Legal disputes over informed consent for cosmetic procedures: A descriptive study of negligence claims and complaints in Australia

Nash

Plastic Surgical Nursing

et al. 2014

a total of 1,645 patients underwent primary liposuction by the fi rst author. Secondary liposuction and liposuction, combined with other procedures, were excluded. There were 1,330 women and 315 men in the group studied whose average age was 34 years. MethodsAn analysis of all completed complaint investigations within this patient cohort was undertaken.Complaints were categorized into the following:1. Aesthetic concerns. 2. Complications of surgery.3. Quality-of-care issues such as delayed time to operation with excessive waiting time on the day of surgery, criticism of the hospital facility, and service provided or criticism of staff behavior.Detailed analysis was also undertaken of the methods used to resolve complaints. All liposuction procedures were carried out as day cases under general anesthesia using a tumescent technique. RESULTSTwenty-seven formal complaints were received by the complaints department ( Table 1 ). Twenty-four complaints were made within the fi rst year of surgery and three were made within 3 years.Five complainants had issues with more than one category. Most of the formal complaints were aesthetic concerns where the patient felt that not enough benefi t was achieved. The anatomical areas that led to most formal aesthetic complaints were the hips, fl anks, and the inner thighs. Surgical complications resulted in two complaints: a mons pubis haematoma and acute urinary retention. There were three complaints related to staff being "abrupt" or "rude" or "unhelpful" and facility service. Fourteen complaints required more than one correspondence to resolve, making the average number of letters sent by the complaints department to each patient two. The time to resolution of a complaint was 6 weeks to 4 months, with P atient expectations and demands have increased throughout all medical specialties over the last decade ( Wise, 2010 ) and the analysis of complaints, adverse incidents, and measures to improve practice are now at the core of clinical governance (Patel & Morrison, 2013;VanderWal & Lens, 1995). Liposuction remains one of the most commonly performed cosmetic operations and ("UK Plastic Surgery," 2012) we decided to analyze complaints made by 1,645 patients who had undergone liposuction to identify trends and potential areas for improvement. PATIENTS AND METHODS Complaints-Handling SystemUpon admission to hospital, each patient received an information booklet that contained the address of the complaints department and was asked to write in if he or she felt dissatisfi ed with any aspect of the treatment. We defi ned formal complaints as those made in writing and sent by post to the complaints department as outlined in the booklet. A standard letter acknowledging receipt of the complaint and a promise to try and deal with it within 6 weeks was then returned to the complainant. Detailed investigation of each complaint was subsequently undertaken by the surgeon and the complaints-handling nursing team. A response was then sent to the complainant along with a follow-up clinic appointmen...

Section: Discussionmentioning

confidence: 98%

Analysis of Formal Complaints in 1,645 Liposuction Operations

Nash

Plastic Surgical Nursing

et al. 2014

Craniomaxillofacial Trauma & Reconstruction

“…4,7 In contrast, other authors stress the importance of personal surgeon-patient communication as superior to written information. 10,11 We think that the use of written information, audiovisual recordings, and other decision aids, as an adjunct to face-toface discussions, may strengthen the patient's ability to make an informed decision, and we also think that surgeons and patients should always remember that the patient-doctor relationship should be based on trust.…”

Section: Options and Methodology Of Informed Consentmentioning

confidence: 99%

“…Some patients fail to recall risks, despite full and clear information has been provided preoperatively. 11 Furthermore, some patients do not want and agree with being informed of possible risks. Another important issue is the too positive preoperative advice that may lead to patients having a feeling of dissatisfaction with the final outcome of their treatment.…”

Section: Patients and Informed Consentmentioning

confidence: 99%

Informed Consent in Orthognathic Surgery

Boffano

Gallesio

Garzaro

et al. 2014

Historically, the patient–doctor relationship has been based on trust. Adequately informing a patient confirms this relationship and fulfills the legal obligation of the physician to inform the patient to the best of his knowledge. Informed consent is the process of providing patients with the realistic and necessary information in a manner which they can understand and recall and allows them voluntarily to make an informed choice on the treatment. In this article, the current knowledge about informed consent in orthognathic surgery is reviewed and discussed.

Annals of Medicine and Surgery

“…Cosmetic surgeons and professionals face high risks of negligence claims. An Australian study reviewed 481 malpractice claims (2002–2008), showing 16% of legal disputes involving consent over cosmetic procedures, 70% claiming non-disclosure of a particular complication by their medical provider; and liposuction, breast augmentation, face/neck lifts, eye/brow lifts, and rhinoplasty/septoplasty composing 70% of cases [ 26 ].…”

Section: Establishing Medical Negligence In New South Wales (Nsw)mentioning

confidence: 99%

Medical negligence - Key cases and application of legislation

Cheluvappa

Selvendran

2020

Background Law entails precedent-based common law and parliamentary-legislation-based statutory law. Australian courts recognise civil wrongs, called torts. The most common tort worldwide is negligence. The first aim of the paper is to educate the Australian nursing community about medicolegal issues, statutes, important cases, legal applications, and negligence statistics pertaining to clinical practice. The second aim is to determine whether medicolegal negligence claim-numbers are commensurate with recorded statistics on adverse events. The third aim is to determine and discuss preventative approaches to minimise culpability. Materials and methods Relevant searches were done using Pubmed, Google Scholar, and Austlii. Data, negligence legislation, key cases, and law processes were collated and analysed based on court decision citations, legal impact, and relationships between legislation application and case law. Although New South Wales legislation was used throughout this paper, parallel statutes exist across Australian jurisdictions. Results The basics of the civil tort offence of negligence are explained with step-by-step explanations. Key judgments and application of legislation in key medical negligence cases are discussed. Relevant medicolegal issues and negligence statistics are discussed. The civil tort of negligence is elaborately discussed, step-by-step, with relevant Common Law and legislation relevant to NSW. The watershed cases of Hadiza Bawa-Garba and Nurse Amaro are summarised with the ramifications for doctors and nurses. Expedient strategies to assist doctors and nurses in minimising unlawful action are discussed. Conclusions Adverse medical events are high in Australia. However, new claims are decreasing. Negligence claim-numbers are disproportionate to statistics on adverse events. The Hadiza Bawa-Garba and Nurse Amaro cases have opened a legal can of worms with manifold negative ramifications for the nursing community.