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Russell v. Brown

8/18/2005



I.


On March 19, 1996, the plaintiff, a 49-year-old man, went to see Dr. Brown, a board-certified otolarynologist and a member of Chattanooga Ear, Nose & Throat Associates, P.C., also a named defendant in this action. The plaintiff had seen Dr. Brown five years earlier, at which time Dr. Brown had removed a benign tumor from the plaintiff's neck. On the occasion of the 1996 visit, the plaintiff's primary complaint was a chronic sore throat, which he attributed to the fact that he was a frequent traveler. Dr. Brown diagnosed the plaintiff's condition as recurrent tonsilitis, and suggested that he undergo a tonsillectomy. The plaintiff inquired about the risks associated with this surgery, as his 21-year-old daughter had recently undergone the same procedure. Dr. Brown responded to his questions.


As Dr. Brown was leaving the office, the plaintiff asked if the surgery would have a beneficial effect on his snoring. Dr. Brown returned to conduct a second physical exam and discovered that the point of obstruction was in the plaintiff's palate, tonsils and deviated septum. He diagnosed the plaintiff with a condition of mild sleep apnea. Dr. Brown testified at trial that he believed the plaintiff's sleep apnea was medically insignificant. The latter diagnosis did not alter Dr. Brown's treatment plan, i.e. to perform a tonsillectomy. He also testified that he informed the plaintiff that he would trim the uvula and a small portion of the palate. The plaintiff, however, recalled only that Dr. Brown told him that the surgery would involve the "trimming of the uvula." Dr. Brown's office notes from that visit indicate the following: "surgery discussed, risks and complications, schedule tonsillectomy, septoplasty, [uvulopharyngoplasty]."


Dr. Brown does not dispute the plaintiff's testimony that the doctor did not advise him of non-surgical alternatives to remedy his snoring. One such alternative included a CPAP machine, which is a device that requires the patient to wear a mask strapped around the patient's head, through which humidified, warm air passes. A second alternative, the laser assisted uvuloplatoplasty, or LAUP, is a laser procedure. Dr. Brown testified that only one of twelve otolaryngologists in the Chattanooga area had the laser unit required to perform a LAUP. Dr. Brown also mentioned in his testimony a third option - a dental appliance - but noted that such devices are uncomfortable and that patients tend not to wear them.


Dr. Smith is an anesthesiologist with the defendant Anesthesiology Consultants Exchange, Inc. On April 1, 1996, Dr. Smith conducted a pre-anesthetic evaluation of the plaintiff.


The plaintiff's surgery was scheduled for April 4, 1996. On that date, the plaintiff signed a consent form which provided, in pertinent part, as follows:


I, the undersigned, a patient in Erlanger East Hospital, hereby authorize Dr. Brown (and whomever he may designate as his assistants) to administer such treatment as is necessary, and to perform the following operation eptoplasty, tonsillectomy, UVPP and such additional operations or procedures as are considered therapeutically necessary on the basis of findings during the course of said operation.


I hereby certify that I have read and fully understand the above Authorization for Surgeon to Operate, the reasons why the above-named surgery is considered necessary, its advantages and possible complications, if any, as well as possible alternative modes of treatment, which were explained to me by Dr. Brown. I also certify that no guarantee or assurance has been made as to the results that may be obtained.


The consent form was signed by the plaintiff, and w

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