Interventional Radiologist Fails to Consult Neurosurgeon on Procedure

This case involves a forty-seven-year-old female patient, with a medical history of breast cancer, who underwent several embolization procedures with regards to treatment of a spinal tumor at C3-C4. The procedures were met with some complication in that the patient experienced significant left-sided sensory and motor deficits postoperatively. A vascular study was performed but no perfusion defects were mentioned in the diagnostic report. Furthermore, the interventionalist did not consult a neurosurgeon before attempting to embolize the vasculature after a failed first attempt, and the interventional radiologist did not fully explain to the patient why he was performing a second procedure. According to the patient, the doctor made her sign the second consent while she was coming out of anesthesia from the first procedure and she was not aware.

Question(s) For Expert Witness

  • 1. Should a neurosurgeon have been consulted on this case and what are your thoughts on the manner in which the plaintiff gave informed consent?

Expert Witness Response E-000572

In my opinion, any difficult medical or surgical case should be consulted with one’s peers as many other treatment modalities may present when discussed in a stepwise, diagnostic fashion. The informed consent issue seems to lie in a grey area of medicine as the physician should have explained the options when the patient was fully able to comprehend what decision he or she was making, but the physician had the ultimate duty to go ahead and act in the best interests of the patient if they were unable to understand the circumstances of their treatment.


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