Informed Consent in North Carolina Medical Malpractice Cases

Medical professionals have a duty to abide by certain ethical and medical standards of care in administering to patients. When doctors, nurses or aides fail in those duties, patients can claim negligence and may be eligible to receive compensation for the harm suffered as a result. bloodpressure.jpg

While many negligence claims are fairly straightforward, claims of medical malpractice tend to be a bit more complex because of the technical aspects of medical care, as well as the various state laws regarding appropriate care standards.

Included in those standards is the duty to offer patients informed consent. The doctrine of informed consent holds that every person has a right to be given sufficient information in order to make intelligent decisions about his or her own care. A patient has a right to be told about the nature of the condition, the nature of the proposed treatment, the risks involved in undergoing treatment and the risks in not moving forward with treatment.

This was the issue in Snider v. Louisiana Medical Mutual Insurance Co., recently reviewed by the Louisiana Supreme Court. Although this is an out-of-state case, the issues it presents are relevant to medical malpractice claims in the Carolinas as well.

According to court records, a 27-year-old man was hospitalized in 2007 with a myocardial infarction, better known as a heart attack. He was treated by a cardiologist, who at the time diagnosed him with coronary disease and acute coronary syndrome. He was treated with angioplasty and the implantation of a heart stent, as well as medication that would reduce his cholesterol and thin his blood.

A few months later, this same patient was rushed to the emergency room for symptoms that included chest pains, shortness of breath, faintness and dizziness. His medical history was disclosed and the cardiologist on staff, Dr. Robin Yue, recommended he undergo surgery to have a pacemaker implanted. The procedure was performed later that day, and the patient was discharged the following day.

The same day of his discharge, the patient suffered an unrelated injury, wherein his 2-year-old daughter ran to greet him, jumped in his arms and struck him in the chest. He subsequently suffered injury to the surgery site. Later that night, he returned to the emergency room complaining of symptoms that would suggest another heart attack was at hand.

Another doctor treated him and ordered that he be monitored for signs of infection and blood clots. He was hospitalized for several days, then released. Soon thereafter, he met with his regular cardiologist, who found signs that there was an infection at the site of the pacemaker surgery. Removal of the device was recommended.

Soon thereafter, the patient filed a medical malpractice complaint against the doctor who had implanted the pacemaker. That complaint was heard by a medical review panel, which concluded Dr. Yue did not comply with the appropriate standards of care, which the board found resulted in minor damage. Specifically, the board determined, the doctor rushed the decision to implant a pacemaker. He should have instead monitored the patient for a period of one to two days before deciding to make a decision with such permanent consequence.

The patient subsequently filed a medical malpractice lawsuit against the doctor, alleging negligent treatment. He faulted the doctor for failing to exercise a reasonable degree of caution, failing to provide diligent and skillful care, failing to undertake conservative treatment, proceeding to surgery when medication would have sufficed, failing to consult with the patient’s treating physician and performing an unnecessary surgery that resulted in complications and the need for additional surgery.

The case went before a jury in the spring of 2012, and the jury sided with the doctor, finding that the patient failed to prove by preponderance of the evidence that the doctor breached the applicable standard of care owed to the patient because he had given informed consent to the procedure.

Informed consent means the patient was supplied with all relevant information (disclosure), had the capacity to understand the potential consequences of the decision made and voluntarily offered that consent.

The patient appealed, and the appellate court reversed the jury’s findings, holding that the jury erred because the judgment was contradictory to both the law and the evidence and the doctor did not comply with the portions of state law that spells out how doctors must obtain informed consent from patients. Specifically, while the patient signed a consent form, the doctor did not provide all of the required information that would have been deemed necessary for the patient to make an informed decision.

The court found that the patient may have reasonably withheld consent had he been told about the non-emergent nature of his condition, as well as the low-risk alternative of not doing anything.

However, the state supreme court in turn reversed the appellate court’s decision, finding that it erred because the consent was appropriately obtained because the patient had ample opportunity to ask questions and have those questions answered fully in a satisfactory manner.

If you are dealing with a medical malpractice claim, contact the personal injury lawyers at Lee Law Offices today by calling 800-887-1965.

Additional Resources:
Snider v. Louisiana Medical Mutual Insurance Co., Dec. 10, 2013, Supreme Court of Louisiana

More Blog Entries:
Successful Pharmaceutical Lawsuits Consider All Technicalities, Dec. 10, 2013, Anderson Medical Malpractice Lawyer Blog

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