Contemplating complications: living the experience, learning the lessons

Abstract

Complications related to the use of new diagnostic and therapeutic techniques are inherent to innovation in medicine. Appropriate consent should be obtained before subjecting patients to these techniques. In spite of doing this, when a complication does occur, one can easily relate to its devastating impact on the patient and his/her relatives. The toll that such events take on the treating physician also needs to be considered. The burden of conscience when a patient consents to such a procedure with implicit faith in the physician is immense. A case of irreversible paraplegia due to non-target embolisation of the anterior spinal artery in a young lady undergoing bronchial artery embolisation for hemoptysis is discussed. A feeling of "sadness and guilt" and a scientific analysis of the cause for the adverse event result in changing the protocol of the procedure leading to increased safety for future patients. Wide consultation with colleagues and help from institutional review boards are useful in assuring the treating physician about the justification of performing such procedures and help in coping should complications occur. The manner in which these events are managed, especially by medical teachers in teaching hospitals, is an important learning point for medical students and doctors in training. The need for appropriate open forums in institutions is emphasised, where such events are shared by physicians, resulting in unburdening themselves and potentially in education for all present.