Consent

The Goyals went to the Heart Centre to meet Odim on March 1. Vipan Goyal specifically recalled that his wife asked Odim if he had done this type of procedure before, and was told that he had. Sheena Goyal recalled that Odim said to her that he would not touch a child if he had not done the operation before. Vipan Goyal recalled that he was upset and angry with his wife for asking Odim such a question. He admitted that he had a great respect for doctors and that he was not one to question what they told him.

Sheena Goyal said that she and her husband told Odim on more than one occasion that he was like God to them. Vipan Goyal recalled that Giddins had told him earlier that Odim was coming to Winnipeg from Boston and that he was one of the best. The Goyals also indicated that once the HSC had arranged to have a surgeon in Winnipeg, there was no discussion or suggestion from the VCHC that Vinay be sent out of province.

Odim said he told the Goyals about the risks of being on bypass (bleeding, organ dysfunction, pulmonary problems) and the risk of the procedure (removing the shunts). Odim testified that the longer the bypass time, the higher the probability of problems with these issues, but he said he did not explain that to the Goyals. He only told them that the procedure would take six to eight hours. Odim said he told the Goyals this was a moderate risk case, and that out of a hundred babies, ten might not make it. He also told them about problems with non-fatal complications, and what would happen if Vinay did not have the operation.

There was some discussion as to whether or not the operation should be performed in Winnipeg, and the Goyals asked Odim about his experience. Odim testified that he told them that this was his first position, but that he had trained in centres that had done cases like Vinay's. He also said that he had been intimately involved in both the pre-operative and post-operative care of those types of patients. Odim testified that he did not elaborate to them what he meant by intimately involved. Nor did he actually say that he had been involved in the intra-operative or surgical part of the care of patients like Vinay. When asked of his own experience, he said, "from the operative point of view of issues of doing shunts and doing the procedure, I had experience with a number of cases like Vinay." (Evidence, page 24,318) He testified, however, that he had never placed this type of VSD patch as a primary surgeon. However, he did not provide the Goyals with this information.

The Goyals provided their consent to the procedure. The operation was scheduled for March 17.

Vinay's case was one of some complexity. Odim testified that when the decision was made to perform Vinay's operation in Winnipeg, he did not formally or informally invite other members of the team to raise concerns or to discuss whether or not they felt the team was ready to proceed with this patient. Vinay's case was presented on February 21. However, Giddins and Odim were the only doctors in attendance. In a letter dated March 1, Odim wrote to Giddins, "It is clear the progressive course of cyanosis in this child and his palliated condition require surgical correction. We plan to bring the family and child to clinic for preliminary discussions and evaluations." (Exhibit 7, page GOY 4)