Emergency medicine expert witness and Chief Editor of web-based eMedicine Dr. Erik Schraga would like legal professionals and experts to know that eMedicine offers continually updated clinical reference information which may prove useful in cases they are working on. The following excerpt on cardiology provides information on aortic stenosis medicolegal pitfalls.
* Patients with severe valvular AS should receive appropriate counseling regarding their conditions, including restriction of physical activity and the need for surgery, if appropriate. Physicians should document these points in patients’ records.
* In cases where the patient refuses AV replacement surgery, the patient needs to have a full understanding of the potential implications (including sudden cardiac death) of his or her decision.
* The patient who agrees to undergo aortic valve replacement needs to understand its possible consequences, including perioperative death, the need for lifelong anticoagulation depending on the type of prosthesis, the need for bacterial endocarditis prophylaxis, and the risk of prosthesis malfunction with potential need for reoperation at a higher operative risk.
* Discussion and careful documentation of these issues not only would help patients become familiar with their condition and therapeutic options, but also would help to avoid misunderstandings and potential litigation.