09HDC01565 - Health and Disability Commissioner

Health and Disability Commissioner
opportunity to ask questions, and he again mentioned his concerns about the risk of
paralysis. Dr F states that Mr A initially agreed to postpone the operation, but at the
conclusion of the meeting said that he wished to proceed. Mr A then signed the
consent form that Dr F had prepared during their earlier meeting.
36. The risks are listed on the consent form (see Appendix 3) as: ―Infection, CSF leak,
neurological deficit, bleeding/haematoma, stroke, anaesthetic risk, AMI [acute
myocardial injury], DVT [deep vein thrombosis]/PE [pulmonary embolism], chest
infection. May not help headaches.‖
37. Dr F subsequently acknowledged that his documentation of the risks was not
complete in terms of respiratory risk and death. He states that although the risk of
death was mentioned several times with respect to other complications, he used the
terms ―risk to life‖ or ―life-threatening‖ rather than ―death‖. Dr F considers that Mr
A‘s apprehension indicated that he understood the gravity of the implications of the
operation, and in particular the risks and potential complications. He does not think
Mr A was under the impression that he was to undergo ―minor surgery‖.
38. The consent form also states: ―I acknowledge that an assurance has not been given
that the procedure will be performed by a particular doctor, but that doctor will,
however, have appropriate experience.‖
39. Dr G observed the consent process but did not participate. Although he does not
remember the specifics that were discussed, he cannot recall anything unusual or out
of the ordinary about the conversation.
40. Mrs C was not present for Dr E‘s meeting with Mr A. She said that her son had
phoned after the meeting with Dr E to say he was going ahead with the operation, and
that when she and her husband visited later that evening, he was relaxed and
comfortable.
41. Mrs C said that when her son first told her and her husband about the operation, he
said it was a small operation to take away his headaches, with the normal risks that
come with general surgery. Mrs C does not believe her son was informed about the
risk of respiratory failure, and that with his history of asthma and respiratory
problems, had he known this, he would not have agreed to the surgery. She considers
the only reason her son wanted the surgery was to return to work. She states that Dr E
assured him that this would happen.
42. Mrs C also states that she and her son were under the impression that Dr E would be
performing the surgery himself, and that her son had chosen Dr E because he was
originally from the same country. Dr E advised HDC that he never told Mr A or his
mother that he would be performing the surgery personally, and nor did he state the
opposite. He said that, if asked, he would have told Mr A that the surgery would be
performed using a ―team approach‖. Dr E also asserted that, given the post mortem
findings did not point to any surgical mishap, ―the question as to whether [Mr A] was
aware of the precise makeup of the surgical team or not is actually not relevant‖.
5 September 2012 8
Names have been removed (except Canterbury DHB and the experts who advised on this case) to
protect privacy. Identifying letters are assigned in alphabetical order and bear no relationship to the
person’s actual name.