lasik without patient consent

[EMSDoc]

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Can anyone offer their opinions on this frustrating experience I had??

I recently accompanied my girlfriend to a well known Lasik Center in NYC. The Center is marketed around the talents and success of a certain physician, who appears to have excellent credentials and experience (we did our research). We were also referred to him by 5 family members who were very happy with their results.

So we went in for a free screening and were told we were eligible for surgery by another doctor whose name we didn't learn until after the surgery. This doctor explicitly told us he was the pre and post op doctor. He never once mentioned he would be performing her surgery. We wrongfully assumed this doctor would only be involved in the pre and post op work and that the principal surgeon who we originally sought out would perform the actual surgery. After all, the office is littered with the principal surgeons awards, achievements, certificates. Not one mention of this "pre-op doctor could be find anywhere in the office or their website. My gf did not realize the pre-op doctor was performing her surgery until she was already in the chair half blinded by the array of eye drops used.

We were clearly misled by the "pre-op" doctor in that he never stated he would be performing the surgery. We are still completely unaware of his credentials, history, experience as a lasik surgeon (perhaps he is still a fellow). Had my gf known he was performing the surgery, she would have declined for fear of his inexperience. Complaining and discussing the situation among the principal surgeon and several staff members only led to contradictions, condescension, and absolutely no apology.

Although consent was given for the surgery, we assumed it would be by the advertised surgeon and not the "pre-op" doctor (whom we did not know was also a surgeon). My gf never gave the "pre-op" doc consent to operate on her and would not have if she had known from the beginning he was the scheduled surgeon. Nothing she signed contained any of the surgeons' name. This was a very upsetting situation knowing we trusted her vision to someone we knew nothing about. Although I understand we are partially to blame for assuming, were there any ethical and legal wrongdoings on the part of the surgeons here?

Can we say he operated without her consent?

 

[KHE]

Can anyone offer their opinions on this frustrating experience I had??

I recently accompanied my girlfriend to a well known Lasik Center in NYC. The Center is marketed around the talents and success of a certain physician, who appears to have excellent credentials and experience (we did our research). We were also referred to him by 5 family members who were very happy with their results.

So we went in for a free screening and were told we were eligible for surgery by another doctor whose name we didn't learn until after the surgery. This doctor explicitly told us he was the pre and post op doctor. He never once mentioned he would be performing her surgery. We wrongfully assumed this doctor would only be involved in the pre and post op work and that the principal surgeon who we originally sought out would perform the actual surgery. After all, the office is littered with the principal surgeons awards, achievements, certificates. Not one mention of this "pre-op doctor could be find anywhere in the office or their website. My gf did not realize the pre-op doctor was performing her surgery until she was already in the chair half blinded by the array of eye drops used.

We were clearly misled by the "pre-op" doctor in that he never stated he would be performing the surgery. We are still completely unaware of his credentials, history, experience as a lasik surgeon (perhaps he is still a fellow). Had my gf known he was performing the surgery, she would have declined for fear of his inexperience. Complaining and discussing the situation among the principal surgeon and several staff members only led to contradictions, condescension, and absolutely no apology.

Although consent was given for the surgery, we assumed it would be by the advertised surgeon and not the "pre-op" doctor (whom we did not know was also a surgeon). My gf never gave the "pre-op" doc consent to operate on her and would not have if she had known from the beginning he was the scheduled surgeon. Nothing she signed contained any of the surgeons' name. This was a very upsetting situation knowing we trusted her vision to someone we knew nothing about. Although I understand we are partially to blame for assuming, were there any ethical and legal wrongdoings on the part of the surgeons here?

Can we say he operated without her consent?

That's a really interesting scenario.

I used to run a clinic that does various refractive surgeries and I've never heard of this happening. I no longer work at that clinic but what I have had happen is I have referred patients to a well known surgeon and gotten surgical reports back from a doctor OTHER than the one I referred to. Whether the patients knew that it was someone else or not I do not know. The results have been adequate but I phoned up the doctor I refer to and specifically told him that I didn't want an unknown doctor operating on my patients. He apologized profusely and since then only he sees my patients.

As to the legal basis of your question...I'm not a lawyer so I have no clue. A substantial part of it though probably hinges on the outcome. Did she had a good outcome? If she did, she probably hasn't suffered any real damages so action in a court of law is probably out but you may have recourse with the state medical board.

