A Rectum, a Finger, and a Lawsuit in New York

The patient feels violated. Doctors feel it was necessary. A court will decide.

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Some cases are medical. Some are legal. Some, unfortunately, end up being both. New York State's Supreme Court is poised to consider the double-sided case of Brian Persaud, a 38-year-old construction worker who has reportedly sued a New York hospital for performing a rectal exam that he says he didn't want.

After receiving a head injury, Persaud was taken to the emergency room at New York-Presbyterian Hospital/Weill Cornell Medical Center, where ER docs conducted a work-up. The New York Times's blog City Room reports:

According to a lawsuit he later filed, Mr. Persaud was then told that he needed an immediate rectal examination to determine whether he had a spinal-cord injury. He adamantly objected to the procedure, he said, but was held down as he begged, "Please don't do that." As Mr. Persaud resisted, he freed one of his hands and struck a doctor, according to the suit. Then he was sedated, the suit says, with a breathing tube inserted through his mouth.

After Mr. Persaud regained consciousness, he was arrested, then taken—still in his hospital gown—to be booked on a misdemeanor assault charge. Gerrard M. Marrone, who was Mr. Persaud's lawyer, got the criminal charges dropped, then helped Mr. Persaud file a civil lawsuit against the hospital.

I don't claim to know what the court should decide—heck, all I know about the case is what I've read online (here's another news report about it). But I can certainly sympathize with any patient who feels that a doctor ignored a request. I'd like to think that I can ask any doctor why a particular test or procedure is necessary and count on getting an explanation that will enable me to make a rational decision to agree to it. In fact, I once fired a surgeon—or maybe he fired me—when he failed that test of explanation. But a patient in the ER can't necessarily walk out the way I did. That's why good doctor-patient communication is so important.

(Disclosures: The blogger is a friend of mine, and a relative is attending Weill Cornell. I have no inside information about the case.)