Denied by the state Supreme Court, a woman wants to sue a hospital again

A tragic outcome, but the need to blame someone has got to end. The hospital is not responsible. The court agreed. The risk of HIV and other viruses are on the informed consent sheet before any blood transfusion.

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  • Anonymous

    “The risk of HIV and other viruses are on the informed consent sheet before any blood transfusion”

    Get real. I had eight surgeries in the past ten years and not ONCE did the surgeon provide time to actually read the consent form. I was handed a clipboard and a pen and told I needed to sign. Meanwhile, the doc is standing over you checking his watch.

    Not saying there’s justification for an expensive lawsuit here, but it’s ridiculous to use informed consent to support anything. It’s a bleeping joke and you know it.

  • Anonymous

    I do not believe for a second that you have had eight surgeries following that scenario. It would be extremely rare that a surgeon himself would hand you the consent form and pen and hover over you as you sign. Far more likely that a nurse or unit clerk would handle that in advance. The surgeon wouldn’t even waste his time showing up until all the paperwork is in place and you’re being wheeled into the OR.

    If you don’t take the time to read something before you sign it, regardless of how much imagined “pressue” there is, blame yourself.

  • Anonymous

    I don’t know, during all my surgeries or procedures I always have to sign teh consent form. Usually it is not the Dr. himself that has given them to me. Like the poster above says it is almost always the nurse or tech. (I’m not sure any Dr. himself has ever had me sign this form), and they have always told me to READ and then sign. They leave for awhile and then come back to get it. The exception is when I have colonoscopies or EGDs. They hand it to me and wait while I sign but I have had so many of them that they know I have no need to read it anymore.

  • Anonymous

    I gather this unfortunate case happened in 1985, before blood was routinely screened for HIV. The plaintiff was also 16 years old at the time.

    It seems rather callous to say she should have just read the consent form. It’s quite likely that the HIV risk wasn’t listed on the form or even discussed, not back in 1985. And I have a hard time seeing how a 16-year-old – a minor – would truly understand the risks and be able to fully and legally consent.

  • Anonymous

    “And I have a hard time seeing how a 16-year-old – a minor – would truly understand the risks and be able to fully and legally consent.”

    then blame the parent/guardian who should have done so.

  • NeoNurseChic

    Where is this place where doctors don’t have to obtain informed consent and nurses are doing it? Certainly not where I work. Basically, physicians are required to obtain informed consent and nurses often do double check with patients to make sure they understand everything and do not have further questions. However if a patient (or their guardian) does have more questions, then the nurse has to get the physician back again.

    I work with families on as many things as possible, but when it comes to consent, that’s not my area. In order to obtain consent for treatment in the NICU, vaccinations (each one has to be consented separately), conscious sedation, procedures, etc – the physician has to go over the consent with the parent and obtain the signature. The most I can do is witness…

    I did show up for one surgery last year (for myself), and nobody had obtained my consent. I remember the resident even asking aloud why none of the patients seemed to be consented that day (since it was not the norm…). I already had given my glasses to my mom, and the surgeon read the consent to me since I couldn’t see it myself. He was very thorough.

    I’ve never had someone just hand me a consent form for something major and not explain anything on it…but maybe that’s just me…

  • ipanema

    All posters have points. But I find the following disturbing.

    Sherwood-Armour was infected with the virus in 1985 when she was 16 years old and had back surgery at Danbury Hospital. Some of the blood she received supplied by the American Red Cross was not tested for HIV antibodies and was contaminated.

    Two days after Sherwood’s operation, the hospital received a notice from the Red Cross recalling all untested blood. From then on, a newly available test was used to screen blood donations.

    Don’t the hospital and Red Cross have any responsibility in this? RC supplying untested and contaminated blood and the hospital using it? I’m puzzled. On the other hand, I understand the apprehension of the hospital’s lawyer opposing the defendant’s request for a re-hearing. Perhaps there is something worth arguing?

    Whoever signed the consent form has no means of knowing whether the blood is contaminated or not.

    How much do we trust our hospital? In my case, I always pray that nothing happens to me. That’s all I can do.

  • NeoNurseChic

    Ipanema,

    I was reading this under the assumption that this incident occurred before blood was routinely screened for HIV. These stories are tragic but have happened to more people than we’d like to think who received blood transfusions before this was a standard screening. Remember Ryan White? He was a child with hemophilia who contracted HIV from a blood transfusion.

    I don’t know what the time frame was from when the technology was developed to routinely test all donated blood for HIV to when that testing was actually routinely carried out. Also, where in that timeline did this case fall? After reading the article, I got the impression that the woman received the blood before the medical community had put this screening into routine practice.

    In my mind, I would think that absolves the hospital since they technically did not do anything wrong. Blood wasn’t screened and it took some time before the medical community truly recognized HIV and understood that a blood transfusion posed a risk for contracting it.

    I do feel sorry for the woman in this story, but I also can’t see how the hospital could take the blame for something that simply wasn’t done at the time.

