First of all there are laws which pertain to "informed consent."
42 CFR @ 482.51 ( these are Civil Federal Regulations, CFR) A PROPERLY EXECUTED INFORMED CONSENT MUST BE IN THE PATIENT'S CHART PRIOR TO SURGERY EXCEPT IN EMERGENCIES."
42 CFR 482.51 (b)(V) PROPERLY EXECUTED INFORMED CONSENT FORMS FOR PROCEDURES AND TREATMENTS SPECIFIED BY THE MEDICAL STAFF, OR BY FEDERAL AND STATE LAW IF APPLICABLE, TO REQUIRE WRITTEN PATIENT CONSENT." SPECIFICALLY INCLUDED AND REQUIRED TO BE IN THE CHART PRIOR TO SURGERY IS AN INFORMED CONSENT WHICH CONTAINS;
1) The name and signature of the patient
2) The name of the hospital
3) The name of the procedure
4) The name of ALL practitioners performing the procedure and individual significant tasks if more than one practitioner.
7) Alternative procedures and treatments and their risks.
8) Statement that the procedure was explained to the patient.
9) Signature of the professional person witnessing the consent.
10) The name and signature of the person who explained the procedure to the patient.
Here is what my informed consent said. This is the whole consent for the surgery, anesthesia, blood transfusions, students practicing on me, everything. This has been found insufficient by a regulatory body.
1. I hereby authorize Dr.____________________ and whomever he/she designates as his/her assistants to perform upon____________________ the following procedure: _____________________________________(What about your right to know who these people are, and their duties?)
In addition I authorize my surgeon to perform any additional procedures that he/she deems advisable due to conditions found at the time of surgery. What is the purpose of an informed consent is you are going to allow them to do anything they want without any information?
2. I AUTHORIZE MY PHYSICIAN TO ORDER THE ADMINISTRATION OF BLOOD/BLOOD PRODUCTS TO ME SHOULD MY PHYSICIAN DETERMINE THAT BLOOD REPLACEMENT THERAPY WOULD BE BENEFICIAL. I understand the risks, benefits, and alternatives, which have been explained to me. With this who is to say what has or has not been explained? Please also note that the blood products "informed consent" is in bold face type and ALL CAPS! Isn't it curious that they use this as a means to draw your eye to the IMPORTANT blood products and not the rest of the sheet of paper which contains a surgical consent for anything whatsoever they desire? What risks, benefits and alternatives? They never explained anything like that to me! I didn't need a blood transfusion anyway, but I should have paid a lot more attention, something that is difficult with all the hubub in a preop area. They slipped the surgical consent into the blood products page in a very sneaky and unethical way.
3. ___ I DO NOT AUTHORIZE THE ADMINISTRATION OF BLOOD/BLOOD PRODUCTS TO ME. I understand that my refusal to accept blood products may result in death or in temporary or permanent damage to one or more organs such as the brain, heart, and/or kidneys. (NOTIFY SURGEON AND ANESTHESIA IMMEDIATELY IF PATIENT REFUSES BLOOD.)
4. The nature and purpose of the procedure, possible alternative methods of treatment, the risks involved, and the possibility of complications have been fully explained to me. I acknowledge that no guarantee or assurance has been made as to the results or outcome of the procedure. ( This is NOT what is required. These things must be written out, so that it is sure that the patient received this information. The medical people can and will say that you have been told everything, only to find out later that it isn't true. They will point to a clause like this... This is in violation of the law.)
5. I hereby authorize and direct the above named physician(s) to arrange for additional services deemed reasonable and necessary, including the administration of anesthetics, radiological procedures, pathology services, or consultants from manufacturers, or laboratory tests (HCG urine/serum testing is required on menstruating pre-operative female patients during their menstruating years (from start of menses to one year after their final menses) If patient refuses please have them sign the refusal statement on the back of this consent form. (this does not comply with informed consent either. You get a refusal for pee test, but not Versed or general anesthesia which result can include death. See anything on here about anesthesia risks or benefits?)
6. I consent to the disposal, by authorities of Kootenai Medical Center, of any tissues or parts that may be removed. (This means they can experiment with your body parts, play with your DNA etc.)
7. For the purpose of advancing medical education, I also consent to the admittance of observers to the procedure room. (This means that you will have people giving you pelvic exams, examining your prostate, practicing catheterization etc. They are NOT merely observing. If you get an infection, too bad, you were advancing the cause of medicine. Aren't you special.)
8. I certify that I have read and fully understand the above consent for the procedure, that the explanations therein referred to were made, and that all blanks or statements requiring insertion or completion were filled in and inapplicable paragraphs, if any were stricken before I signed.
Signature of Patient________________________ Date/Time___________
Signature of Witness________________________ Date/Time___________
Physicians Signature________________________ Date/Time___________
The slick little RN obviously had a little trick up her sleeve for patients like me who were asking too many questions. She went over the blood products and then made a little mark AT THE BOTTOM of the page without giving me time to read it. I still thought it was only for blood transfusion which I wasn't going to need anyway. THEN she gaily said "Oh you signed in the wrong place" and snatched the paper away. This was with practiced ease. She knew how to trick patients into signing a blanket consent for anything. Clever girl. This whole alleged "informed consent" is in violation of the law. It contains nothing of substance and does not meet the requirements of the law. They do not care. The Surgeons signature was not timed also in violation of the following law. My surgeon was over an hour late for surgery and left me there being systematically poisoned with Versed and being charged BY THE MINUTE FOR HIS TARDINESS!
