Consent Required??

[ivanl3]

What is the name of your state (only U.S. law)? PA

Is (advanced) consent required (or the norm) to insert a urinary catheter into am adult mans penis while he is unconscious having a cardiac ablation performed?

The background is that a cardiac ablation was performed on a man. Unbeknownst to him, despite several meetings on the procedure, the insertion of a urinary catheter was planned to be inserted during this procedure all along. He only learned that this was done, to his horror, when he woke from the procedure. There were multiple complications caused by this catheter they I prefer not to detail here (b/c I don't think anything was done wrong by the medical professionals once the complications occurred).

As a side note, the patient would not have chose to have the ablation had he known a urinary catheter was required.

So at this point all am I asking is if, in PA, consent is required from a patient when a Dr is planning to use an internal urinary catheter as part of a procedure? If that answer is yes, can you point me to the law that makes it illegal not to obtain consent? If the answer is NO, thank you for your time. If you don't know, thanks for reading.

 

[Proserpina]

What is the name of your state (only U.S. law)? PA

Is (advanced) consent required (or the norm) to insert a urinary catheter into am adult mans penis while he is unconscious having a cardiac ablation performed?

The background is that a cardiac ablation was performed on a man. Unbeknownst to him, despite several meetings on the procedure, the insertion of a urinary catheter was planned to be inserted during this procedure all along. He only learned that this was done, to his horror, when he woke from the procedure. There were multiple complications caused by this catheter they I prefer not to detail here (b/c I don't think anything was done wrong by the medical professionals once the complications occurred).

As a side note, the patient would not have chose to have the ablation had he known a urinary catheter was required.

So at this point all am I asking is if, in PA, consent is required from a patient when a Dr is planning to use an internal urinary catheter as part of a procedure? If that answer is yes, can you point me to the law that makes it illegal not to obtain consent? If the answer is NO, thank you for your time. If you don't know, thanks for reading.

"NO".


(I have to wonder, also, why on earth he'd refuse what is a potentially life-saving procedure if he'd known that he'd need a cath)

 

[tranquility]

Actually, the answer is "yes". However, it will be claimed you did give consent. The doctor needs to explain the treatment, alternatives and risks of a procedure in order to get informed consent. While all minutia of a procedure need not be explained, the relevant or material facts of the process need to be given. That is usually defined by the "significant risks" criteria. The only way to truly know if the catheterization was a relevant or material fact would really depend on how significant the risk was.

Since your damages seem to be great, you should see an local attorney regarding malpractice. As in any negligence, there is not a law or clear answer until all the facts are known. It may require a medical expert to help determine the facts.

 

[Proserpina]

Actually, the answer is "yes". However, it will be claimed you did give consent. The doctor needs to explain the treatment, alternatives and risks of a procedure in order to get informed consent. While all minutia of a procedure need not be explained, the relevant or material facts of the process need to be given. That is usually defined by the "significant risks" criteria. The only way to truly know if the catheterization was a relevant or material fact would really depend on how significant the risk was.

Since your damages seem to be great, you should see an local attorney regarding malpractice. As in any negligence, there is not a law or clear answer until all the facts are known. It may require a medical expert to help determine the facts.

While informed consent is required, the minutiae need not be explained. And with virtually every cardiac surgery, a urinary cath is standard. It really does fall under "minutiae".

 

[ivanl3]

Thanks Tranquility. I will place the call.

 

[tranquility]

While informed consent is required, the minutiae need not be explained. And with virtually every cardiac surgery, a urinary cath is standard. It really does fall under "minutiae".

So is anesthesia, but, they mention that. I explained the law, you gave an answer that may or may not be correct. (Well, it was wrong on the law; it's just that a urinary cath's risk may be less than "significant" so could be correct in reality. [Which, I think is likely.] The benefit is irrelevant. That it is standard, is irrelevant.)

 

[ivanl3]

While informed consent is required, the minutiae need not be explained. And with virtually every cardiac surgery, a urinary cath is standard. It really does fall under "minutiae".

In this case, the patient had a cardiac ablation in '07 and no urinary cath was required so he had no expectation that one would be required this time. In his mind, right or wrong, the notion of sticking a tube up his penis into his bladder is not considered minutiae -- in fact he considers it to be quite an important and material fact to mention -- and request consent to perform.

People may disagree with his perspective, especially those more familiar with this procedure (ablation), but I have no problem at all seeing his perspective.

 

[ivanl3]

I spoke with an attorney. Her reaction was that this should have been explained in the consent discussions but she could not (yet) determine if the case was worth pursuing. That determination could only be made once the long term damages of the catheterization are known. She did not believe the pain, horror and suffering (mental and physical) that occurred on the day of the procedure (and immediate subsequent days) was enough to make the case one worthy for her firm to pursue. She did ask that I keep her informed on how the recovery progresses -- at which time her opinion may change.

She also conceded that other firms may be willing to pursue the case based strictly on the pain and suffering that occurred already, but did not think many would do so.

Sounds fair to me.

 

[ecmst12]

Most likely, it was in the paperwork he received and probably didn't read that carefully. It was not necessary for it to be specifically verbally discussed.

The lawyer's response is typical and expected.

And if the complications were from him trying to pull the catheter out himself when he woke up because he was confused and agitated....he can't sue for that. But he will heal from it.

 

[ivanl3]

Most likely, it was in the paperwork he received and probably didn't read that carefully.

It wasn't.

And if the complications were from him trying to pull the catheter out himself when he woke up because he was confused and agitated..

Nothing could be further from the truth.

 

[tranquility]

It wasn't.

You'd be surprised at how many fudging words are in those things. Read it broadly, not in specifics. If there ever is litigation over this, those fudging words will be explained to the jury by the opposing attorney's questions to look like the specific issue was described in detail. Your attorney will, of course, imply they meant nothing of the kind and (with a dramatic BANG on the table) anyone who even implies that is a scurrilous dog.

 

[ivanl3]

You'd be surprised at how many fudging words are in those things. Read it broadly, not in specifics. If there ever is litigation over this, those fudging words will be explained to the jury by the opposing attorney's questions to look like the specific issue was described in detail. Your attorney will, of course, imply they meant nothing of the kind and (with a dramatic BANG on the table) anyone who even implies that is a scurrilous dog.

Based on the response from the attorney I spoke with in person, I don't see a suit being filed here (unless something unforeseen occurs). I do think the Doc was completely out-of-line not mentioning (in fact not clearly spelling out) that this was part of the plan. And I strongly suspect he will do so in the future.

As with most litigation, if a suit were to be filed, I doubt even more so that it would ever get to trial.

 

[betachains]

Speaking in general, it is quite common for a urinary catheter to be placed without specific informed consent or even discussion with a doctor. Obviously, if the patient is awake the nurse placing the catheter will give a bit of explanation. For long procedures done under anesthesia, catheters are frequently put in after the patient is out. I've never seen a specific consent form for this, since it is considered part of the surgery.

 

[Proserpina]

Speaking in general, it is quite common for a urinary catheter to be placed without specific informed consent or even discussion with a doctor. Obviously, if the patient is awake the nurse placing the catheter will give a bit of explanation. For long procedures done under anesthesia, catheters are frequently put in after the patient is out. I've never seen a specific consent form for this, since it is considered part of the surgery.

I do agree.

 

[ecmst12]

It would fall under consenting to any procedures necessary for completion of XX procedure.