Consents

[PinchandBurn]

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At the asc they want to change the consents. They want the laterality and level.

So for example interlaminar esi at L4/5.


Historically all that was needed was epidural steroid injection. Thus if for whatever reason I couldn't get into L4/5 I can change to L5/s1 etc.

My note would reflect the correct level of course.

To me the patient doesn't care of the level and the risks are the same. Do you all specify for injections?


Now for more surgical stuff like mild, minute man, i would say levels are important.

 

[clubdeac]

At the asc they want to change the consents. They want the laterality and level.

So for example interlaminar esi at L4/5.


Historically all that was needed was epidural steroid injection. Thus if for whatever reason I couldn't get into L4/5 I can change to L5/s1 etc.

My note would reflect the correct level of course.

To me the patient doesn't care of the level and the risks are the same. Do you all specify for injections?


Now for more surgical stuff like mild, minute man, i would say levels are important.

From a medicolegal standpoint I've been told to keep laterality and level out of it as the patient can technically sue you for battery if you decide to do a different level or change sides. Not sure if this is true but that's what I was told

 

[geauxg8rs]

I From a medicolegal standpoint I've been told to keep laterality and level out of it as the patient can technically sue you for battery if you decide to do a different level or change sides. Not sure if this is true but that's what I was told

State will also fine you and discipline for wrong site surgery

 

[callmeanesthesia]

Don’t your consent forms contain language allowing you to modify the procedure if needed? “And any other necessary procedure” or something like that?

 

[mdo1738]

I do not specify level or laterality for interlaminar ESI or MBB/RFA. Just say lumbar or cervical.

 

[Agast]

Just add “or other indicated level” to the consent if you think you need to switch

I don’t consider interlaminar to have a laterality.

 

[interjectionreflection]

Agree it should be general because how many times do you change site during the procedure. Alternatively if they absolutely do not budge you could consent level as b/l +/- L1/2, L2/3, L3/4, L4/5, L5/S1.

 

[Ducttape]

If there is a level I can't get in, I tell the patient then we make a new consent or add an addition to the previously signed consent and initial.


Should list level to be done.


One doc in system had a bunch denied by one of the Medicare advantage plans because he did not specify a level on his consents.

 

[kstarm]

I am a bit surprised people would change levels/procedure without talking to the patient. It is really easy to go over the options and just update the consent form, I literally just initial the updated level. If you were getting a procedure that your doctor ordered and the interventionalist changed it, wouldn't you want to know why it was being changed? Especially when you know more than the general public the near misses, errors, and bad apples that operate out there.