42 CFR 482.24 (C)(1) ORDERS DATED AND SIGNED All medical records entries must be legible, complete, dated, timed, and authenticated in written or electronic form by the person responsible for providing or evaluating the service provided, consistent with hospital policies and procedures. Nothing in my medical records is any of this. The problem with where I went was that they claim to have no fiduciary duty to see that the laws are being followed in their facility.
(i) All orders, including verbal orders, must be dated, timed, and authenticated promptly by the ordering practitioner, except as noted in paragraph (c)(1)(ii) of this section. (My surgeon didn't put a time his signature... Hmmm could it be that he didn't want to be caught by saying he was there to answer questions or explain the procedure prior to surgery, WHEN HE WASN'T? Or is it that he doesn't want anybody to know how freaking LATE he always is. Another law broken.)
Here is yet another law broken;
42 CFR 482.13 (a) STANDARD: NOTICE OF RIGHTS
(1) A hospital must inform each patient, or when appropriate, the patient's representative (as allowed under state law), of the patient's rights, in advance of furnishing or discontinuing patient care whenever possible. They must not have figured it was possible to do this for me, so they circumvented the law.
(2)(b) The patient has the right to participate in the development and implementation of his or her plan of care. Oh yeah right. See above "informed consent." Does it look like I was allowed have this right? Another broken law.
(2)(b)(2) The patient or his or her representative (as allowed under state law), has the right to make informed decisions regarding his or her care. The patient's rights include being informed of his or her health status, being involved in care planning and treatment, and being able to request or refuse treatment. This right must not be construed as a mechanism to demand the provision of treatment or services deemed medically unnecessary or inappropriate. They WAAAAY broke this law. Not only was I not informed of Versed, or that they would force me to have general anesthetic, even the surgery turned out to be so horrible, I would never have consented to it either. I refused all drugs except pain meds for all the good it did me!
Here's what the law says about drugs like Versed;
42 CFR 482.13 (e) STANDARD: RESTRAINT OR SECLUSION All patients have the right to be free from physical or mental abuse, and corporal punishment. All patients have the right to be free from restraint or seclusion, of any form, imposed as a means of coercion, discipline, convenience or retaliation by staff.
(B) DEFINITION OF RESTRAINT: A drug or medication when it is used as a restriction to manage the patient's behavior or restrict the patient's freedom of movement and is not a standard treatment or dosage for the patient's condition. These things are exactly why Versed was used. I had zero anxiety, this drug was used to coerce me into accepting general anesthetic, it was used for the convenience of the nasty CRNA and I feel it was used in retaliation for my saying NO to some of what they wanted. This snarky little creep wanted to violate my right to sign out AMA, so he chemically restrained me with this poison. I guess little nursey poo showed me who was boss. It's against the law! This CRNA also mentally abused me by turning me into a helpless amoeba and then making crude insulting statements about me when I was incapacitated with Versed. I sure would like to know what he said when I was unconscious. My implicit memory caused me to have a visceral hatred of him, so I imagine it wasn't good....
(3) The patient has a right to be free from all forms of abuse or harassment. Besides abusing me, the little anesthesia nurse also harassed me about general anesthetic even going so far as to threaten me with inducing it in the preop area. There are laws about what you did to me.
Speaking of laws pertaining to CRNA's here's another law that was broken.
42 CFR 482.52 (4) A certified registered nurse anesthetist (CRNA), as defined in 410.69(b)of this chapter, who, unless exempted in accordance with paragraph (c) of this section is under the supervision of the operating practitioner or of an anesthesiologist who is immediately available if needed. My surgeon AND HIS LAWYER were unaware of this law apparently! That's how much they give a damn about patient rights and laws.
42 CFR 482.21 (c)(2) QAPI FEEDBACK AND LEARNING; Performance improvement activities must track medical errors and adverse patient events, analyze their causes and implement preventative action and mechanisms that include feedback and learning throughout the hospital. Here is what an investigative entity said about where I went "the hospital failed to investigate incidents in order to decrease medical errors and adverse patient events." They completely dismissed my adverse event. Said it was "Standard of Care"
I'm going to throw this in here because people are having a hard time getting their medical records. Patients often struggle for access to medical records - USATODAY.com Here is the law about that. I haven't been able to get my medical records either. My surgeon has a whole chart which I am not allowed to see. All I got was his self serving sanctimonious letters to others. The Medical Center apparently redacted my medical records as well.
US Code Title 5, 552 (a)(d) ACCESS TO RECORDS Each agency that maintains a system of records shall-
(1) Upon request by any individual to gain access to his record or to any information pertaining to him which is contained in the system, permit him and upon his request, a person of his own choosing to accompany him, to review the record and have a copy made of all or any portion thereof in a form comprehensible to him, except that the agency may require the individual to furnish a written statement aauthorizing discussion of that individual's record in the accompanying person's presence;
(2) Permit the individual to request amendment of a record pertaining to him and-
(A) Not later than 10 days (excluding Saturdays, Sundays, and legal public holidays) after the date of receipt of such a request, acknowledge in writing such receipt; and
(B) Promptly, either-
(i) Make any correction of any portion thereof which the individual believes is not accurate, relevant, timely or complete; or
(ii) Inform the individual of its refusal to amend the record in accordance with his request, the reason for the refusal, the procedures established by the agency for the individual to request a review of that refusal by the head of the agency or an officer designated by the head of the agency, and the name and business address of that official.
If any of you would like to look at the proof that this medical center violates patients on a regular basis and see what a pattern of abuse looks like, just look here...Bureau of Facility Standards Look under hospitals etc. and click on some of the hospitals and see what they are up to...