Consent Required??

[Proserpina]

I think the informed consent question would be enough to trigger a settlement, if and only if, long term complications occurred. I think this link supports my position:

http://www.nolo.com/legal-encyclopedia/medical-malpractice-informed-consent-29872.html

I concede that it is not open-and-shut, but I think there is a strong enough argument that a settlement would be reached if long term complications persisted.

Mmmmhmmm.

In many cases, settlement = oh go away, you're too boring and litigious and it would cost us more to take this to court.

You understand that....right?

 

[OHRoadwarrior]

Wait until the pictures appear on the internet and the blackmail letter arrives. Then you will have a case.

 

[betachains]

If there is any significant settlement because of an informed-consent issue in this case, I would be astounded. The OP may be better off having the case evaluated for negligence, if the complications were way off the chart.

The reality is that urinary catheters are placed all the time without prior discussion, especially with a doctor. Occasionally there are problems, usually in older men with enlarged prostates. Even in cases with complications, I have never heard of lack of informed consent as a basis for settlement.

But, hey, the OP can establish new case law.

 

[tranquility]

Informed consent IS negligence. It just focuses on professional negligence. (Aka, malpractice.)

The patient must be informed about the treatment contemplated, the alternatives and the risk. There MUST be a claim (by the doctor) there was a prior discussion on the matter, or a claim there was no material risk.

There is no "new" law here. Perhaps you should describe the vastness of what you have "heard" of before any credence is given.

 

[betachains]

Well, all I can tell you is that in the real world, no surgeon (except for urological procedures) will be getting informed consent for short-term insertion of a urinary catheter. They (more likely the nurses) may warn patients that they may wake up with a catheter and the urge to pee.

Sorry, but once you enter a hospital,you have little autonomy whatever the theoretical considerations. As evident from posts here, most people have no idea what happens. I am surprised that all medmal attornies do not have doctors/nurses on retainers. Any of them will immediately conclude that OP has no case on informed-consent grounds.

Interestingly, lawyers - even high profile medmal lawyers - don't ask any more questions than other patients. At least in my experience.

 

[betachains]

tranquility said:
Yesterday 11:14 PM
Informed consent IS negligence. It just focuses on professional negligence. (Aka, malpractice.)

The patient must be informed about the treatment contemplated, the alternatives and the risk. There MUST be a claim (by the doctor) there was a prior discussion on the matter, or a claim there was no material risk.

There is no "new" law here. Perhaps you should describe the vastness of what you have "heard" of before any credence is given.


We are talking about short-term urinary catheterization. Practically no doctor will obtain informed consent for that. Heck, in the ER screaming, hell-no patients get catheters stuck in their penises all the time. Go ahead and sue.

 

[LdiJ]

Hopefully it is a moot point, but something tells me if long term complications persisted, an out of court settlement would be reached here regardless of any such generic language. There is no denying that the patient had no understanding or appreciation of this risk. The doc dropped the ball in that regard, IMO. And I believe that rather than risking a large award from a court, the case would be settled.

Again, hopefully it is a moot point.

Ivan, do you realize that catheterization (I don't think I spelled that right) is common for both males and females after surgery? Are you aware that its done for both sanitary and medical reasons?

Are you somehow afraid that his penis is not going to retain its normal "functions" because a catheter was inserted?

 

[ivanl3]

Ivan, do you realize that catheterization (I don't think I spelled that right) is common for both males and females after surgery?

1.) Now I am. I was always aware they are fairly common but now I understand they are more common than I realized. Although I do see a distinction between ablations and surgery -- ma be semantics. Also keep in mind that this was the same patients' second ablation withe the same Dr at the same facility and no Urinal cath was used during the first one.

Are you aware that its done for both sanitary and medical reasons?

Yes

Are you somehow afraid that his penis is not going to retain its normal "functions" because a catheter was inserted?

