Sandra George underwent a procedure to remove a right sided
acoustic neuroma (tumour) during which an adjoining facial nerve
was severed which resulted in Ms George suffering from facial
Ms George has a limited grasp of the English language and
required interpreting assistance at each of the pre-operative
Ms George commenced proceedings in the District Court of New
South Wales alleging (among other things) that the procedure was
performed negligently and that she was not provided with adequate
information prior to giving her consent.
The trial Judge found Ms George was successful in establishing
that there had been a failure to warn her of the risks.
The decision was appealed, and it was found that the medical
practitioners involved in Ms George's care had taken reasonable
care in ensuring she was provided with, and had understood, the
relevant information about the risks of the procedure.
Sandra George is an elderly Macedonian speaker with a limited
grasp of the English language. In 2009, she began to suffer from
worsening hearing impairment and associated issues.
It was found that Ms George had a right sided acoustic neuroma
(tumour) of the vestibular nerve. Following four consultations, Ms
George underwent a procedure to remove the tumour.
The procedure was performed following consultations during which
Ms George had been assisted by interpreters. At the first two
consultations, a friend acted as an interpreter for Ms George. At
the second two consultations, Ms George was assisted by an
During the course of the procedure, an adjoining facial nerve
was severed which resulted in Ms George suffering from irreparable
In 2012, Ms George commenced proceedings against the surgeon,
Nigel Biggs and St Vincent's Hospital Sydney seeking damages in
negligence. Ms George's position was that she was provided with
inadequate information pre-operatively and prior to giving her
consent to the procedure, and that the damage to her facial nerve
occurred as a result of the negligence of Dr Biggs.
The trial Judge found the patient was not successful in relation
to her allegation that there had been negligent performance of the
surgery, however, the patient was successful in establishing that
there had been a failure to warn her of the risks and was awarded
The hospital and Dr Biggs appealed the decision.
The Court of Appeal allowed the appeal and set aside the
judgment in favour of Ms George. It was found (among other things)
the medical practitioners involved in Ms George's care had
taken reasonable care in ensuring she was provided with, and had
understood, the relevant information about the material risks of
Ms George's was operating under the mistaken understanding
that she had a brain tumour and that this misunderstanding lead her
to opt for surgical intervention; and
Ms George's misunderstanding was not due to any breach of
duty on the part of the medical practitioners.
Perhaps most importantly, the Court of Appeal rejected the
argument that practitioners must take additional steps to ensure a
patient understands, or that the patient understands an
interpreter. The Court of Appeal clarified the content of the duty
of care owed by a practitioner to a patient with limited grasp of
the English Language. The Court of Appeal held that the duty is to
take reasonable care to ensure that the material risks relating to
a surgical procedure are conveyed, and that the practitioners
satisfy themselves that the substance of the information has been
conveyed and been understood.
This decision should act as a reminder to practitioners that not
only do they have a duty to ensure that patients are adequately
advised of the risks of treatment and alternative treatment
options, but they must also convey the information in a manner in
which the patient can understand. Where a patient has a limited
grasp of the English language, an accredited interpreter should be
used in order to ensure that the substance of the information has
been conveyed and been understood.
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guide to the subject matter. Specialist advice should be sought
about your specific circumstances.
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What happens if a patient, particularly a mental health patient,.
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