Consent Required??

[tranquility]

Women are used to doctors sticking things in our hoo-has, we get it done at least once a year (well, that's the recommendation anyway) so I doubt a cath would be something to concern a female. And since we don't have prostates, injury is less common.

If the risk is greater with males, the likelihood it is a material or significant fact (Thus requiring mentioning in obtaining informed consent.) is greater as well.

And it's good that he has no interest in suing since he wouldn't get very far.

Unless you know the local communities theory on this matter, you have no idea this is true. A local attorney with knowledge of the practice in the community felt differently according to the OP.

 

[ecmst12]

Sounded to me like the attorney consulted said he has no case.

 

[ivanl3]

Sounded to me like the attorney consulted said he has no case.

No, what she said was that she felt that the Dr did fail to obtain IC for the cath (and should have). But unless the long term damages become great, the chances of an award being granted (via jury or settlement) are not great enough for her firm to justify the investment required to file suit. She asked to be kept informed of his recovery (mental and physical) b/c her opinion on the matter may change based on that progress (or lack thereof). She said he has 2 years to file suit.

Finally, she said that other firms in the area might be willing to file suit already, but not her firm (which is arguably the most well respected medmal firm in the city).

I thought this was a very fair and balanced response to the facts of the situation. I was very impressed with how quickly she grasped all the salient details of the situation and the compassion she expressed over the phone.

 

[tranquility]

While not on point, it does seem the OP(friend) would not be able to sue the HOSPITAL on the matter. Fault would rely on the person who did the act. (If in violation of informed consent.)
Tucker v. Community Medical Center, 833 A. 2d 217 - Pa: Superior Court 2003

Facts:

*220 On November 1, 1995, [Husband] was admitted to [CMC] to undergo an exploratory laparotomy by [Hijazi] due to [Husband's] persistent lower abdominal pain. Once [Husband] had been anesthetized, the CMC scrub nurse, Erica Schuback, provided a # 16 French Foley catheter to the circulating nurse, Dorothy Gaughn, so that [Husband] could be catheterized for the surgery. Nurse Gaughn applied 10 cc's of lubricant to the flexible latex catheter and proceeded to insert it through the urethral opening (meatus) and into the urethra. When the catheter was almost halfway inserted, Nurse Gaughn felt some resistance and slightly withdrew the catheter as she simultaneously rotated it in an effort to determine whether the pliable catheter had "kinked" during insertion. As she performed this adjustment maneuver, Nurse Gaughn noted the presence of red-tinged fluid in the catheter tubing and, therefore, immediately withdrew the catheter from [Husband's] urethra and notified [Hijazi] who was scrubbing for the surgery in an adjacent room.

Issue #3:

3. Whether the [trial court] erred in dismissing Court IV of [Husband and Wife's] Amended Civil Action Complaint, stating a claim against [CMC], for lack of informed consent to the catheterization procedure performed by [CMC's nurse]?

Held (emphasis mine):

¶ 14 We turn to Husband and Wife's third claim: Whether the trial court erred in dismissing Court IV of the Amended Complaint, which alleged a claim against CMC for lack of informed consent to the catheterization procedure performed by CMC's nurse. The record indicates that Count IV of Husband and Wife's Amended Complaint alleged a claim of negligence arising from lack of informed consent against CMC because, as Husband and Wife alleged, CMC "had a duty to and/or assumed the duty to inform [Husband] of the fact that catheterization was to be performed on him [...]." See Husband and Wife's Amended Complaint, 3/21/1997, at 9. Following CMC's preliminary objection, the trial court dismissed the claim on December 26, 1997.

¶ 15 In considering preliminary objections in the nature of a demurrer, we must examine the complaint to determine whether it sets forth a cause of action which, if proved, would entitle a party to the relief sought; if such is the case, the demurrer may not be sustained but if the complaint fails to set forth a cause of action, preliminary objections in the nature 225*225 of a demurrer are properly sustained. See Doe v. Dyer-Goode, 389 Pa.Super. 151, 566 A.2d 889 (1989).

¶ 16 Upon review, we are satisfied that the trial court acted properly when it dismissed Count IV of Husband and Wife's Amended Complaint. It is clear that Count IV of the Amended Complaint sets forth a claim of corporate negligence because it alleges that CMC "had a duty to and/or assumed the duty to inform [Husband] of the fact that catheterization was to be performed on him [...]." See Husband and Wife's Amended Complaint, 3/21/1997, at 9. Pennsylvania law forbids a claim of corporate negligence against a hospital to be founded upon a theory that the hospital failed to ensure the patient's informed consent. See Kelly v. Methodist Hosp., 444 Pa.Super. 427, 664 A.2d 148 (1995).[3] Accordingly, Count IV of Husband and Wife's Amended Complaint failed to state a cause of action, and the trial court acted properly when it dismissed the claim. Therefore, Husband and Wife's argument fails.

