## Facts

- Paul Hidding underwent a decompressive central laminectomy (L-3 to the sacrum) performed by orthopedic surgeon Dr. Randall Williams to treat spinal stenosis and severe back pain.
- After surgery, Hidding permanently lost bowel and bladder control and remained incontinent until his later death from an unrelated cause.
- Hidding signed a hospital consent form containing general language warning of possible “loss of function of body organs.”
- Testimony indicated Hidding had limited education and that the generic consent language was not understood to include permanent bowel and bladder dysfunction.
- Plaintiffs presented expert testimony that permanent bowel and bladder dysfunction is a known risk of this procedure and should be specifically discussed before consent.
- Evidence showed Dr. Williams had significant alcohol-abuse problems around the time of surgery and his license was later suspended for alcohol abuse.
- Paul and Rubinell Hidding sued alleging negligent surgery and lack of informed consent based on nondisclosure of (1) the risk of nerve damage causing bowel/bladder dysfunction and (2) the surgeon’s alcohol abuse.

## Issues

1. Whether informed consent was invalid because the surgeon failed to disclose that permanent bowel and bladder dysfunction was a known risk of the lumbar laminectomy.
2. Whether the surgeon’s alcohol abuse constituted a material fact that must be disclosed as part of informed consent.

## Decision

- The court of appeal affirmed the trial court’s judgment for plaintiffs.
- The court upheld findings that Dr. Williams failed to obtain informed consent by not adequately disclosing:
  - the known risk of nerve damage resulting in loss of bowel and bladder function, and
  - his alcohol abuse, treated as a material risk to the patient’s decision whether to proceed with surgery with that physician.
- The court deferred to the trial court’s credibility and factual determinations under the manifest-error/clearly-wrong standard.
- The damages award of $307,006.50 to Mrs. Hidding was upheld.

## Legal Principles

- Informed consent requires disclosure sufficient to allow an informed, intelligent decision, including the nature of the condition, the proposed procedure, material risks, prospects of success, risks of no treatment, and available alternatives.
- Materiality is evaluated by an objective reasonable-patient standard: whether a reasonable person in the patient’s position would consider the information significant in deciding to undergo the procedure.
- Generic consent-form language may be insufficient where a known complication is serious and should be specifically disclosed.
- Significant physician impairment that could affect competence (including alcohol abuse) may constitute a material risk requiring disclosure within the informed-consent analysis.
- Appellate review of informed-consent findings is constrained by deference to the trial court’s reasonable factual determinations under the manifest-error standard.

## Conclusion

The court affirmed liability and damages because the surgeon did not obtain informed consent where he failed to specifically disclose a known, serious risk of permanent bowel and bladder dysfunction and failed to disclose his alcohol abuse, both of which were material to a reasonable patient’s decision.


Hidding v. Williams, 578 So. 2d 1192 (La. Ct. App. 5th Cir. 1991)