COMMENTARY

Your Malpractice Advisor: Lawsuit Risks in Urology

Ann W. Latner, JD

Disclosures

October 25, 2010

In This Article

A Lawsuit Due to Lack of Communication

The importance of discussing potential risks with patients cannot be underestimated. Talking to patients to ensure that they understand their treatment and have realistic expectations about outcomes is essential to avoiding a lawsuit.

One busy urologist recommended an adult circumcision for a patient with phimosis. The patient had been unable to have sex with his wife for a long time and asked the physician if he would be able to do so after the procedure was performed. The physician, rushed and less interested in talk than in action, said "Yes, sure," to the patient, but neglected to warn him that impotence could result from the surgery.

When the patient became impotent after the procedure, he sued the urologist. Could this physician have avoided the lawsuit? Probably. Had he taken the time to listen to the patient's concerns and explain all the possible outcomes of the treatment, the patient would have had a more realistic expectation.

It would be good for physicians to provide patients with written information listing possible risks and side effects, as long as it is given in addition to having a frank discussion with that patient. Written information alone is not enough.

In addition, physicians would be wise to document everything, including conversations held with the patient about the risks; if the physician gives the patient a written handout, that should also be noted in the file.

The Risks of Relying on Medical Forms

When a patient is going for surgery, he or she generally has to fill out a medical authorization form. Although this form offers some protection, it does not in any way replace having a conversation with a patient.

One urologist found this out the hard way. The physician was performing an adult circumcision on a patient when he noticed a suspicious lesion on the man's penis. An immediate biopsy revealed that it was cancer, and the physician, doing what he felt was the right action, amputated the penis.

Needless to say, the patient and his wife were both distraught that the penectomy had not been discussed with them before it was performed. The physician argued that the medical form authorized him to do whatever was necessary, and in his opinion, the amputation was necessary to protect the patient's life. Could this physician have avoided being sued? Another few days would not have made a difference in the outcome of the patient, but it could have made a huge difference in the patient's acceptance of the situation. The physician really needed to wake the patient up and give him the news and speak with the patient about it before performing the penectomy. The physician should have taken the time to speak to the patient and his wife before taking action.

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