Any patient due for a surgery should be properly informed of the risks involved

Dear Editor,

I saw a letter in yesterday’s Stabroek News titled, `I consented to a vascular bypass at the back of the knee and woke up to a whole leg amputated.’

First and foremost I do sympathise with this patient. I can only imagine the physical and psychological pain he must be experiencing.

While I am no vascular surgeon, what this patient has written and if it is true and frankly I have no reason to doubt him raises serious concerns.

The first concern has to do with the patient’s informed consent. Any patient that is due for a surgery should be informed of the risks involved. The risks are then weighed with the benefits. If the risk far outweighs the benefits and the patient’s life is not at risk then the patient is advised against the surgery. The fact that while the patient was unconscious on the table the surgeon was running around to the relatives to get consent to amputate the patient’s leg would suggest the patient was not adequately informed. Secondly, the relatives cannot give consent to such a procedure. It is only the patient who can do so, providing he has the mental capacity or the doctor in the case of an emergency when he has to act in the best interest of the patient.

This patient apparently had an aneurysm. This is simply a swollen blood vessel with thin fragile walls. Trying to correct that can result in the blood vessel bursting. This is similar to an overinflated balloon. A little prick and it will burst. If that aneurysm burst during surgery then the patient is likely to bleed to death. The only option is to lose the limb rather than losing the life. This should have been communicated to the patient.

In my opinion if this risk was not communicated to the patient then that is negligence on the part of the surgeon. It should not be a verbal consent. It should be a written and signed consent. The patient should also be given written information, in layman’s language, on the surgery proposed, the risk and the benefits. The fact is that most patients do not always remember what they are told hence the need for written information.

I’ve been writing for years about what is happening in Guyana. The fact is that the medical council is weak. How can doctors investigate doctors?

I’ve written on multiple occasions that the medical council needs revamping. I was the lone voice. Now others are speaking out. They have attacked. They wrote to my boss in the UK. I will not stop. I encourage patients to speak out and sue the clothes off their backs.

To that patient, no amount of money can replace what you have lost. Sue the hospital. Sue the doctor. It is time this nonsense stops. Patients are not cash cows. We are here to help and not exploit patients.

Yours faithfully,

Dr. Mark Devonish MBBS MSc

MRCP(UK) FRCP(Edin)

Consultant Acute Medicine

Nottingham University Hospital

UK

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