Consent for removal of acoustic neuroma & translation issues

Handed down today were the reasons for judgment in George v Biggs & St Vincents Hospital [2015] NSWDC 11 per Levy SC DCJ.

The decision focused on whether consent was properly obtained for neuro-otologic surgery for removal of a right sided acoustic neuroma of the 8th cranial or vestibular nerve. In the course of the procedure there was an inadvertent intra-operative division of adjacent right 7th cranial or facial nerve causing right-sided facial paralysis.

The plaintiff asserted that she did not understand the location of her tumour nor its benign nature: [13].

The decision is quite lengthy,  traversing a number of areas of interest including:

  • The challenge faced by the court in ruling on conflicting expert opinion without the benefit of cross examination or conclaves: [55], [57]
  • The probative value of evidence of usual professional practice at [61] – [66];
  • The scope of the informed consent duty, in circumstances where a patient has incomplete understanding of information in English (at [459] – [475]); See in particular the elements discussed at [474] and the comment about the risks of use of unskilled interpreters at [532];
  • The absence of evidence or notes from the interpreters: [497];
  • The issue of inherent risk, under section 5I of the Civil Liability Act 2002 (NSW) at [963] – [996].

There was a verdict for the plaintiff with damages assessed.

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