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ADENOIDECTOMY:

     1.   Bleeding.

     2.   Nasal speech.

     3.   Nasal regurgitation of food or liquids.
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ANESTHESIA:

Arterial Catheterization:

     1.   Decrease in blood flow to area supplied by the artery.

     2.   Nerve damage.

     3.   Loss of or loss of function of the limb or portion of the limb
supplied by the artery.

Central Venous and Pulmonary Artery Catheterization:

     1.   Hemorrhage (bleeding) into the lungs, the pericardium (sac which
surrounds the heart),

the chest cavity and elsewhere.

     2.   Pericardial tamponade (compression of the heart due to
accumulation of blood or fluid in

the sac around the heart).

     3.   Cardiac arrest (heart attack).

     4.   Stroke.

     5.   Pneumothorax (lung collapse).

     6.   Infection.

     7.   Cardiac arrhythmias (irregularities of the heart rhythm).

     8.   Shock (severe drop in blood pressure).

     9.   Damage to blood vessels.

     l0.  Damage to trachea (windpipe) and/or pharynx (throat).

     ll.  Injury to vocal cords.

     l2.  Distal embolization (air, fat particles or blood clots which
circulate in the bloodstream

until becoming lodged in a vein or artery).

     l3.  Damage to nerves, the lymph ducts, the heart and the lungs.

     l4.  Infusion to fluid into the chest cavity, lungs and pericardium.

Transesophageal Echocardiography:

     1.   Esophageal injury.

     2.   Damage to teeth.

Epidural, Spinal, Regional:

     1.   Allergic, abnormal or hypersensitivity reaction to drugs or
equipment may be fatal.

     2.   Aspiration (inhalation) into the bronchi (airway) or lungs of
stomach contents, stomach

acids and foreign objects.

     3.   Leakage of cerebrospinal fluid.

     4.   Chipped or broken teeth.

     5.   Convulsion (seizures).

     6.   Epidural blood clot or abscess (bleeding or infection in the
space adjacent to  the spinal

cord which may damage the spinal cord).

     7.   Broken needles or catheters which may lead to complications and
necessitate additional

treatment.

     8.   Production of an unintended high level of anesthesia which may
necessitate need for

artificial respirators and insertion of a breathing tube.

     9.   Incomplete analgesia (pain or discomfort during the procedure).

     l0.  Injury to the lips, tongue and inside of the mouth or airway injury.

      ll.  Laryngeal and vocal cord trauma or edema (injury to or swelling
of the vocal cords).

     12.  Loss of bowel or bladder function or sexual function.

     13.  Heart attack or other heart problems.

     14.  Decreased blood pressure.

     15.  Shock.

     l6.  Nerve damage ranging from loss of sensation to total paralysis.

     l7.  Back pain.

     l8.  Death.

     l9.  Brain damage.

     20.  Severe headaches.
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ANESTHESIA AND PREGNANCY:

List of complications which have occurred to an unborn child in
association with obstetrical

anesthesia includes:

     1.   Hypoxia or anoxia (deprivation of sufficient amounts of oxygen
which, if pro-longed, can

cause death or brain damage).

     2.   Cardiac and/or respiratory depression (reduction of the heart
and/or breathing rate which

can lead to hypoxia or anoxia).

     3.   Brain damage.

     4.   Mental retardation.

     5.   Injury to body organs.

     6.   Seizure disorders.

     7.   Quadriplegia (paralysis of both arms and both legs).

     8.   Paraplegia (paralysis of both legs).

     9.   Spasticity (involuntary contraction of one or more muscles with
associated loss of muscle

function).

     l0.  Meconium aspiration (drawing of meconium, a fetal waste product
sometimes present in

the fluid surrounding the fetus, into the lungs of the unborn child.

     ll.  Broken bones.

