An 18-year-old cat was taken to a veterinarian by its owners who were concerned about its abnormal breathing. The veterinarian examined the cat and recommended running diagnostic tests, including a bronchoscopy, to assess if it had an upper airway obstruction or another issue. The veterinarian recommended taking a staged approach to the testing to reduce distress to the cat, starting with an echocardiogram, thoracic radiographs and a laryngeal examination, before undertaking the bronchoscopy.

The echocardiogram was performed and revealed signs of heart disease but did not explain the cat’s symptoms. The veterinarian spoke with the owners over the phone to relay the findings, and recommended proceeding with a bronchoscopy. Shortly after the bronchoscopy, the cat developed a heart block and became apnoeic, resulting in emergency care.

The bronchoscopy results did not reveal any abnormalities. The cat’s owners were called in to the clinic to discuss post-resuscitation care and after being extubated, the cat appeared to be recovering well in the afterhours clinic. However, the next morning, it went into cardiac arrest and could not be resuscitated.

The client complained that they were not adequately informed of the risks involved with the diagnostic work or using general anaesthetic, and that they should have been offered the option to withdraw from diagnostic investigations prior to the bronchoscopy. They were also concerned that they were not given a written consent form to sign.

The client said their phone conversation with the veterinarian was short and that there was no discussion around what the risks of using general anaesthetic for the proposed bronchoscopy were.

Under the Code of Professional Conduct, veterinarians are required to adequately document informed consent.

The veterinarian’s practice did not use a consent form to document discussions with the client and their informed consent. There were no entries in the veterinarian’s clinical notes that documented the phone discussion before the proposed bronchoscopy or the discussions held in the initial consultation.

The Complaints Assessment Committee (CAC) considered that the veterinarian’s conduct fell short of the expectations set out under the Code but was satisfied that the veterinarian had enough information to confidently, and without any undue risk, use a general anaesthetic to undertake more diagnostics. The CAC determined that the veterinarian failed to document the informed consent process with the client to undertake the proposed course of action.

The veterinarian reflected on this situation and accepted that they did not communicate the full risk assessment to the client.

The veterinarian demonstrated to the CAC that they have since put a consent form in place. The CAC was satisfied that there was no ongoing risk to the public interest, and that further action under the Act was not warranted.

In its finding, the CAC reminded the profession that informed consent is an ongoing process. Veterinarians are responsible for ensuring clients have and understand all of the relevant information needed to make an informed choice. It is also a requirement that informed consent is adequately documented.

For more information about VCNZ’s complaints process, visit https://www.vetcouncil.org.nz/Web/1.Support-and-Information/Vets/Concerns.aspx