Malpractice Consult

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.

Other cases discussed in this edition of "Malpractice Consult" include cecum perforated during prostatectomy, injections fail to improve Peyronie's disease, and dementia diagnosis blamed on urologic procedure.

In the lawsuit, the urologist contended the circumcision was properly performed and the patient’s curvature was due to a previously asymptomatic Peyronie’s condition, which was exacerbated after the circumcision procedure.

A lawsuit was filed against both the urologist and the radiologist involved in the treatment of the kidney stone, claiming that he was not informed of the abnormality on the left kidney noted on the CT scan and the recommendation for follow-up.

In the lawsuit, the physician was accused of not timely responding to the information that there was no urine returned after catheterization.

In this case, the patient tried to keep the observing urologist in the case as another source of payment by claiming a physician-patient relationship existed, thus establishing he had a legal duty to ensure the care was within the accepted standard.

During the trial, the defense was able to put forth the claim that the perforations did not occur during the operation.

In this case, the woman claimed her damages from the negligent nerve injury included pain and weakness in her legs and a second operation to replace the sling.

The usual claim against a manufacturer in a product liability case is that the product is defective, either as designed or as manufactured, or that there was a failure to warn of something known about the product.