Patients lawsuit for RSD following foot surgery

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The Southeastern Texas Record are reporting:
Med-mal suit blames podiatrist for foot pain

Full story

 

Re: Patients lawsuit for RSD following foot suregry

Surely, this complication should have been covered in the consent? Does the case have any merit?

 

Re: Patients lawsuit for RSD following foot suregry

My understanding of the consent form is that it covers usual complications. This is an unusual complication.
RSDS (now called Regional Pain Syndrome) can occur in any foot surgery, so do you have this in your hammer toe surgery consent form?

Regards,

Stanley

 

Re: Patients lawsuit for RSD following foot suregry

Stanley;

I could not agree more. RSD, or CRPS as it is known now is not something seen everyday by most physicians.

I happen to see 10-12 or more cases of this problem on a yearly basis. I am not sure why that is, but I do.

Whether or not it was a cause of the surgery will likely not be the point in this case, but rather when it was identified and treatment was initiated.

Beware patients on long term anti-depressive medications, especially multiple pills. These patients seem to be at the highest risk for RSD for some reason. Just always keep it in your thought process as the presenting symptoms are pretty obvious after ruling out the usual suspects for post-operative pain.

Bruce

 

Re: Patients lawsuit for RSD following foot suregry

I have seen RSDS/CRPS secondary to a 'simple' nail chemical matrixectomy. Hence I include this as a risk for ALL procedures, now matter how minor they may be considered.

I have even heard of cases of DVT/PE secondary to similar nail procedures done by podiatrists, so I feel that you cannot go to far on your consent form - up to and including death. Over the top? Thank you to the legal profession once again...

LL

 

Re: Patients lawsuit for RSD following foot suregry

What the law is and what happens in court may be two different things. So I will be changing my consent forms to include CRPS. Since according to the lawyers, the patient has to understand what they are signing, how would you explain this in layman's terms; or the way it was explained to me, how could you explain this so a fifth grader would understand it?

I am enclosing a link to a very good resource that explains CRPS very well.

http://rsdrx.com/CRPSABSTRACT.htm

Interestingly, even venupuncture can cause CRPS.

Regards,

Stanley

 

Re: Patients lawsuit for RSD following foot suregry

Patient's rarely file suit for a "bad result" or because they were not informed of a potential negative outcome.

They will file suit against a physician who has no empathy or who loses their ability to feel compassion for that patient.

This is not to say that there won't ever be frivolous lawsuits no matter how good you supposed relationship is with a patient.

That said, at what point do we cease to inform of any and all potential outcomes adn even if we do what truly makes the difference?

I'd rather quit practicing then to even attempt to list every potential negative outcome. I will just continue to do the best I can for my patients and let them know the most common complications.

Bruce

Bruce

 

Re: Patients lawsuit for RSD following foot suregry

Bruce,

As someone who practices in the most litiginous county in the US, I am sorry I can't agree with you. There are some people who will sue just for the money.
There are people who don't know if anything was done wrong, so they consult an attorney looking for answers, and the attorney hunts until he finds an expert who will say anything for money.
Remember, the legal system is all about the lawyers making money. It is not about right and wrong, it is about winning.
That is why I like medicine, where the goal is to do the right thing. As a result, our discussions are about what is the right thing, and we do get worked up over it. :boxing:
Imagine an attorney's listserve: My client was a serial killer who killed 37 grandmothers in their sleep, and not only did I get him off, but he countersued the state for wrongful imprisonment and got a three million dollar settlement. From my cut, I bought a condo in Florida.:wacko:
As my mother used to say, "Even if you trust the one you are playing cards with, still cut the deck".
Even though the consent form only protects you from assault and not negligence, I will still add CRPS (when someone tells me how to explain it in fifth grade language) to my consent form.
The reality is someone did get sued for not having CRPS as a complication, and I don't want to be the second.

Best regards,

Stanley

 

One can't help but wonder will our future consent forms be like the encyclopedia Brittanica?

Rather than explain every possible complication would it not just be advisable to include an explanation of all 'frequently occurring'' risks of a procedure & include a list of those complications although rarely encountered should also be considered? In a similar way that medications provide a list of possible side effects.

Am I oversimplifying or should all clinicians indeed provide a medical reference book as part of any consent?

Regards,

 

It is my understanding that under the Common Law interpretation of Statute Law in the UK it is now accepted that informed consent means informing patients about ill-effects that have a "reasonable" likelihood. This is taken as anything that has at least a 1 in 100 chance of occuring.

But its different in the UK and commonwealth countries, as opposed to the US, here the burden of proof lies on the plaintiff not the Defendent.

 

Lawrence,

As I said in Post #4, informed consent requires discussing normal complications.
Regarding the burden of proof, it is the same here in the US. However, when there is a jury involved, they sometimes go with emotion, and not with what is right. They see the poor patient, and the "rich doctor's insurance company". The patient will have to fend for themself while the "rich doctor's insurance company" will not miss the money. :craig: This happens less and less, especially when doctors move away from highly litiginous areas. The jurors now realize if they continue to find in the plaintiffs behalf when there is no merit, they will have no doctors to take care of them in the future.



Regards,

Stanley