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TITLE 25HEALTH SERVICES
PART 7TEXAS MEDICAL DISCLOSURE PANEL
CHAPTER 601INFORMED CONSENT
RULE §601.2Procedures Requiring Full Disclosure of Specific Risks and Hazards--List A

      (i) If cancer is present, may increase the risk of the spread of cancer.

      (ii) Increased risk of damage to adjacent structures.

  (4) Uterine suspension.

    (A) Uncontrollable leakage of urine.

    (B) Injury to bladder.

    (C) Injury to the tube (ureter) between the kidney and the bladder.

    (D) Injury to the bowel and/or intestinal obstruction.

  (5) Removal of the nerves to the uterus (presacral neurectomy).

    (A) Uncontrollable leakage of urine.

    (B) Injury to bladder.

    (C) Injury to the tube (ureter) between the kidney and the bladder.

    (D) Injury to the bowel and/or intestinal obstruction.

    (E) Hemorrhage (severe bleeding).

  (6) Removal of the cervix.

    (A) Uncontrollable leakage of urine.

    (B) Injury to bladder.

    (C) Sterility.

    (D) Injury to the tube (ureter) between the kidney and the bladder.

    (E) Injury to the bowel and/or intestinal obstruction.

    (F) Need to convert to abdominal incision.

  (7) Repair of vaginal hernia (anterior and/or posterior colporrhaphy and/or enterocele repair).

    (A) Uncontrollable leakage of urine.

    (B) Injury to bladder.

    (C) Sterility.

    (D) Injury to the tube (ureter) between the kidney and the bladder.

    (E) Injury to the bowel and/or intestinal obstruction.

    (F) Mesh erosion (with damage to vagina and adjacent tissue).

  (8) Abdominal suspension of the bladder (retropubic urethropexy).

    (A) Uncontrollable leakage of urine.

    (B) Injury to bladder.

    (C) Injury to the tube (ureter) between the kidney and the bladder.

    (D) Injury to the bowel and/or intestinal obstruction.

  (9) Conization of cervix.

    (A) Hemorrhage (severe bleeding) which may result in hysterectomy.

    (B) Sterility.

    (C) Injury to bladder.

    (D) Injury to rectum.

  (10) Dilation and curettage of uterus (diagnostic/therapeutic).

    (A) Possible hysterectomy.

    (B) Perforation (hole) created in the uterus.

    (C) Sterility.

    (D) Injury to bowel and/or bladder.

    (E) Abdominal incision and operation to correct injury.

  (11) Surgical abortion/dilation and curettage/dilation and evacuation.

    (A) Possible hysterectomy.

    (B) Perforation (hole) created in the uterus.

    (C) Sterility.

    (D) Injury to the bowel and/or bladder.

    (E) Abdominal incision and operation to correct injury.

    (F) Failure to remove all products of conception.

  (12) Medical abortion/non-surgical.

    (A) Hemorrhage with possible need for surgical intervention.

    (B) Failure to remove all products of conception.

    (C) Sterility.

  (13) Selective salpingography and tubal reconstruction.

    (A) Perforation (hole) created in the uterus or Fallopian tube.

    (B) Future ectopic pregnancy (pregnancy outside of the uterus).

    (C) Pelvic infection.

  (14) Fallopian tube occlusion (for sterilization with or without hysterectomy).

    (A) Perforation (hole) created in the uterus or Fallopian tube.

    (B) Future ectopic pregnancy (pregnancy outside of the uterus).

    (C) Pelvic infection.

    (D) Failure to obtain sterility.

  (15) Hysteroscopy.

    (A) Perforation (hole) created in the uterus.

    (B) Fluid overload/electrolyte imbalance.

    (C) Possible hysterectomy.

    (D) Abdominal incision to correct injury.

(h) Hematic and lymphatic system.

  (1) Transfusion of blood and blood components.

    (A) Serious infection including but not limited to Hepatitis and HIV which can lead to organ damage and permanent impairment.

    (B) Transfusion related injury resulting in impairment of lungs, heart, liver, kidneys, and immune system.

    (C) Severe allergic reaction, potentially fatal.

  (2) Splenectomy.

    (A) Susceptibility to infections and increased severity of infections.

    (B) Increased immunization requirements.

(i) Breast surgery (non-cosmetic).

  (1) Radical or modified radical mastectomy.

    (A) Limitation of movement of shoulder and arm.

    (B) Permanent swelling of the arm.

    (C) Loss of the skin of the chest requiring skin graft.

    (D) Recurrence of malignancy, if present.

    (E) Decreased sensation or numbness of the inner aspect of the arm and chest wall.

  (2) Simple mastectomy.

    (A) Loss of skin of the chest requiring skin graft.

    (B) Recurrence of malignancy, if present.

    (C) Decreased sensation or numbness of the nipple.

  (3) Lumpectomy.

    (A) Loss of skin of the chest requiring skin graft.

    (B) Recurrence of malignancy, if present.

    (C) Decreased sensation or numbness of the nipple.

  (4) Open biopsy.

    (A) Loss of skin of the chest requiring skin graft.

    (B) Recurrence of malignancy, if present.

    (C) Decreased sensation or numbness of the nipple.

(j) Male genital system.

  (1) Orchidopexy (reposition of testis(es)).

    (A) Removal of testicle.

