New TMDP Consent Form for 2020

The Texas Medical Disclosure Panel (TMDP) has adopted changes to informed consent forms, which will take effect at the beginning of 2020. Ophthalmologists will use the new Disclosure and Consent for Medical Care and Surgical Procedures form.

Beginning Jan. 1, a patient must sign the new version of the applicable form before a physician provides the care or procedure to have it presumed in a court proceeding that the physician obtained informed consent.

The amended, adopted versions of the two forms, each in both English and Spanish, were published in the Texas Register on June 21. The 2020 English version of the medical care/surgical procedures form is available here, and the Spanish version is available here

The presumption physicians receive in court by having a patient sign the form is rebuttable in a court of law; if the patient did sign the applicable form prior to the care or procedure, the patient would have to prove in court that the information he or she received was insufficient. But if the physician does not get the patient’s signature on the informed-consent form beforehand, and the patient alleges that the physician didn’t make the required disclosures, the physician has the burden of proving he or she obtained proper informed consent.

For the rest of this year, physicians must use the current versions of these forms to obtain informed consent and benefit from the presumption in court. Forms for both 2019 and 2020 are available on the Department of State Health Services' website here

In 2018, The Texas Medical Disclosure Panel  (TMDP) approved changes to the lists of medical care and surgical procedures that require disclosure of specific risks and hazards. Effective August, 2018 as posted in the Texas Register on August 17, physicians providing these eye care services (list A, below) must disclose each of these specific risks and hazards to their patients or persons authorized to consent for their patients and to establish the general form and substance of such disclosure. List B names procedures requiring no disclosure of specific risks and hazards.

Updated lists across all specialties are found on the Texas Department of State Health Services website.


Texas Administrative Code
TITLE 25 HEALTH SERVICES
PART 7 TEXAS MEDICAL DISCLOSURE PANEL
CHAPTER 601 INFORMED CONSENT

RULE §601.2 Procedures Requiring Full Disclosure of Specific Risks and Hazards – List A

(f) Eye treatments and procedures.

(1) Eye muscle surgery.

  • Additional treatment and/or surgery.
  • Double vision.
  • Partial or total blindness.

(2) Surgery for cataract with or without implantation of intraocular lens.

  • Complications requiring additional treatment and/or surgery.
  • Need for glasses or contact lenses.
  • Complications requiring the removal of implanted lens.
  • Partial or total blindness.

(3) Retinal or vitreous surgery.

  • Complications requiring additional treatment and/or surgery.
  • Recurrence or spread of disease.
  • Partial or total blindness.

(4) Reconstructive and/or plastic surgical procedures of the eye and eye region, such as blepharoplasty, tumor, fracture, lacrimal surgery, foreign body, abscess, or trauma.

  • Blindness.
  • Nerve damage with loss of use and/or feeling to eye or other areas of face.
  • Painful or unattractive scarring.
  • Worsening or unsatisfactory appearance.
  • Dry eye.

(5) Photocoagulation and/or cryotherapy.

  • Complications requiring additional treatment and/or surgery.
  • Pain.
  • Partial or total blindness.

(6) Corneal surgery, such as corneal transplant, refractive surgery and pterygium.

  • Complications requiring additional treatment and/or surgery.
  • Pain.
  • Need for glasses or contact lenses.
  • Partial or total blindness.

(7) Glaucoma surgery by any method.

  • Complications requiring additional treatment and/or surgery.
  • Worsening of the glaucoma.
  • Pain.
  • Partial or total blindness.

(8) Removal of the eye or its contents (enucleation or evisceration).

  • Complications requiring additional treatment and/or surgery.
  • Worsening or unsatisfactory appearance.
  • Recurrence or spread of disease.

(9) Surgery for penetrating ocular injury, including intraocular foreign body.

  • Complications requiring additional treatment and/or surgery.
  • Possible removal of eye.
  • Pain.
  • Partial or total blindness. 

RULE §601.3 Procedures Requiring No Disclosure of Specific Risks and Hazards--List B

(f) Eye.


(1) Administration of topical, parenteral (such as IV), or oral drugs or pharmaceuticals, including, but not limited to, fluorescein angiography, orbital injection or periocular injections.
(2) Removal of extraocular foreign bodies.
(3) Chalazion excision.