Case Study 25 : OPERATION COMPLICATIONS
Challenges
A 58-year-old female developed episodes of mild, crampy abdominal pain over 3 months. Physicians diagnosed her with malignant ovarian tumor and thus advised surgery. During the operation, the surgeon inadvertently punctured the aorta. The team immediately rectified this by calling in a vascular surgeon.
Upon recovery, the patient was surprised to find out that she was billed for the services of a second surgeon.
Question
How could complications in medical care be avoided?
Solutions
As a human endeavor, any surgical procedure may present unwanted complications, leading to consequences ranging from simple misunderstandings to expensive lawsuits. In any case, they represent unpleasant experiences and best avoided.
The ultimate way to lessen this risk involves the doctor ensuring free and informed consent: that the patient receives the necessary medical information, understands the information given, and exercises freedom in making decisions. Such orientation covers complications that may likely or unlikely arise, along with added inconveniences these could suppose for the patient (discomfort, costs, care, etc.).
At least two basic approaches exist in applying this principle of free and informed consent. The first is to remain extremely legalistic and explain details meticulously to the patient, documenting and seeking countersignatures for all explanations done. This approach can prove too tedious; besides, potential lawsuits could still arise, as some aspects of care might eventually be overlooked.
The second approach aims for an optimal interpersonal relationship between the health care team on the one hand, and the patient and family on the other. Strictly speaking, this goes beyond legalities; but in actual practice, this helps keep trouble away. With trust, the patient will more easily understand the possibility of complications even with the best of surgeons. Brought to the extreme, in the unfortunate event of inadvertence or error, the patient will easily excuse the doctor who strives to provide the best possible care.