    (B) Atrophy (shriveling) of the testicle with loss of function.

  (2) Orchiectomy (removal of the testis(es)).

    (A) Decreased sexual desire.

    (B) Difficulties with penile erection.

    (C) Permanent sterility (inability to father children) if both testes are removed.

  (3) Vasectomy.

    (A) Loss of testicle.

    (B) Failure to produce permanent sterility (inability to father children).

  (4) Circumcision.

    (A) Injury to penis.

    (B) Need for further surgery.

(k) Maternity and related cases.

  (1) Delivery (vaginal).

    (A) Injury to bladder and/or rectum, including a fistula (hole) between bladder and vagina and/or rectum and vagina.

    (B) Hemorrhage (severe bleeding) possibly requiring blood administration and/or hysterectomy (removal of uterus) and/or artery ligation (tying off) to control.

    (C) Sterility (inability to get pregnant).

    (D) Brain damage, injury or even death occurring to the fetus before or during labor and/or vaginal delivery whether or not the cause is known.

  (2) Delivery (cesarean section).

    (A) Injury to bowel and/or bladder.

    (B) Sterility (inability to get pregnant).

    (C) Injury to ureter (tube between kidney and bladder).

    (D) Brain damage, injury or even death occurring to the fetus before or during labor and/or cesarean delivery whether or not the cause is known.

    (E) Uterine disease or injury requiring hysterectomy (removal of uterus).

  (3) Cerclage.

    (A) Premature labor.

    (B) Injury to bowel and/or bladder.

    (C) Rupture to membranes and possible infection.

(l) Musculoskeletal system.

  (1) Arthroplasty of any joints with mechanical device.

    (A) Impaired function such as stiffness, limp, or change in limb length.

    (B) Blood vessel or nerve injury.

    (C) Pain.

    (D) Blood clot in limb or lung.

    (E) Failure of bone to heal.

    (F) Infection.

    (G) Removal or replacement of any implanted device or material.

    (H) Dislocation or loosening requiring additional surgery.

    (I) If performed on a child age 12 or under, include the following additional risks: problems with appearance, use, or growth requiring additional surgery.

  (2) Arthroscopy of any joint.

    (A) Blood vessel or nerve injury.

    (B) Continued pain.

    (C) Stiffness of joint.

    (D) Blood clot in limb or lung.

    (E) Joint infection.

    (F) If performed on a child age 12 or under, include the following additional risks: problems with appearance, use, or growth requiring additional surgery.

  (3) Open reduction with internal fixation.

    (A) Impaired function such as stiffness, limp, or change in limb length.

    (B) Blood vessel or nerve injury.

    (C) Pain.

    (D) Blood clot in limb or lung.

    (E) Failure of bone to heal.

    (F) Infection.

    (G) Removal or replacement of any implanted device or material.

    (H) If performed on a child age 12 or under, include the following additional risks: problems with appearance, use, or growth requiring additional surgery.

  (4) Osteotomy.

    (A) Impaired function such as stiffness, limp, or change in limb length.

    (B) Blood vessel or nerve injury.

    (C) Pain.

    (D) Blood clot in limb or lung.

    (E) Failure of bone to heal.

    (F) Infection.

    (G) Removal or replacement of any implanted device or material.

    (H) If performed on a child age 12 or under, include the following additional risks: problems with appearance, use, or growth requiring additional surgery.

  (5) Ligamentous reconstruction of joints.

    (A) Continued instability of the joint.

    (B) Arthritis.

    (C) Continued pain.

    (D) Stiffness of joint.

    (E) Blood vessel or nerve injury.

    (F) Impaired function and/or scarring.

    (G) Blood clot in limb or lung.

    (H) If performed on a child age 12 or under, include the following additional risks: problems with appearance, use, or growth requiring additional surgery.

  (6) Vertebroplasty/kyphoplasty.

    (A) Nerve/spinal cord injury.

    (B) Need for emergency surgery.

    (C) Embolization of cement (cement passes into blood vessels and possibly all the way to the lungs).

    (D) Collapse of adjacent vertebrae (bones in spine).

    (E) Leak of cerebrospinal fluid (fluid around the brain and spinal cord).

    (F) Pneumothorax (collapsed lung).

    (G) Failure to relieve pain.

    (H) Rib fracture.

  (7) If the following procedures are performed on a child age 12 or under, problems with appearance, use, or growth requiring additional surgery should be disclosed.

    (A) Arthrotomy (opening of joint).

    (B) Closed reduction with or without pin or external fixation.

    (C) Surgical management of open wound.

    (D) Partial excision or removal of bone.

    (E) Removal of external fixation device.

    (F) Traction or casting with or without manipulation for reduction.

  (8) Amputation of limb.

    (A) Pain and/or phantom sensation in removed limb.

    (B) Need for further surgery.

    (C) Infection.

    (D) Hemorrhage (severe bleeding).

    (E) Difficulty with prosthesis fitting.

(m) Nervous system treatments and procedures.

  (1) Craniotomy, craniectomy or cranioplasty.

    (A) Loss of brain function such as memory and/or ability to speak.

    (B) Recurrence, continuation or worsening of the condition that required this operation (no improvement or symptoms made worse).

    (C) Stroke (damage to brain resulting in loss of one or more functions).

Cont'd...

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