1. Conclusion
1.1. Lack of informed consent
1.1.1. Court concluded that Ms. Mills did sign the informed consent before the procedure
1.2. Breach of express warranty
1.2.1. There was enough evidence to show that Ms Mills did not achieve the outcome of the surgery which was presented to him in the pictures.
2. Impact
2.1. BELMA KEY- Appellant V.HECTOR M. VIERA, M.D., F.A.C.S., and COSMETIC SURGERY ASSOCIATES - Appellees 2/17/2009
2.1.1. Belma Key cited Mills Versus Pate regarding breach of warranty claim for her case support as she was told liposuction procedure would result in a smooth and flat abdomen
2.1.1.1. Court ruled in favour of Appellees
2.2. Gail MacFarlane- Apellant, Robert L. Burke- Appellee 6/23/2011
2.2.1. As per MacFarlane's petition Burke failed to advise her of the potential complications and obtain an informed consent for the proper right knee replacement procedure.
2.2.1.1. Appelate affirmed the trial court's rendition of summary judgment for MacFarlane's health care liability claim concerning Burke's alleged failure to obtain informed consent for MacFarlane's right knee replacement surgery.
3. Importance
3.1. Informed Consent is extremely important to be filled and signed by the patient before any procedure
3.2. Presentation of before and after surgery needs to be carefully selected to avoid breach of warranty
4. Influence
4.1. Plastic Surgery practices have been extremely careful regarding before and after pictures for the patients expectations.
4.2. Hospitals are extremely focused on getting an informed consent for any procedures to be done in the hospitals.
5. Facts
5.1. Parties
5.1.1. Joyceline Mills, Patient - Appellant
5.1.2. Dr. John Pate, Surgeon - Appellee,
5.2. What Happened
5.2.1. In 1999, Joyceline Mills decided that she wants to have liposuction performed. She heard Dr. Pate's radio advertising that he was board certified, an expert in liposuction, and could change one's life, Ms. Mills made an appointment with him
5.2.1.1. On 9/29/1999, Ms Mills had first consultation with Dr. Pate. She told Dr. Pate that she wanted to remove the fat bulges she had on her abdomen, hips, and thighs.
5.2.1.1.1. according to Ms.Mills, Dr.Pate told her she would be beautiful and have smooth skin
5.2.1.1.2. Patient reviewed post-operative pictures of other patients by doctor's staff showing smooth skin with no rippling or sagging
5.2.2. 11/17/99 - Ms. Mills signed informed consent form for the surgery
5.2.2.1. Explaining usually one treatment is needed.
5.2.2.2. 4-5 % patients need 2nd touch-up procedure but no surgeon's fees will be charged
5.2.2.3. Possible side effects were explained
5.2.3. 12/02/99 - Liposuction performed by Dr.Pate on abdomen,hips,flanks and thighs
5.2.3.1. After 3 or 4 months post-surgery, Ms. Mills noticed irregularities in the skin which was attributed to swelling from surgery by the doctor.
5.2.3.2. Patient was told that irregularities will go away as swelling subsides
5.2.4. Patient not satisfied with results and was told to have second surgery which included thigh lift and a touch-up procedure.
5.2.4.1. 01/09/01: Ms Mills signed informed consent for 2nd surgery
5.2.5. 1/16/2001: 2nd surgery for thigh lift and touch up procedure.
5.2.5.1. Patient not satisfied with the results of second surgery
5.2.5.2. Patient was promised smooth skin, no ripples, bulges, and bags, but there was definite bagging on her left thigh, rippling and a bulge on her left abdomen, and disproportionate hips.
5.2.6. 08/30/01- Final appointment with Dr.Pate
5.2.6.1. Dr. Pate told the patient to have a tummy tuck procedure. The need of tummy tuck was never mentioned during the initial consultation
5.2.7. After 1 month, Ms. Mills consulted Dr. Miller, a plastic surgeon.
5.2.7.1. Ms. Mills was referred to Dr. Gilliland, a doctor in Houston with a specialization in body contouring to provide better results.
5.3. Dr. Gilliland performed abdominoplasty and body lift on Ms. Mills
5.3.1. Patient was satisfied with the results of the procedure
5.3.1.1. Patient would have avoided all other surgeries if she had achieved these result
5.4. Procedural History
5.4.1. 01/23/2002- Ms Mills notified Dr Pate regarding intent to sue under the Medical Liability and Insurance Improvement Act
5.4.1.1. 1/23/2003- Medical malpractice suit was filed against Dr. Pate
5.4.1.1.1. Failure to obtain her informed consent with respect to the probable outcome of the liposuction procedures and the need for future treatment.
5.4.1.1.2. Breech of express warranty
5.4.2. Dr. Pate filed an amended "no evidence" motion for partial summary judgment, alleging that there was no evidence to support the essential elements of Ms. Mills' claims.
5.4.3. Court sided with Dr. Pate's and granted both of Dr. Pate's motions for summary judgment
6. Issue
6.1. Ms. Mills appealed the summary judgment as to her informed consent and breach of express warranty claims.
6.1.1. Was there a sufficient evidence to reject the lack of informed consent
6.1.2. Was there a sufficient evidence to reject the claim for breach of express warranty
7. Analysis/Application
7.1. lack of Informed consent
7.1.1. Ms. Mills Argument
7.1.1.1. Failure to adequately disclose information to her for need for second liposuction.
7.1.1.2. She would have refused the treatment if Dr. Pate would have disclosed risks and hazards of the procedure.
7.1.2. Dr. Pate's Argument
7.1.2.1. Patient was appropriately informed about need for second procedure with informed consent
7.1.3. The court's Decision
7.1.3.1. The doctor did inform the patients of the risks that could occur with the touch up liposuction
7.1.3.2. The court upheld the decision of trial court. Court did not find any evidence which indicates that Dr. Pate did not obtain the informed consent before the second surgery.
7.2. breach of express warranty
7.2.1. Ms.Mills' arguement
7.2.1.1. The patient was told that she is a great candidate for the surgery and she will have beautiful skin after the surgery.
7.2.1.2. Post procedure Pictures of other patients showed smooth skin and no saddlebags.
7.2.1.3. Physician did not deliver the results which were promised and so he is liable for breach of express warranty
7.2.2. Dr.Pate's arguement
7.2.2.1. Ms. Mills has no evidence to support the claim and was just trying to include the breach of express warranty without any evidence.
7.2.3. The court's findings
7.2.3.1. Dr. Pate did not fulfill his promise to Ms. Mills as she was promised a smooth skin and hence Breach of express warranty was valid.
7.2.3.2. Reversed the trial court's judgement regarding breach of express warranty
8. Rule of Law
8.1. Informed Consent
8.1.1. Must be signed by the patient
8.1.2. Completely understood by the patient
8.1.3. Clear explanation of the side effects of the procedure
8.1.4. Any available alternatives to the procedure
8.2. Express warranty
8.2.1. Expected results of the procedure
8.2.2. Negligence in providing professional services