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GASTRECTOMY OR VAGOTOMY AND PYLOROPLASTY:

     1.   Infection in incision or inside abdomen.

     2.   Bleeding which may require transfusion.

     3.   Leakage from stomach (fistula).

     4.   Inability to maintain weight.

     5.   "Dumping syndrome" (chronic vomiting after eating).

     6.   Inability to eat large amount of food, especially early after
surgery.

     7.   Diarrhea.

     8.   Need for vitamin B-12 injections for life if total gastrectomy
is needed.

     9.   Recurrence of condition for which surgery was originally done.
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GLAUCOMA SURGERY:

     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.   Less attractive eye.

     7.   Unsuccessful or temporary control of glaucoma or worsening of
glaucoma.

     8.   Cataract formation or progression.

     9.   Need for additional treatment and/or surgery.
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HEMATIC AND LYMPHATIC SYSTEM:

Transfusion of blood and blood components:

     1.   Fever.

     2.   Transfusion reaction which may include kidney failure or anemia.

     3.   Heart failure.

     4.   Hepatitis.

     5.   AIDS (acquired immune deficiency syndrome).

     6.   Other infections.
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HEMODIALYSIS:

     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.  Hypotension (abnormally high blood pressure).

      2.  Blood vessel access problems.

      3.  Antiocoagulant complications such as hemorrhage.

      4.  Sepsis (infection in blood stream).

      5.  Cardiac arrhythmias (irregular heartbeats).

      6.  Allergic reactions to tubing and dialyzer.

      7.  Abdominal pain.

      8.  Pulmonary edema (excess fluid in lungs).

      9.  Hypertension (high blood pressure).

     10.  Systemic poisoning from accumulation of toxic levels of
metabolic by-products.

     11.  Air bubbles in the bloodstream.

     12.  Abnormal levels of minerals in the blood.

     13.  Acute hemolysis.

     14.  Seizure.

     15.  Blood loss.

     16.  Hypothermia (lowered body temperature).

     17.  Hyperthermia (fever).

     18.  Transfusion complications, such as allergic reaction to blood
products.

     19.  Metabolic disorders (protein loss, malnutrition, elevated blood
sugar).

     20.  Acquisition of viral infection such as hepatitis or HIV.

     21.  Cardiac arrest (heart stoppage).
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HEMORRHOIDECTOMY OR EXCISION OF ANAL FISTULA OR FISSURE:

     1.   Bleeding at operative site.

     2.   Post-operative pain, especially with bowel movements.

     3.   Temporary/permanent difficulty controlling bowel movements or
passage of gas.

     4.   Recurrence of hemorrhoids or fistula or fissure.

     5.   Narrowing of anal opening requiring additional surgery or
repeated anal dilatations.
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HERNIA REPAIR:

     1.   Infection in the incision, possibly requiring additional surgery
to remove mesh if used for

repair.

     2.   Bleeding into incision or scrotum resulting in marked swelling
with pain, possibly

requiring additional surgery.

     3.   Recurrence of hernia.

     4.   Injury to or loss of testicle(s) or spermatic cords(s), possibly
causing sterility.

     5.   Nerve injury resulting in numbness or chronic pain in groin area.
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INSERTION OF INTRA-AORTIC AUGMENTATION BALLOON:

     1.   Paraplegia (paralysis of both legs or both arms).

     2.   Loss of extremity.

     3.   Bowel infarction.

     4.   Renal failure.
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INSERTION OF TEMPORARY HEMODIALYSIS ACCESS CATHETER:

     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.  Blood clots, requiring re-operation.

      2.  Infection.

      3.  False aneurysm (damaged blood vessel with swelling and risk of
rupture).

      4.  Recurrent thrombosis (blood clot).

      5.  Severe edema of extremity (swelling).

      6.  Inadequate blood supply to extremity (interference with blood
supply).

      7.  Inadequate blood supply to nerves with resulting paralysis.

      8.  Pneumothorax (air in chest cavity causing collapse of lung).
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INSERTION OF TEMPORARY PERITONEAL DIALYSIS CATHETER:

     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.  Peritonitis (infection inside the abdominal cavity).

      2.  Bleeding.

      3.  Infection.

      4.  Intestinal perforation (piercing of an organ within the
abdominal cavity).

      5.  Ileus (sluggishness and distention of intestines).
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INTEGUMENTARY SYSTEM TREATMENT AND PROCEDURES:

Radical or modified radical mastectomy (simple mastectomy excluded):

     1.   Limitation of movement of shoulder and arm.

     2.   Swelling of the arm.

     3.   Loss of the skin of the chest requiring skin graft.

     4.   Failure to completely eradicate the malignancy.

     5.   Decreased sensation or numbness of the inner aspect of the arm
and chest wall.

     6.   Injury to major blood vessels.
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INTRAVENOUS INJECTION OF RADIOPAQUE CONTRAST MEDIA (BOTH IONIC AND

NONIONIC):

          This procedure has been identified by the Louisiana Medical
Disclosure Panel as having

no risks that are required to be disclosed.  Absence of required
disclosure of risks does not mean

that consent for the treatment or procedure is not necessary.
Furthermore, it may be necessary to

disclose risks if a complicating

medical condition is present.
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Intrepid Resources ®
5000 West Esplanade Ave. #432
Metairie, LA. 70006
504.455.5895 Phone | 504.455.9392 Fax
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