Nerve injury is a distressing complication for patients and surgeons that is difficult and frustrating to understand and treat. Whether the standard of care has been met when this complication occurs is a common question for both patients and surgeons but there is no information about how the public feels about nerve injury.
The author surveyed 1409 individuals insured in a senior products health program using a 22-item questionnaire about nerve injury during hip replacement. Participants were given written descriptions of total hip arthroplasty, nerve injury, and the standard of care.
Seventeen percent of participants indicated that a direct nerve laceration is a standard of care violation. Respectively, 98%, 100%, 94%, and 97% of participants responded that the standard of care requires the surgeon to promptly identify the nerve injury, completely inform the patient about the nature and prognosis of the injury, and present options for treating the nerve injury. Eleven percent indicated that they lack trust in health care. Participants with distrust were more likely to find a standard of care violation than other participants. Women and non-white participants responded more commonly that a standard of care violation occurred with the nerve injury. Income level, age, prior surgery, and educational background were not differentiating factors as to whether participants found that a violation of the standard of care had occurred.
Most participants would accept the possibility of nerve injury during hip replacement but they would expect to be informed in advance that this complication is possible.