was more suggestive of a chronic pain syndrome.
The case was taken to trial and the judge confirmed no negligence during the operation but the surgeon was found guilty of inadequate consent.
The ruling stated that Mrs. X had not been warned of a 5% risk that was associated with the surgery which could make her back pain worse. If she had been warned about the same she would not have proceeded with the surgery.
The case was settled for a moderate sum.
LESSONS TO BE LEARNT
- Patients should be made aware of any risks associated with the process and of any reasonable alternative or variant treatments.
- A record of the patient’s discussion must be maintained in the patient’s note.
Souce : Medical Protection Society