Malpractice Consult

In this "Malpractice Consult" column, Dawn Collins, JD, also discusses cases involving penile pain following cystoscopy, alleged failure to diagnose kidney obstruction, and death follow stent placement.

"Incidental radiology findings are low-hanging fruit that organizations should develop processes for handling proactively," writes Brianne Goodwin, JD, RN.

Informed consent in medicine generally refers to one of two things: the process by which a provider obtains consent through discussion of risks, benefits, and alternatives with patients, and the actual form that is signed by the physician and the patient. Both are critical pieces to any medical malpractice litigation where a claim for lack of informed consent has been pled.

Lawsuits involving telephone triage tend to allege failure in a physician’s duty to treat, abandonment of the patient, or provision of sub-standard care.

Other cases discussed in this column include ureter damage during hysterectomy, failure to follow up on kidney mass, and incontinence following pelvic organ prolapse surgery.

With the New Year being associated with resolutions of improved health and fitness and reducing the number on the scale, it seems a particularly appropriate time to share some information about how obesity impacts urologic care and treatment, and the impact of obesity on malpractice litigation.

As a practicing urologist, it is in your best interest to understand what a spoliation charge means in the state where you practice and the requirements of proof.

The literature is rife with information and data, sometimes conflicting, as to whether disclosure and defensive medicine are beneficial to reducing liability and the chances of a lawsuit. One reason for this conflicting data is that the health care system as a whole is in the midst of a massive change, going from an authoritative physician model to one in which patients are increasingly engaged in their own medical care and treatment decisions.

Read about this and two other cases in this "Malpractice Consult" column.

It is imperative that physicians know the law of the state they practice in with regard to their relationship with and responsibility for advanced practice providers who are providing urologic care, writes Brianne Goodwin, RN.

The patient sued, alleging, that the urologist should not have performed surgery on the patient, and that the second bowel perforation should have been detected and repaired during the original operation. He also claimed he should not have been discharged from the hospital in 3 days.

In this column, I will discuss expert witnesses and preparing for trial in a medical malpractice case.

Dawn Collins, JD, also writes about a lawsuit in which a patient sued over an alleged failure to diagnose Fournier's gangrene.

In this first installment in a new bimonthly column, I will cover discrete, but important issues that present themselves in medical malpractice suits to best inform the urologic community of their existence and how attorneys may handle them.

The defendants did not dispute the patient's claims but did question the severity and frequency of her complaints and whether they related to the original operation.

In this case, the man currently has no evidence of metastatic disease or other long-term injury from his claimed negligence that the physicians allowed the cancer to become extracapsular during the 6 months of following his PSA levels.

In most states, the standard for obtaining consent includes discussion of risks versus benefits, some known complications, and any alternative treatment options.

One of the most damaging scenarios to the defense in medical malpractice cases is that of dueling defendants.

In cases involving a claim that a patient had an unnecessary operation where cancer was suspected but not found, the issues usually are a lack of informed consent and failure to further investigate the condition to get a definitive diagnosis.

Other cases discussed in this installment of "Malpractice Consult" include chronic testicular pain following vasectomy and a claim that a spinal tumor should have been found during treatment for post-vasectomy urinary problems.

In malpractice cases that involve the occurrence of a known complication during a procedure, the issues usually raised are informed consent for the procedure and the timely recognition and appropriate treatment of the complication.