Surgical management of a giant right atrial myxoma.

Cardiac tumours represent around 0.2% of tumours overall, and primary cardiac tumours are even more uncommon. We report the case of a 72-year-old female with a 7 cm × 4 cm right atrial mass which was prolapsing through the tricuspid valve. The mass was resected and histological analysis confirmed a myxoma. This report describes a rare finding of a giant right atrial mxyoma and subsequent surgical management.

Liability for providing a prognosis in surgical practice.

The common law's development of the doctrine of informed consent has progressively imposed broader obligations on surgeons to provide patients with information about the surgical and alternative treatment choices available. Prognosis is critical because the patient cannot provide informed consent without information about the likely evolution of the physiological or pathological processes involved in the surgery under consideration. But does the duty of care that a surgeon owes a patient require a precise prognosis to be given in every case? A recent decision of the Court of Appeal considers that question.

Res ipsa loquitor: No sui generis application to aesthetic surgery.

The doctrine of res ipsa loquitor can allow a plaintiff to raise an inference of negligence which a defendant is then compelled to refute. However, the doctrine has rarely been applied in clinical negligence contexts because courts have been reluctant to require doctors to refute an inference of responsibility for pathophysiological outcomes. But does that imperative apply equally to aesthetic surgery? A recent case shows that it does.

Patient autonomy as a limit on a doctor's duty to follow-up.

The principle of personal autonomy means that patients are free not to attend scheduled medical appointments and to risk the complications that may occur as a consequence of their non-attendance. But the situation may be more complicated if the patient's doctor recognises that the patient may be vulnerable to a particular risk. What are the limits of the doctor's obligation to follow-up or recall the patient for a further consultation? Some recent cases cast light upon this issue.

Liability for failure to warn of a risk that does not materialize?

Doctors in the UK may be reconciled to the fact that they can be held liable for failing to warn patients about complications associated with procedures. They nevertheless might reasonably assume that their liability will be confined to situations where there has been a failure to warn about an inherent complication that subsequently occurred. It might therefore also be assumed that, where a doctor has properly warned the patient about the risk of the complication, the patient cannot seek to recover but this short paper describes several overseas cases where doctors have been held liable in these situations and postulates why courts in the UK may be attracted to this extension of liability.