Quick Summary: A patient cannot be subjected to the inherent risks of a medical procedure without being permitted the opportunity to intelligently accept or reject the procedure.  COURT OF APPEALS OF INDIANA, 1999.

   The patient, his wife and his mother had an outpatient appointment with a nurse regarding a knee operation he was to have the following day. The nurse fully explained the procedure.

   The patient’s mother adamantly told the nurse her son should not be given a spinal anesthetic because of complications she, the mother, had with spinal anesthesia in the past.

   The nurse assured the patient and family the anesthesiologist would not use a spinal anesthetic. She said he would simply be put to sleep.

   The nurse had the patient sign two printed consent forms, one for the operation and one for general anesthesia. Neither the patient or his family saw the physician prior to the day of the surgery.

   The day of surgery the physician was running behind schedule. The nurse twice pre-medicated the patient with IV Demerol, then gave a third dose to compensate for the delay.

   With the patient heavily pre-medicated the physician gave him a spinal anesthetic. There were complications. The patient sued the physician for negligence and for lack of informed consent.

   The Court of Appeals of Indiana found no malpractice despite the adverse result. However, the court said there was a lack of informed consent because the physician did not perform the procedure the patient expected from his pre-surgical appointment with the nurse. Bunch v. Tiwari, 711 N.E. 2d 844 (Ind. App., 1999).