Nurse Expert Witness – Completely Informed Consent

Not Completely Informed Consent
Nurse from Pennsylvania

A young man wanted to alleviate pain in his feet by congenitally deformed fifth toes. In diagnosis, his doctor determined that the patient suffered from moderately splayed feet, with congenital joint fusion of the fifth toes. The fourth toes also were deformed and enlarged. The doctor’s progress notes did not include any discussion of the deformity with the patient.

The patient underwent surgery, and awoke to find that both his fifth and fourth toes on both feet had been operated on. Neither doctor’s admitting notes or admitting diagnosis discussed the fourth toe. No justification or discussion with the patient of the fourth toe appears in any hospital record of the eight-day stay. Yet, notation of a procedure involving the fourth and fifth toes does appear in the doctor’s pre-operative note. It also appears on the consent form. However, it does not appear on the anesthesiologist’s report. Though the patient signed a consent form authorizing the procedure Medical Advisors’ expert found that the doctor had been negligent. “Because this was elective surgery and the patient did not express any symptoms related to the fourth toe, I feel that this condition should have been discussed more thoroughly with the patient as well as documented accordingly, and relative to the Joint Commission on Accreditation of Hospitals regulations all alternatives must be discussed with the patient, “he concluded.

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