A new case from the Court of Appeal delves deeply into California law governing informed consent and negligent medical advice, starting with the threshold issue of whether a surgeon’s full discussion on a particular procedure will shield the physician from liability if he or she was negligent in recommending the surgery in the first place.

An omission in medical treatment is nearly impossible to defend when there is a written protocol specifically addressing the failed act. That is why an open dialogue between physician and staff on office policies and procedures is necessary to avoid patient injuries.

Medicine need not be practiced through the lens of litigation. Recording the relevant information for your thought processes, however, will only help should that be where you end up.

Consultants are not apt to directly tell the referring physician how he or she should treat the patient. But a radiologist’s repeated recommendations to a surgeon for clinical follow-up can come very close.

A gentleman in his mid-60s presented to the hospital for a total knee replacement. Two months later, Dr. A learned that a foreign body had been found in the patient’s lumbar spine after an MRI had been ordered as part of a sciatica workup.