SINUS PROBLEM: What might be considered a simple or straightforward surgery can result in complications and significant problems

Anyone who has suffered with a sinus condition will know that management with steroids and antibiotics is standard procedure and that, in extreme cases, surgical intervention is a possibility.

Mr. P., an office worker, had a long history of sino-nasal problems. Ultimately he elected for surgery. He signed a standard CONSENT form which referenced possible complications to include risk of eye or brain damage. A CT Scan had identified a polyp in the nasal canal and his Physician felt that he would benefit from surgery. Surgery was not, however, essential but was elective.

In the event, during the course of the surgery, the physician breached the lamina papracea which is the bony wall separating the eye orbit from the nasal cavity. Pain and visual issue resulted from this occurrence. It appears that the formation of an orbital haematoma led to Mr. P’s issues which were pain, dizziness and double vision. The latter did not settle down and further surgical intervention was not an option.

The Case settled for substantial monetary compensation. Important here is that there were were issues around the true nature of the CONSENT to surgery given by Mr. P. in the context of potential complications which, though rare, are well known as a possible complication of such surgery even when carried out by an experienced surgeon.

In a previous posting on the issue of Medical Negligence, we have looked at the entire issue of CONSENT and the requirement that such consent be informed consent. The patient must be given a clear understanding of potential issues around the surgery and must give consent in such a context.

What was important in Mr. P’s case and relevant to his entitlement to be compensated were the following:

  • The Surgeon did not appear to emphasise the elective nature of the surgery to the patient ie. did not advise him that it was a quality of life consideration for the patient and not an essential life or death surgery.
  • He did not advise clearly that ongoing non-invasive medical treatment was a real theraputic option.
  • He did not specifically warn Mr. P. that orbital damage might result in vision issues nor of the consequences of such an injury.

The case tells us that INFORMED CONSENT must involve an explanation of the role of medical treatment (or no treatment at all) rather than just surgery, in non-life threatening medical conditions. The consequences of a complication, not just a general mention of possible adverse effects, must be explained.

 

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