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Informed consent prior to anaesthetic procedure (07HDC08687)

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(07HDC08687, 31 March 2008)

Anaesthetist ~ Private hospital ~ Informed consent ~ Appropriateness of care ~ Professional standards ~ Caudal block ~ Pressure sore ~ Pain relief ~ Rights 4(1), 6(2), 7(1)

A woman complained about the services provided by an anaesthetist at a private hospital, when she underwent an elective surgical procedure. Prior to surgery the patient told nursing staff that she had psoriasis over her lower back and gluteal area, and for this reason declined a preoperative enema. She also told the anaesthetist that she had concerns about her postoperative pain management.

Following surgery the woman was in a significant amount of pain. The anaesthetist made a decision to insert a caudal block. The patient subsequently developed an ulcer in the area and stated that she had not consented to the block. 

It was held that the anaesthetist should have provided the woman with more information preoperatively given her preoperative concerns, and did not obtain adequate consent prior to proceeding with the insertion of the caudal block, breaching Rights 6(2) and 7(1). It was also held that by administering the block on the ward and in an area on the patient affected by psoriasis, the anaesthetist did not minimise the risk of infection, breaching Right 4(1).

The anaesthetist was referred to the Director of Proceedings, who decided not to issue proceedings.