    Unless I read the article wrong and there’s more to the story than that?

  • Anonymous

    “I do not believe for a second that you have had eight surgeries following that scenario.”

    Despite your pleasantly articulated skepticism, I was never asked to complete a consent form by anyone other than the attending, and on only one occasion did he ask if I had any questions. “Here, this just says I explained everything to you,” were his words as he handed me the clipboard (at the end of the consult — the surgeries took place 1-3 weeks later).

    They were all outpatient procedures, and only three involved general anesthesia. Perhaps that makes a difference in how seriously informed consent is taken.

    Yes, of course I could have asked questions of the surgeon, nurses, or residents if I had them. My point was only that informed consent documents prove nothing except that patients can sign their names.

  • Anonymous

    So the case was decided against the plaintiff in the trial court, and the judgment upheld on appeal, and no appeals court ordered the case returned to the trial court. It is the plaintiff that wants the opportunity to have the same issues completely re-heard by the trial court. When does this end? Only with a favorable judgment?

    At a minimum, this sounds abusive. The trial court is being used as an appeals court in this case, now that all avenues for appeal on state level are exhausetd. Shouldn’t the plaintiff be taking the case to a federal court of appeals?

    Cannot defense counsel request summary dismissal with prejudice, particularly at this point?

  • ipanema

    Thanks NeoNurseChic. She was just two days early of RC recall for untested blood, pity her.

    This is actually the uncertainty if one goes under tranfusion. We don’t know whose blood is it or if it’s safe. I had one during my herniated disc operation in 1998. Before I was wheeled off to OR and before anaesthesia was administered, I signed a document. It was a nurse and someone else who came and explained to me. I was only informed of the transfusion after I woke up. The doctor explained to me how much blood I lost, hence, the transfusion.

    We can still hear and read stories of contaminated blood nowadays though. I don’t know how honest people can be when they donate/sell blood. I’m not sure if they have to fill-in some forms outlining their medical history. I’m sure this is done.

    I was worried after that operation, I don’t know if the donor had some illness, and I have his/her blood in me! Sorry but I’m really a coward when it comes to this. That’s why I never came to be a nurse, instead I became a regular to a place I don’t like going. :)

  • Anonymous

    Anonymous 1:49 a.m., the HIV risk likely would not have been discussed with the parents/guardian either. Nowadays, of course, the risk of contaminated blood is much better known, but that wouldn’t have been the case in 1985.

    I don’t see that this woman has any legal recourse. A lot of people were caught in that gap; I know someone personally who got AIDS from a blood transfusion in the early 1980s and has since died. It’s tragic but 20/20 hindsight unfortunately can’t be applied retroactively.

    Our friend Kevin displays a touching faith in the signed informed consent. As a physician, he knows all the risks; the average layperson does not have this depth of knowledge.

    And let’s be honest: are patients ever really informed of all the rare side effects and complications and the worst-case scenarios? I mean, when was the last time you told patients there was a risk they could catch on fire in the OR? IME many of the risks, especially the rare ones, are often downplayed because well-meaning physicians and nurses don’t want to unduly frighten patients. All well and good, but this paternalism can leave patients and families unprepared when they are the unfortunate 1 percent who experiences a rare incident. It does no good to say “this is a known risk” or “you signed the consent form” when in fact they *weren’t* ever told.

  • WilliamManginoMD

    What type of ‘Back’ surgery required transfusion in a 16 year old?

    Lets pretend, for a moment, that there were equivocal indications for whatever operation was chosen.

    Is this semi-elective repair for scoliosis? Did the kid have discogenic pain?

    If so, was there accompanying neurologic loss and/or weakness/atrophy?

    If it was a disc related procedure- couldn’t it have waited? If it was for scoliosis-was the chest wall so deformed as to be compromising respiratory function? If there was respiratory functional impairment, was it measured by PFTs or was there an existing clinical correlate highly indicative of reduced functional coronary and respiratory capacity?

    Lets go one step farther — do you really think that a two or three unit blood loss, during a surgical procedure where hemostasis was achieved at the end of the operation, was life threatening to the point where risk of transfusion might have outweighed benefit of restoring a hematocrit to 35%. Was that risk worth taking considering that death would be unlikely even at a temporary crit of 27%?

    Why transfuse a 16 year old with no coronary artery disease who is otherwise hemodynamically stable?

    I doubt if her SVO2 offered any emergency indication to warrant blood.

    Of course-I don’t know what the operation was-but my gut tells me there might have been other choices. Even if I’m wrong-it’s good to think about these things.

    This scenario aside its good to remember three things:

    1- Everybody should be sympathectomized at birth.

    2- Higher mean arterial pressures aren’t associated with survival in the periop period.

    3- Red cells don’t always need a lot of company to get their jobs done.

    Best wishes,

    William Mangino MD

  • Anonymous

    Impanema, yes all blood donors have forms to fill out but they also have testing done to make sure they are a good candidate for donation.

  • ipanema

    thanks Anon 11:32 :)

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