Legal Case: Melanie Fox
The AN Patient Archive was founded on our conviction that AN patients deserve to be fully informed about their options. As the case below illustrates, it is not enough for surgeons to dismissively mention radiosurgery during their consultation. Informed consent requires a more balanced picture of the options. We believe this case represents a major landmark in the care of all AN patients; too many of us are still having to make treatment decisions based on incomplete and inaccurate information!
Note: the case presented here is a matter of public record.
MELANIE FOX AND ROBERT FOX,
WILLIAM A. BUCHHEIT, M.D.
THOMAS WILCOX, M.D.
COURT OF COMMON PLEAS, PHILADELPHIA COUNTY
MARCH 2001 TERM
Verdict in September 2003
|Verdict:||$1,500,000 for Plaintiffs|
|Breakdown:|| $1,300,000 for Melanie Fox;
$ 200,000 for R. Fox (consortium).
|Plaintiff's Attorneys:|| April L. Strang-Kutay of Goldberg, Katzman
& Shipman, P.C., Harrisburg, Pennsylvania;
James E. Colleran of the Law Offices of James E. Colleran, Philadelphia, Pennsylvania
In the spring of 1999, Plaintiff, Melanie Fox was diagnosed with a 1 cm. acoustic neuroma, discovered incidentally as she was asymptomatic. An audiogram demonstrated normal, symmetrical hearing with 100% speech discrimination bilaterally.
Ms. Fox, then 41 years of age, sought consultation concerning treatment options with the Defendant surgeons. Observation was not recommended because while Plaintiff’s audiogram was entirely normal, ABR testing revealed early degradation of the 8th cranial nerve. Radiosurgery was mentioned as an option for a certain category of patients (those who are elderly, afflicted with other medical conditions which make conventional surgery risky, or those patients harboring an acoustic neuroma in their only hearing ear). As the Plaintiff did not fit the above-indicated categories, surgery was advised, and she was told that radiosurgery was not an appropriate option for her.
Following surgery which took place in July, 1999, Ms. Fox lost total hearing in the affected ear, developed tinnitus, encountered new onset vestibular problems, suffered refractory “sub-occipital” headaches, and developed aseptic meningitis, requiring re-hospitalization. At the time of trial in August, 2003, Plaintiff was still suffering from a multitude of post-surgical complications which continued to adversely influence her life with her husband, and 9 year old son.
The Plaintiffs claimed, at trial, that it is not legally sufficient to merely mention the possibility of radiosurgery as a treatment option, without giving an accurate description of the procedure and an accurate, up-to-date accounting of statistics associated with post-treatment results (such as facial nerve function and preservation of hearing). Defendants argued that they were not obligated to describe the advantages of radiosurgery.
Informed consent requires that patients be given accurate, up-to-date, and valid information about alternative treatment options. Only by clearly explaining the pros & cons of various competing methods of treatment can a physician be assured that he has fully informed the patient such that an individualized, knowledgeable decision on treatment can be selected.
Last Edited: Monday, November 17, 2003