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MATERNITY AND RELATED CASES:
Delivery (vaginal):
1. Injury to bladder and/or rectum, including a hole (fistula)
between bladder and vagina
and/or rectum and vagina.
2. Hemorrhage possibly requiring blood administration and/or
hysterectomy and/or artery
ligation to control.
3. Sterility.
4. Brain damage, injury, or even death occurring to the fetus
before or during labor and/or
vaginal delivery whether or not the cause is known.
5. Uterine disease or injury requiring hysterectomy.
6. Pulmonary embolus.
7. Risk of infection.
8. Possible painful intercourse.
Delivery (Cesarean Section)
1. Infection.
2. Injury to bladder and/or rectum, including a fistula (abnormal
hole) between bladder and
vagina and/or rectum and vagina.
3. Hemorrhage possibly requiring blood administration and/or
hysterectomy and/or artery
ligation to control.
4. Sterility.
5. Brain damage, injury, or even death occurring to the fetus before
or during labor and/or
cesarean delivery whether or not the cause is known.
6. Uterine disease or injury requiring hysterectomy.
7. Pulmonary embolus.
8. Disfiguring scarring.
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MUSCULO-SKELETAL TREATMENTS AND PROCEDURES
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.
A surgical procedure upon, or even a closed manipulation of an
extremity, entails risk to a
greater or lesser degree, to all major systems of
that limb, and can
result in varying degrees of
weakness, deformity, paralysis, pain, numbness, limitation of motion of
the joints, and
amputation. Furthermore, the goals of the
procedure may not be obtained
and other therapy may
be found necessary.
NERVOUS SYSTEM TREATMENTS AND PROCEDURES:
Spine operation, including laminectomy, decompression, fusion,
internal
fixation, or procedures
for nerve root or spinal cord compression; spine operations for diagnosis;
pain, deformity;
mechanical instability; injury; removal of tumor, abscess, or
hematoma
(excluding coccygeal
operations).
1. Pain, numbness or paralysis, or clumsiness.
2. Weakness of
arms(s), hand(s), leg(s) or foot (feet) including
paraplegia (paralysis of both
arms or paralysis of both legs) and quadriplegia (paralysis of all four
extremities).
3. Loss of function of bladder.
4. Loss of function of bowel.
5. Loss of sexual function.
6. Unstable spine.
7. Recurrence or continuation of
the condition that required the
operation.
8. Injury to major blood vessels.
9. Leakage of spinal fluid.
l0. Failure to relieve pain or increase in pain.
11. Failure or breakage of internal fixation.
12. Infection.
13. Death.
14. Hemorrhage, requiring transfusion.
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ORAL SURGERY:
Removal of Tooth (Including Impacted Tooth) (An impacted tooth is under
the gum or bone):
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Injuries to adjacent teeth and/or
hard or soft tissues.
5. Paresthesia or numbness of face and/or mouth.
6. Fracture of mandible (upper jaw) or maxilla
(lower jaw).
7. Opening between mouth and sinus or mouth and nose.
8. Tooth or fragment in maxillary sinus.
9. Incomplete removal of tooth.
10. Dry socket.
Repair or Removal of Damaged Teeth:
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Paresthesia or numbness of face and/or mouth.
5. Loss of teeth.
6. Loss of bone.
Removal of Exostosis, Tori, Tuberosities (Excess Bone):
l. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Slough (Unanticipated loss of hard
and/or soft tissue).
5. Paresthesia or numbness of face and/or mouth.
6. Opening between mouth and sinus or mouth and nose.
7. Injury to adjacent structures.
Dental Implants:
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Permanent and disfiguring scarring.
5. Premature loss of implant and attachments.
6. Loss of bone.
7. Mobility of implant (Failure of implant to attach).
8. Paresthesia or numbness of face and/or mouth.
9. Mandibular fracture (lower jaw).
10. Injury to adjacent teeth.
11. Inability to place implant in intended site.
12. Injury of maxillary sinus.
Maxillary and Mandibular Osteotomies (Cutting and Movement of Jawbones):
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Permanent and disfiguring scarring.
5. Difficulty in mastication (chewing).
6. Malocclusion (improper bite).
7. Continued muscle pain and headaches.
8. Impaired or obstructed airway (difficulty in breathing) which
might cause death.
