Lawyer Monthly Magazine - July 2019 Edition

What are some key ENT complications that can arise post surgery? In medical negligence cases, complications and problems can arise through no fault of the surgeon; you don’t know what the end result will be from the surgery, which in itself may be extremely difficult and in order to achieve the desired end goal of the surgery, certain risks have to be accepted. There are two key factors regarding this: one is regarding consent, and the other is the surgery itself. Consent is extremely important. There is something called the Montgomery ruling that has arisen the last few years. This means the doctor and surgeon has a duty to inform the patient of any risks the patient would deem to be material or that you think the patient themselves may think are material; this is vital, because a complication or an event can occur through no fault of the surgeon, but the point is that the patient has to make the decision themselves to whether they would like to proceed with that surgery despite the risks at hand. They must have consented for it. For example, a major risk of ear surgery is that the patient will run a risk of having paralysis on the side of the face, (a facial nerve paralysis), and diseases in which There will never be a situation where there is no risk of complications during or post surgery; everyone is different and everyone heals differently. Speaking to ENT Consultant and Expert Jack Lancer, he reveals the best way to try and limit the negative impact cases involving medical negligence can have. we operate on can involve that nerve. Sometimes the nerve is bruised or damaged whilst operating, and even though there may be a 1-2% chance of this ever occurring, it is key that the patient is told before and gave consent to proceed. Otherwise, the patient can quite rightly say ‘If I would have known that was a potential risk, I may not have proceeded with the surgery.’ Consent applies to all aspects but even if the patient is told of all the risks, that does not give the surgeon carte blanche to let anything happen. This brings us to the second aspect. Even if proper consent is given, we have to look at all aspects of the surgery, the management pre and post operation and ensure everything was carried out to a standard that a reasonable body of surgeons would also use. This is known as the Bolam test, whereby if a problem has occurred, it may not be deemed negligent if a body of like-minded surgeons would have also acted in the same way. Of course, the above cases are different from the cases I see regarding road traffic accidents or personal injury. I may see people who have a whiplash injury, which is common itself, but from an ENT point of view, they may be complaining about tinnitus and dizziness and during these cases, I will provide reports on the impact of their injuries. One of the main things I deal with is noise-induced hearing loss, which is an after effect of working in a noisy environment for many years, and employers, especially many years ago, did not supply adequate hearing protection, thus resulting in the individuals suing the employer for not offering the appropriate protection; if the hearing test shows that there is severe loss of hearing, that may be able to gain compensation. Preventing Medical Negligence in Court Jack Lancer ENT Surgeon & Consultant Park Hill Hospital Thorne Road, DONCASTER, DN2 5TH T: 01777 817160 E: jacklancer.rhinoplasty@ gmail.com CONTACT ENT SURGERY “ Consent applies to all aspects but even if the patient is told of all the risks, that does not give the surgeon carte blanche to let anything happen. JUL 2019 48 Expert Witness www. lawyer-monthly .com