Opinion ID: 1154871
Heading Depth: 3
Heading Rank: 3

Heading: The Adequacy of Dr. Mallin's Disclosure

Text: After deciding which legal standard to apply, the issue becomes whether the information Dr. Mallin provided Korman satisfies this standard as a matter of law. Although Korman maintains that a patient would have no inkling that painful and unsightly scarring is a normal consequence of uncomplicated breast reduction surgery after reviewing the pamphlets, videos and consent forms provided by Dr. Mallin, we cannot agree. Dr. Mallin's office notes indicate he discussed scarring at both visits. Both the videos and pamphlets provided by Dr. Mallin emphasize that breast reduction surgery resulted in permanent scars. Finally the consent forms signed by Korman specifically refer to the risk of unsightly and painful scarring. The trial court concluded that the information Dr. Mallin provided Korman clearly advised her of the scarring risk and therefore granted Dr. Mallin's motion for summary judgment. Nonetheless, merely identifying a risk does not necessarily provide a patient with the information necessary for an informed decision. [5] For a trial court to decide on summary judgment that a doctor has disclosed sufficient information to allow a reasonable patient to make an informed decision about treatment, the record must establish that the physician explained to the patient in lay terms the nature and severity of the risk and the likelihood of its occurrence. See Hondroulis, 553 So.2d at 420. After reviewing the record on appeal, we are unable to conclude that Dr. Mallin's explanation of the risks inherent in this procedure satisfied his duty of disclosure as a matter of law. In her affidavit, Korman states that she requested additional information about the scarring at the second consultation and that, in response, Dr. Mallin told her not to worry and that she would be happy with the results. A number of courts have held that a patient's request for more detailed information regarding a risk is a factor in determining whether there has been adequate disclosure. See Distefano v. Bell, 544 So.2d 567, 571 (La. App. 1989) (holding that physician's duty of disclosure was expanded when patient requested physician to explain the least likely complications of proposed surgery), writ denied, 550 So.2d 650 (La. 1989); see also Kinikin v. Heupel, 305 N.W.2d 589, 595 (Minn. 1981) (holding that where a doctor is aware or should be aware that a patient attaches particular significance to a risk, further disclosure may be required even under the professional community standard). Our own comments in Pedersen emphasize a physician's duty to respond fully to a patient's questions concerning treatment. 822 P.2d at 909. Furthermore, although it is undisputed that Korman read that portion of the consent form which states that all risks of the procedure were increased by 50% because she smoked, this information has little meaning in the absence of a base probability figure establishing the average risk to an average patient. The record does not indicate that Dr. Mallin disclosed to Korman the probability that painful and unsightly scarring would occur in her case or explained the increased risk of such scarring attributable to smoking. Cf. Barner v. Gorman, 605 So.2d 805, 806 (Miss. 1992) (where plaintiff, who underwent plastic surgery to minimize prominent neck scar, alleged that the surgeon had failed to disclose to her the risk of more severe scarring inherent in that procedure despite the fact that the risk of such recurrence was greater in a patient with her skin coloring); see also Nisenholtz v. Mount Sinai Hosp., 126 Misc.2d 658, 483 N.Y.S.2d 568, 570 (N.Y.Sup. 1984) (holding that physician has a duty to provide a reasonable explanation of potential risks and available alternatives under New York informed consent statute). There is no question that an individual contemplating elective cosmetic surgery will attach particular significance to the risk of unsightly and painful scarring. Although Dr. Mallin certainly provided Korman with a significant amount of information concerning the proposed procedure and its attendant risks, we cannot say that he satisfied his duty of disclosure as a matter of law in light of the above circumstances. Whenever nondisclosure of particular risk information is open to debate by reasonable-minded men, the issue is for the finder of facts. Canterbury, 464 F.2d at 788 (footnote omitted). We conclude that it is a factual question whether Dr. Mallin's explanation of the scarring risk was adequate to allow a reasonable patient to make an informed and intelligent decision whether to undergo the procedure.