Description

THIS IS THE INSTRUCTION FROM THE PROFESSOR:

THIS IS A OPEN CONVERSATION FOR THE CLASS;

An ophthalmologist scheduled corrective surgery for a nine-year-old female patient who had been diagnosed with a right Duane Syndrome strabismus. Before the procedure, the ophthalmologist had a discussion of risks and benefits with the patient’s mother, and she obtained informed consent to proceed with the surgery.

On the day of the surgery, the ophthalmologist began the procedure by disinserting the lateral rectus muscle of the left eye. Then, realizing her mistake, she reattached the muscle in its original position before carrying out the full operation on the right eye, which was the correct eye. After the procedure, the ophthalmologist spoke to the mother and explained that she had inadvertently begun the operation on the left eye but had realized the error, restored the eye to its original condition and closed the incision. She apologized and reassured the mother that the surgical steps completed on the left eye would have no lasting repercussions for the patient.

The patient came to two postoperative follow-up appointments. At the first, she was noted to be doing well. By the second appointment, she had developed an infection in the left eye. The mother then declined to make further appointments with this ophthalmologist, and she later filed a lawsuit on behalf of her daughter alleging wrong-site surgery resulting in left eye infection, blurred vision and continuing pain.

Experts who reviewed the case noted that Duane Syndrome strabismus is a congenital condition that is most commonly seen in the left eye, and they thought this fact possibly contributed to the ophthalmologist’s error in starting on the left eye instead of the right one. An independent medical examination showed that the patient’s left eye infection had resolved with antibiotic treatment. Experts thought that the patient’s other alleged symptoms were not attributable to the surgery on either eye. Based on expert reports, a decision was made to defend this case. The mother subsequently withdrew the claim.

Are there times when it’s acceptable to cover up or avoid revealing a mistake if that mistake would potentially or likely harm the patient?


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