Volume 25, Number 4
A Report for PLIT-sponsored Professional Liability Program
Risks Versus Benefits of Drugs
Are You Explaining the Risks Versus Benefits of all Drugs?
Dr. A performed a routine declaw on a six- month-old cat. Pre-op lab work was within normal limits. Discharge instructions were to limit activity, use a paper litter substitute, give antibiotics twice daily, and pain medicine once daily. A few days later, the cat presented for vomiting and lethargy. Lab work revealed acute renal failure. Treatment was initiated and costs exceed $2500 to date. After reviewing the case, it was determined the renal failure was probably related to the NSAID pain medication that was dispensed.
The client retained an attorney who argued that even though the dose was within published ranges for use in cats, the drug is still extra label. The veterinarian did not explain the risks and so did not get the owner’s informed consent on its use.
This is but one example of possible complications related to the use of NSAIDs. There may be risks to almost every medication or biologic you may prescribe or administer to any animal. From a liability standpoint, you need to communicate with the owner and inform them of the risks versus benefits.
Ten tips to achieve your client’s informed consent:
1. Use client information handouts (many are available from the drug manufacturers).
2. Explain to the client the risks outlined for all medications you dispense.
3. Inform the owner if the drug is extra label. You may say the drug is used quite commonly in this species and serious side effects are uncommon but can occur.
4. Explain the possible side effects and what to look for. Advise the client to stop the medicine and call if a problem is suspected.
5. Follow the most recent dose recommendations.
6. Confirm that dosages are correct and double-check that the label is typed correctly.
7. Report suspected drug reactions to the manufacturer.
8. Do lab work prior to NSAID therapy as well as at scheduled intervals while on any drug long term.
9. Ask clients if they have any concerns or additional questions.
10. Document in the record this client educa- tion. Consider having the clients initial or sign they were informed of the risks.
This sounds very time consuming but it doesn’t have to be. Establish a protocol or method that works well for your practice. If you do this, a client will not be able to come back and say you did not inform them of the risks.