9. Undesirable facial appearance.
l0. New or continued temporomandibular joint symptoms (TMJ).
11. Nerve injury.
12. Failure of bone to heal.
13. Loss of teeth, bone or soft tissue.
14. Damage to teeth requiring additional treatment (root canal).
15. Relapse or shift of jaw structures.
l6. Opening between mouth and sinus or mouth and nose.
Genioplasty (Chin Reconstruction), Sliding Osteotomy (Cutting and Moving
the Bone), Bone
Graft, Alloplast
(Synthetic Implant):
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Permanent and disfiguring scarring.
5. Undesirable chin contour.
6. Failure of bone to heal.
7. Paresthesia or numbness of face and/or mouth.
8. Resorption of hard and/or soft tissues secondary to alloplast
implant (synthetic).
9. Injury to dental structures.
10. Rejection of implant material.
11. Lip incompetence (droop of lip).
Surgery for Cleft Lip/Palate & Craniofacial Deformities (Repair of Defects
from Birth Injury,
Prior Surgery, and/or Disease):
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Permanent and disfiguring scarring.
5. Impaired chewing or swallowing.
6. Unstable or inadequate function of dental occlusion (bite).
7. Residual speech problems or impairment.
8. Unfavorable facial symmetry.
9.
Airway impairment (difficulty in breathing) which might cause death.
10. Nerve injury - sensory or motor (feeling and function).
11. Loss of grafted or implanted materials.
12. Blood supply compromise to tissues hard and soft resulting in
loss of tissues.
13. Failure of bone to heal.
14. Failure to correct deformity.
15. Opening between mouth and sinus or mouth and nose.
Removal of Cyst, Benign Tumors or Malignant Tumors from Jaws:
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Permanent and disfiguring scarring.
5. Recurrence of lesion.
6. Loss of bone which would result in facial deformity.
7. Unanticipated loss of teeth or adjacent vital structures.
8. Facial bone fracture.
9. Paresthesia or numbness of face and/or mouth.
10. Metastasis (spread of cancer if tumor is cancerous).
Surgical Treatment of Facial Infection Including Drainage:
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Permanent and disfiguring scarring.
5. Loss or damage to teeth and adjacent structures including bone.
6. Persistence and/or spread of infection to other parts of body.
7. Airway impairment (difficulty in breathing) which might
cause death.
Surgical Removal of Cysts, Benign Tumors and Stones of the Salivary Gland:
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Permanent and disfiguring scarring.
5. Recurrence of original problem.
6. Metastasis (spread of cancer if tumor is cancerous).
7. Damage or loss of adjacent vital structures (salivary).
8. Persistent problem requiring removal of gland.
Temporomandibular Joint Disease (Surgery and/or Manipulation):
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Permanent and disfiguring scarring.
5. Failure to relieve pain.
6. Inability to chew properly.
7. Restriction of jaw movement.
8. Locking of jaw joint (open or closed).
9.
Failure of alloplast (synthetic implant) to function requiring
removal.
l0. Malocclusion (improper bite).
11. Motor or sensory nerve damage (function or feeling).
12. Damage to ear canal, cartilage, or middle ear.
13. Development of arthritis condition.
Surgical Repair of Mandible (Lower Jaw) Fractures:
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Permanent and disfiguring scarring.
5. Failure of bones to heal properly.
6. Malocclusion (improper bite).
7. Damage to teeth or loss of teeth.
8. Motor or sensory nerve damage (function and feeling).
Surgical Repair of Maxilla (Upper Jaw) Fractures:
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Permanent and disfiguring scarring.
5. Failure of bones to heal properly.
6. Malocclusion (improper bite).
7. Opening between mouth and sinus or mouth and nose.
8. Loss of bone or teeth.
9. Chronic sinusitis or sinus infection.
l0. Motor or sensory nerve damage (function and feeling).
11. Telecanthus (widening of the space between the eyes).
12. Abnormal eye movements.
13. Abnormal vision.
14. Difficulty breathing.
15. Overflow of tears.
16. Inability to smell.
Surgical Correction of Soft Tissue Injuries of Face:
1. Infection.
2. Bleeding.
3. Failure of wound to heal.
4. Permanent and disfiguring scarring.
5. Failure to restore appearance.
6. Motor or sensory nerve damage (function and feeling).
7. Salivary gland duct damage.
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