Page 25 - 2022 Risk Basics - Surgical Practice

SVMIC Risk Basics: Surgical Practice

the potentially serious consequences of his or her

decision. If the patient refuses to sign the form, the
documentation in the record regarding any discussion(s)

with the patient, his or her reasons for refusing the care,

and his or her refusal to sign the form will suffice.

 If the patient was referred to the physician as a consult,

the physician must be sure to document the previously
listed information in a letter to the referring physician.

Communicating with Staff

It is important to build and nurture rapport with nursing staff to

avoid a toxic environment in which the nursing staff are
hesitant to call on the surgeon. This can potentially create an

unsafe patient situation and increase liability exposure. The
following case illustrates the need to set the expectation that

the surgical team is encouraged to speak up and

communicate.

CASE STUDY

A 40-year-old male diagnosed with an isolated atrial septal
defect underwent heart surgery utilizing bypass. Following

the surgery, the patient began showing signs of right-
sided hemiparesis and mental changes. Tests performed

after the surgery revealed strokes involving the bilateral

hemispheres. Injuries included mild cognitive and physical
injuries attributed to hypoxia during the surgery. The

patient sued the surgeon, anesthesiologist, CRNA,
perfusionist, and the facility. Allegations included the

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