A little, but far more concerned about the damage done to the bladder. But this concern is only out of compassion (not a legal concern). Despite the damage done to the bladder, IMO, all the medical procedures followed after the complications occurred were proper. That is why my legal focus is on the informed consent issue. As previously stated, this patient, in all likelihood, never wold have had this procedure had he know and internal urinary cath was going to be used. HE would have continued to treat his arrhythmia with meds or had the procedure done with an external cath. No being informed that an internal cath was going to be used lead directly to major complications. The long-term implications of these complications remain unclear -- but likely will not be significant enough to warrant a suit being filed. Knock on wood.

Thanks to all for you help and your opinions. My question has been answered. I think we can all move on. If there are any changes in the situation, I will report back.

 

[ajkroy]

What is an external catheter? That is new to me.

 

[ivanl3]

What is an external catheter? That is new to me.

Google is a powerful too. Try "External Catheter", "Texas Catheter" or "Condom Catheter. The Dr has said that if a 3rd ablation is required, using this type of catheter or none at all will be explored. Using an internal catheter for this patient would be only be considered in the future as a last resort and a life threatening situation exists.

 

[tranquility]

We are talking about short-term urinary catheterization. Practically no doctor will obtain informed consent for that. Heck, in the ER screaming, hell-no patients get catheters stuck in their penises all the time. Go ahead and sue.

Well, for someone who claims to actually know the reality of the law, why would you use this as your example? Sheesh. I think we'd all agree that in certain emergency medical situations, patient consent is presumed to exist for medical treatment that addresses the emergency. My goodness, good comparison.

Now, use your super legal brain to compare and contrast.

1. Emergency situation where a screaming patient needs emergency catheterization or will suffer serious complications.

2. Planned surgery where protective catheterization is routine.

By the way, even in the emergency situation, if the patient is "hell-no" to the procedure and it is done anyway, it is not just a tort, but a crime. Unconscious? That's one thing. But a conscious and aware patient? A physician must respect the refusal of treatment by a patient who is capable of providing consent. Admittedly, an informed consent situation is more difficult if the patient is conscious but incapable of accurately comprehending his own medical condition. But, that's not what we're talking about here now, is it?

 

[betachains]

Spend a few nights in a major ER and get back to me. Tubes get shoved in multiple orifices all the time with patients objecting.

 

[Proserpina]

Well, for someone who claims to actually know the reality of the law, why would you use this as your example? Sheesh. I think we'd all agree that in certain emergency medical situations, patient consent is presumed to exist for medical treatment that addresses the emergency. My goodness, good comparison.

Now, use your super legal brain to compare and contrast.

1. Emergency situation where a screaming patient needs emergency catheterization or will suffer serious complications.

2. Planned surgery where protective catheterization is routine.

By the way, even in the emergency situation, if the patient is "hell-no" to the procedure and it is done anyway, it is not just a tort, but a crime. Unconscious? That's one thing. But a conscious and aware patient? A physician must respect the refusal of treatment by a patient who is capable of providing consent. Admittedly, an informed consent situation is more difficult if the patient is conscious but incapable of accurately comprehending his own medical condition. But, that's not what we're talking about here now, is it?

With all due respect tranq, you're way out here.

 

[ecmst12]

I agree. It would be like requiring a separate consent to insert an IV. You just don't, nor does it have to be specifically discussed during the informed consent process - it's just part of the procedure.

 

[ivanl3]

I agree. It would be like requiring a separate consent to insert an IV. You just don't, nor does it have to be specifically discussed during the informed consent process - it's just part of the procedure.

I can assure you that it will now become standard practice to discuss this at one of the country's most highly respected hospitals --- or at least the cardiac department at this hospital. The department head has already said as much. I cannot give you all the specific quotes but two themes were:

1. If the medical community has become so complacent that inserting a tube into a man's penis is not worthy of a at least a quick discussion with that patient, it is time we re-evaluate ourselves. We have to be better than this.
2. To not learn and adjust from the horrible, and avoidable, situation that occurred in this case would be a complete failure of this institution.