Consent

On March 9, Odim met with Charlotte Caribou. In a letter to Giddins, he said he discussed the surgical plan to close the VSD in detail with her. Odim said he also discussed how the increased pressures in the ventricles and the borderline pulmonary vascular resistance suggested that the post-operative course might be difficult. In addition, Odim said that he explained all the potential risks to Gary's mother. He indicated that she seemed to understand, and that she gave her verbal and written permission for surgery.

It appears that Charlotte Caribou may have been adequately informed as to Gary's cardiac defects. She was aware that he had a hole between his ventricles that had to be patched. Whether or not she understood or was aware of the other issues that made up the risks that Gary faced is an entirely different question. Importantly, she seems not to have been aware of any concerns about Gary's physical strength or his failure to thrive. Also, she was not aware that there were any issues surrounding the team members and their collective and individual experience.

In his testimony, Odim said he did not discuss with Charlotte Caribou his previous experience in performing this operation. He said it was not his practice to discuss his experience, unless the parents specifically asked him about it. He said this had also been the practice of the people under whom he had trained. As noted in Chapter One, in obtaining consent, professional practice is not the sole determinant of the information that must be provided to the patient or the patient's parents.

Odim's surgical practice (as opposed to the period he spent as a surgical resident) was less than one month's duration when he spoke with Charlotte Caribou. This means that he had only been involved in obtaining consents to perform surgery on his own for little more than three weeks. In other words, Odim's habit of not providing information about his experience was not a practice of long standing, but one that he had recently adopted.

When asked if this meant that the onus was on the parents to ask about his experience, Odim said:

What I'm trying to say is that when I see patients in my office, I don't have a list of my procedures that I have done, a C.V. that I give to my patients as I meet them. We discuss the situation. Many families will ask questions. Some will ask, well, how many have you done; some will not ask how many have you done. It is just not something that's been part of my practice. (Evidence, page 24,069)

Odim said he did not feel that the fact that this was the first time he was performing this procedure as the primary surgeon in a new setting elevated the risk in any fashion. He also said that he did not raise with Charlotte Caribou the possibility of having the operation performed in another centre.

He did acknowledge that experienced surgeons generally have lower risks of morbidity and mortality than do inexperienced surgeons, largely because of the benefits of experience. Odim did not feel, apparently, that such information was something that he ought to have shared with Gary Caribou's mother.