 

[ajkroy]

Maybe I missed it, but did the doctor actually go back and check the records of the first ablation and see that no cath was performed the first time? It is entirely possible that, if the patient was sedated, he just didn't remember. Just because he didn't have any complications the first time doesn't mean he didn't have a cath.

In addition, I can imagine that the patient would be just as horrified had he awoken in a diaper.

Seriously, how is he going to manage in his later years when catheters are often a common and practical part of life? Just die instead?

 

[ivanl3]

Maybe I missed it, but did the doctor actually go back and check the records of the first ablation and see that no cath was performed the first time? It is entirely possible that, if the patient was sedated, he just didn't remember. Just because he didn't have any complications the first time doesn't mean he didn't have a cath.

The patient was not unconscious during the first ablation. That was one of the biggest changes from the first ablation. Plus the Dr confirmed that no catheter was used the first time.

In addition, I can imagine that the patient would be just as horrified had he awoken in a diaper.

I have no idea what this means. How could awaking in a diaper be analogous to waking in blood curdling pain and having the the insides of his penis and bladder having been butchered by a catheter he never consented to have inserted in the first place?

Seriously, how is he going to manage in his later years when catheters are often a common and practical part of life? Just die instead?

1. Hopefully there are medical advancements that solve this issue.
2. External catheters can be used in some circumstances.
3. To be honest, if you asked him now, he would prefer death over experiencing what he went through again. That is where the need for therapy comes into play. Suicidal thoughts are on his mind -- even without contemplating having to go through it again. I could only imagine his reaction if someone suggested going thought this again.

 

[Proserpina]

The patient was not unconscious during the first ablation. That was one of the biggest changes from the first ablation. Plus the Dr confirmed that no catheter was used the first time.




I have no idea what this means. How could awaking in a diaper be analogous to waking in blood curdling pain and having the the insides of his penis and bladder having been butchered by a catheter he never consented to have inserted in the first place?




1. Hopefully there are medical advancements that solve this issue.
2. External catheters can be used in some circumstances.
3. To be honest, if you asked him now, he would prefer death over experiencing what he went through again. That is where the need for therapy comes into play. Suicidal thoughts are on his mind -- even without contemplating having to go through it again. I could only imagine his reaction if someone suggested going thought this again.

Butchered? Blood-curdling pain?

He NEEDS therapy. YOU are the one who keeps going on about his mental status.

Look, I know you're trying to help - but really, you're not helping him at all.

 

[ivanl3]

Butchered? Blood-curdling pain?

He NEEDS therapy. YOU are the one who keeps going on about his mental status.

Look, I know you're trying to help - but really, you're not helping him at all.

I've already done what I can do get him therapy as soon as possible. Something that was not happening until I suggested it. Its just that his physical ailments are so severe right now (although long term prognosis is good), therapy is not possible Hopefully it can begin in 30 days or so. He remains heavily sedated and in-and-out of consciousness.

As for me not helping him at all, that is a really ignorant (as in uninformed) comment -- especially when I am the one who suggested that therapy (exactly what you suggest) be arranged. Wow!!

 

[Proserpina]

I've already done what I can do get him therapy as soon as possible. Something that was not happening until I suggested it. Its just that his physical ailments are so severe right now (although long term prognosis is good), therapy is not possible Hopefully it can begin in 30 days or so. He remains heavily sedated and in-and-out of consciousness.

As for me not helping him at all, that is a really ignorant (as in uninformed) comment -- especially when I am the one who suggested that therapy (exactly what you suggest) be arranged. Wow!!

The bottom line is that this is STILL not YOUR legal matter.

Wow all you like.

 

[ecmst12]

Catheters are not necessarily a part of life for older people - in fact, that is when they should be used most sparingly, since they are at highest risk of infection. If a prostate is so enlarged that he can't pee without one, there are drugs and surgical procedures that can fix it. Long term use of a foley should be avoided whenever possible. My teacher was actually surprised that I got to my last semester of nursing school before I had occasion to empty a foley bag - because they are used so rarely on med surg units. Surgical patients usually get them out about 6am the morning after surgery and clinical starts at 7, so I've never gotten to remove one yet. They're used for surgical patients because they can't get out of bed during the immediate post-op period, and because anesthesia can cause bladder spasms, which can lead to overdistension of the bladder which can cause injury - a condom catheter would not address this issue. Caths are inserted while the patient is under anesthesia so it will be more comfortable for them. And it would fall under care they consented to when they agreed to the primary procedure.

 

[ivanl3]

The bottom line is that this is STILL not YOUR legal matter.

Wow all you like.

Nor is it yours.

 

[Zigner]

Clueless...

 

[Proserpina]

Clueless...

So hey - who ya rootin' for next Superbowl?

 

[Zigner]

so hey - who ya rootin' for next superbowl?

p g & e

 

[Proserpina]

p g & e

I've obviously worked in pharmaceuticals for too long.

Because what I read there was, Procter & Gamble, and Ebola.