     12.  Death.
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ANTERIOR OR POSTERIOR DISKECTOMY (with or without fusion):

     1.   Death.

     2.   Quadriplegia.

     3.   Paraplegia.

     4.   Increased pain and numbness.

     5.   Hoarseness.

     6.   Failure of fusion (bone graft fails to stabilize).

     7.   Infection.

     8.   Need for additional surgery.

     9.   Continuation of condition for which surgery was performed.

     10.  Difficulty swallowing.

     11.  Injury to esophagus.

     12.  Bowel and bladder dysfunction.
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ANY PROCEDURE REQUIRING CARDIOPULMONARY BYPASS:

     1.   Stroke.

     2.   Respiratory complications (including need for prolonged
ventilatory support).

     3.   Kidney failure.

     4.   Death.

     5.   Bleeding requiring re-operation.

APPENDECTOMY:

     1.   Infection in the incision.

     2.   Bleeding from or into incision.

     3.   Intrabdominal infection (abscess) requiring additional surgery
and prolonged

hospitalization.

     4.   Leakage from the colon (fistula) requiring additional surgery
and/or colostomy (colon

empties into bag worn on the abdomen).

     5.   Hernia in the incision.
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CATARACT SURGERY WITH OR WITHOUT IMPLANTATION OF INTRAOCULAR

LENS (placement

of lens into eye):

     1.   Loss of vision or decrease in vision.

     2.   Loss of eye.

     3.   Infection.

     4.   Bleeding inside or behind the eye.

     5.   Uncomfortable or painful eye.

     6.   Continued need for glasses.

     7.   Less attractive appearance, i.e. droopy eyelid.

     8.   Need for laser surgery to correct clouding of vision.

     9.   Need for additional treatment and/or surgery.
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CAUTERIZATION OF TISSUE IN THE NOSE:

     1.   Infection.

     2.   Scarring with obstruction of breathing.

     3.   Dryness of nose.
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CERVICAL MANIPULATION/ADJUSTMENT:

     Note: Itemization of the procedures and risks under a particular
specialty does not preclude

other qualified practitioners from using those risks identified for that
particular procedure.

     1.   Stroke.

     2.   Disc herniation.

     3.   Soft tissue injury.

     4.   Rib fracture.
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COLON RESECTION:

     1.   Infection in the incision.

     2.   Intrabdominal infection (abscess) requiring additional surgery
and prolonged

hospitalization.

     3.   Leakage from colon (fistula) requiring additional surgery and
possible colostomy (colon

empties into bag worn on the abdomen).

     4.   Injury to other organ or blood vessel requiring additional
surgery or blood transfusion.

     5.   Diarrhea, sometimes permanent.

     6.   Hernia in incision requiring additional surgery for repair.

     7.   Recurrence of cancer (if surgery is done for cancer).
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COLONOSCOPY:

     1.   Infection.

     2.   Bleeding which may require transfusion and/or surgery.

     3.   Perforation of colon or rectal wall which may require surgery.

     4.   Cardiac arrhythmias (irregular heartbeats).
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CORNEAL SURGERY: CORNEAL TRANSPLANT, PTERYGIUM, OR OTHER:

     1.   Loss of vision or decrease in vision.

     2.   Loss of eye.

     3.   Infection.

     4.   Bleeding inside or behind the eye.

     5.   Uncomfortable or painful eye.

     6.   Increased eye pressure.

     7.   Less attractive eye.

     8.   Need for additional treatment and/or surgery.
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CRANIOTOMY:

     Note: Itemization of the procedures and risks under a particular
specialty does not preclude

other qualified practitioners from using those risks identified for that
particular procedure.

     1.   Death.

     2.   Paralysis or stroke.

     3.   Infection or meningitis.

     4.   Seizure or epilepsy.

     5.   Loss of bone flap.

     6.   Personality change.

     7.   Loss of memory.

     8.   Hemorrhage.

     9.   Blindness.

     10.  Loss of sense of smell or taste.

     11.  Ringing in the ears or hearing loss.

     12.  Problems with balance.

     13.  Double or blurred vision.

     14.  Numbness or sensory loss.

     15.  Operative sight or remote from the operative sight.

     16.  Blood clots.

     17.  Continuation of condition for which surgery was performed.

     18.  Incontinence.

Anterior or Posterior Diskectomy (with or without fusion):

     1.   Death.

     2.   Quadriplegia.

     3.   Paraplegia.

     4.   Increased pain and numbness.

     5.   Hoarseness.

     6.   Failure of fusion (bone graft fails to stabilize).

     7.   Infection.

     8.   Need for additional surgery.

     9.   Continuation of condition for which surgery was performed.

     10.  Difficulty swallowing.

     11.  Injury to esophagus.

     12.  Bowel and bladder dysfunction.
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