Nerve injuries occurring during operations: Some friendly legal advice

Abstract

N ERVE INJURY is a serious complication of vascular surgery, one which creates a relatively high risk of litigation for the vascular surgeon. It may be more prevalent than generally appreciated. For example, when professional liability claims brought against vascular surgeons in Colorado between 1982 and 1989 were recently reviewed, it was found that, of the 37 claims, 14 (38%) alleged neurologic injury as a complication of the vascular surgery.* Of course, this experience is not limited to Colorado, but is a nationwide phenomenon and is one of the considerations which stimulated this issue on “Nerve Injury and the Vascular Surgeon.” The importance of good record-keeping and documentation of a detailed informed consent is no better demonstrated than in the complication of neurologic injury during vascular surgery. For reasons discussed elsewhere in this issue neurologic injuries may occur in association with almost all types of vascular surgery, and as a legal consequence, certain conditions are imposed upon the vascular surgeon. As has been clearly established in numerous cases in the United States,t a fiduciary duty is imposed upon the surgeon to fully and frankly discuss risks of surgery with patients contemplating surgical procedures. while not all possible risks need be discussed, a surgeon must disclose to his patient those substantial risks which the surgeon knows will be important for the patient to understand in order to give his intelligent and informed consent to surgery. $ The requirement of obtaining an informed consent to treatment is a legal doctrine, a duty imposed by law and not existing because of medical standards, and the failure to comply with this legal duty is sufficient to impose liability on the surgeon even though