Dr. Goldberg is Director of Skin Laser & Surgery Specialists of New York and New Jersey, Director of Mohs Surgery and laser research, Mt. Sinai School of Medicine, and Adjunct Professor of Law, Fordham Law School.
Dr. Doe has practiced dermatology for more than three decades and has seen many of his patients become quite elderly. He is saddened by the senility of some of these patients, and he is worried about their ability to consent to various office-provided procedures. One of his patients with dementia has a brother who holds a power of attorney that becomes effective when the described patient is no longer able to make decisions for himself.
The use of patient photography, videotaping, digital imaging and other visual recordings during cosmetic filler treatment is common. Although cosmetic patient photographic documentation is common, liability issues need to be considered and federal regulations observed.
Jane Cosmetic was injected with a dermal filler that resulted in skin necrosis. After other doctors tell her she suffers from body dysmorphic disorder, she files a lawsuit against Dr. Derm, claiming she lacks capacity to give informed consent.
Practicing physicians are allowed to exercise their professional judgment and prescribe approved drugs for unapproved, or off-label, purposes. Physicians have been judicially accorded broad and unconstrained prescribing authority for years; "off-label" simply means that a drug is being used or prescribed in a manner inconsistent with its FDA-approved indication.
Recently, Dr. Skin saw an IT specialist who became angry when the dermatologist was late for a scheduled appointment. The IT specialist calculated his hourly wage and billed his doctor for the time he had to wait. Dr. Skin chose to pay the bill. Was this a smart move?
Mr. Eye, who was hearing impaired, was to be scheduled for Mohs micrographic surgery. Unfortunately, before his surgery he became ill and did not recover, nor did he return to Dr. Skin's office for six months. Unfortunately, Dr. Skin's staff had forgotten about Mr. Eye's hearing impairment. They took his lack of response as senility consistent with his age. Dr. Skin chose to use only palliative treatment while watching the carcinoma invade Mr. Eye's orbit over the next year.
Dr. Surgery He recently performed a large excision and failed to ask his patient about medicine intake. The patient did not take any prescription blood thinners, but he did take high daily dosages of garlic and ginkgo. Unfortunately the patient had progressive postoperative bleeding, which led to volume loss and an ultimate CVA. A lawsuit was brought against Dr. Surgery. Will he lose this case based on negligence?
After Dr. Scar diagnosed a basal cell carcinoma, the patient said, "Tell me nothing. Just get the thing out." When the patient was left with a scar after surgery, she filed a medical malpractice lawsuit alleging she was not given appropriate informed consent and was not warned about the scar. Will Dr. Scar lose the medical malpractice case?
Joe Skin was unable to afford a $100 fee to see a local dermatologist, and left a pigmented lesion untreated until a seizure from metastatic disease ended with him having multiple surgeries at a cost of $350,000 to taxpayers. Unfortunately, Mr. Skin died anyway from metastatic melanoma. But does his dermatologist have any liability?
A patient brings a negligence cause of action against both her dermatologist and the covering physician. The basis of her case against Dr. Eye, her own personal dermatologist, is that he was in a "joint-venture" with the covering dermatologist. Is Dr. Eye, the operating dermatologist, liable?