Informed consent is an essential element of medical care that physicians must not take lightly. The Doctors Company claims database covers the following case: After meeting with a 25-year-old, 157-pound woman regarding her desire to have a breast lift, a plastic surgeon suggested that surgery involve lifting her breasts (size 37D at the time) and adding implants. The physician provided his patient with a dense seven-page consent form, in which specific surgical risks, like tissue necrosis, were mentioned; she signed the consent form. However, the physician did not engage in any detailed discussions with his patient regarding the contents of the consent form and potential negative outcomes.
Prior to mastopexy and augmentation, the plastic surgeon gave her patient antibiotics. After removing a tremendous amount of tissue from both breasts (a total of 741g), the physician’s post-surgical photographs noted healthy, pink nipples. He provided the patient with antibiotics once again to protect against any potential post-surgical infection.
The patient’s 1-week post-op visit yielded negative cultures, but the physician re-prescribed an antibiotic. However, the patient returned 2 days later with painful swelling, to which the surgeon responded by bandaging the chest area. Four days after that, an ultrasound was prescribed to get to the root of the swelling, and it was noted that the areolae were changing color. The surgeon requested that the patient return to his office in 2 more days, at which point he observed clear drainage along with blisters and erythema around incision sites. Blister cultures revealed Alcaligenes, leading the patient see an infectious disease specialist who noted bilateral necrosis surrounding the nipples coupled with infected and inflamed vertical incisions. After nearly a month of taking antibiotics to fight off numerous infections and necrosis, the patient eventually had to endure numerous additional reconstructive surgeries, leaving both her breasts with severe scars and deformities. Shortly thereafter, the patient filed a malpractice suit against the plastic surgeon. It was determined by expert reviewers that the combination of an excessive amount of breast tissue removal and implants were detrimental to the patient’s circulation. Ultimately, the case was settled.
Regardless of whether the physician did indeed remove an excessive amount of breast tissue or perhaps make another surgical error, it is crucial that all physicians acknowledge the reality that surgeries can and do go awry. As such, it behooves physicians to do more than simply hand patients a long-winded consent form to sign. Rather, physicians need to face their own infallibility and should make it crystal clear to patients that surgical or post-surgical complications can potentially delay recovery or affect appearance. Physicians who take the time to discuss realistic surgical expectations, possible less-than-optimal outcomes, and potential complications prior to offering any signage forms afford themselves greater legal protection if faced with a financially and professionally damaging post-surgical malpractice suit.