Prevention of thrombosis in trauma surgery--current legal aspects

Abstract

To date, current jurisdiction has not permitted an answer to the a question as to how long thromboembolism prevention therapy is to be carried out after trauma surgery. However, the Bundesgerichtshof (BGH) reached a decision in 1995 on this matter. Accordingly, patients have to be informed about possible alternative treatment as well as the applicable form of thromboembolism prevention therapy in each specific case. In combination with the fact that the Deutsche Gesellschaft für Phlebologie (DGP, German society for phlebology) has published guidelines on thromboembolism prevention therapy via the internet, this may have considerable impact on the outcome of civil litigation, with consequences for financial compensation. Since civil action requires the medical doctor to prove that he has provided an adequate and acceptable basis for informed consent in patients, in concurrence with the above-mentioned DGP guidelines being potentially misunderstood as representing state-of-the-art treatment, it is deemed necessary to present a list of points that must be brought to the patient's attention when requesting informed consent and, furthermore, the manner in which the guidelines of the medical specialist societies may bring about problems must be pointed out. In the specific context of the German judicial system, criminal law will virtually never lead to a conviction in a case of fatal pulmonary embolism following neglect of or insufficient thromboembolism prevention therapy.