Another thing that is odd is that your posting has an apparent contradiction in it. You said that you were told that you were eligible for surgery by "another doctor". When you said this, did you mean that some other doctor other than the famous surgeon told you she was a good candidate or did you mean that the clinic said she was eligible for surgery by a doctor other than the famous surgeon?

A very interesting case.....I look forward to hearing other peoples opinions on this....

 

[7ontheline]

Do you still have a copy of the consent she signed? I wouldn't be surprised if there's a sentence in there somewhere stating that the surgery would be performed by a member of the practice or something similar. Also, does the surgeon know about your complaint? Did he say that he told you he was going to do the surgery or did he apologize for the misunderstanding?

 

[Olddog1]

The first question is when was your girlfriend supposed to meet the surgeon? Personally, I won't meet a patient the day of surgery, I want to see them at least once in the office. Granted, my surgical practice is not 40+cataracts a week and I don't do refractive. However, I think there needs to be some relationship and a discussion of the surgery, expectations etc...., esp. if it is something other than a cataract surgery. However, I know this is done in some high volume practices. I also have heard of a practice there the "head honcho" surgeon walks in phacos the lens and injects the IOL and walks out; everything before and after that point has been done by someone else.

But I digress, in your case the consent form is the question. On ours it says something like "performance of the procedure will be directed by ____", and somewhere in the document it says something about a teaching hospital and residents may perform parts. It sounds like you did your research on the practice, but why didn't you ask more questions? Did the first doc specifically say Dr. X is performing the surgery? Did you ask is DR. X going to perform the surgery? Did you ask to meet Dr. X? I am somewhat puzzled why she agreed to proceed with the surgery on the day of surgery without meeting the surgeon. Was the plan to meet him in the OR after the valium? Is she sure Dr. X didn't do the surgery and she was sedated? I agree with KHE if she had a good outcome you may write this up to a lesson learned, because I am sure the practice has figured out how to make this legit (in their eyes).

 

[f_w]

This demonstrates a couple of issues very well:
- Lasik is a commodity
- A 'no fee' consultation is a sales meeting, not a physician consultation
- 'Co management' is the downfall of ophthalmology
- I wouldn't have a mole removed without meeting the surgeon (if you don't have the 5 minutes to see me pre-op, I don't want you to touch me)

We were also referred to him by 5 family members who were very happy with their results.

And none of them probably had their surgery performed by the head honcho.

Btw. I know people doing lasik in NYC who are videotaping their consent session (and have the patient sign a consent to being videotaped) to avoid claims of insufficient consent later on.

 

[EMSDoc]

thanks for the feedback everyone...

- so far her recovery is taking longer than expected, so we don't know what the end result is just yet....

- the "pre-op" doc told her she qualified for surgery (by the famous doc we assumed since he said he was only pre and post op).

- she is having trouble getting the a copy of the consent forms...the administrative staff said its up to the head surgeon, so we are waiting on him....(i am wondering which doc signed off on the consent)...i do not recall a clause specifying which doc would be performing the surgery, i dont believe it specified...we will not leave the office next week without bringing home the consent form

- the surgeon was told about the complaint during the follow up visit, where he stated he actually participated and oversaw the operation...however, i was in the waiting room and saw him performing administrative duties during her operation (and my gf was not aware of his presence in the operating room, the valium was slow to act on her since she had eaten just prior to the surgery so she was not heavily sedated)


- he did not apologize

- we assumed she would meet him once the operation was to begin, since the only other doctor was supposed to be only pre and post op...so thought it was obvious that the head surgeon would be doing the surgery

- we admit we were wrong in not demanding to meet the head surgeon before...

- and yes, the family members were operated on by the head surgeon

- we def learned many lessons

 

[JMK2005]

...the administrative staff said its up to the head surgeon, so we are waiting on him

I thought it is common practice to give patients a copy of their consent form when they sign it. Nonetheless, it's part of your medical records that you are entitled to have a copy of.

 

[f_w]

- Your gf has a right to obtain copies of her medical record
- It is absolutely NOT up to the surgeon to decide which records to release
- The office can charge not more than 75c per page for provision of copies

http://www.health.state.ny.us/nysdoh/opmc/medright.htm

http://www.health.state.ny.us/profe...rights/docs/access_to_patient_information.htm