I have reviewed the patient's file and found the following:
The patient first came to see us in June 2008 for spider veins and varicose veins. The patient had been treated previously with sclerotherapy (injecting a solution into the spider veins) but she did not get any results.She was advised that the varicose veins would need treatment by a vascular surgeon but that the spider veins would possibly respond to treatment with the GentleYAG laser.
Before we perform any procedure on any patient, we discuss and inform the patient of all of the "bad" (risks) and "good" (benefits) that can occur with the procedure. The patient then must read and sign this "informed consent". We discussed all of this with the patient prior to the procedure including the fact that sometimes, patients can get brown discoloration of the areas treated with the laser even if they wear a strong sunscreen ( which we advise to all patients) on the treated areas. The patient read and signed a consent for treatment which included all of the above discussions and had 2 lasers treatments at the recommended settings by the Candela laser company in July and September of 2008. She was advised to use sunscreen and avoid sun exposure ( noted in chart).
When she was seen in October 2008, she had developed discoloration at some but not all of the treated sites.We were agressive in our efforts to treat the discoloration and gave her two very strong prescription cream medications that we recommended that she use until the discoloration was gone.
We followed her closely in October and December of 2008 and no further treatments were performed. She had been asked to continue using the prescription creams until the discoloration had gone away, but she only used them for 6 weeks.
In July 2009, she returned again and stated that the veins on the back of her legs had improved from the 2 previous treatments, but that the veins of the right ankle were still present and that she wanted to have another treatment. Her discoloration was improved, but still present. We again reviewed the consent which did discuss the risk of discoloration following treatment and advised her that she needed to continue using the strong topical creams and wear a strong sunscreen. She was given samples and prescriptions of both creams and advised to use them to prevent any further brown discoloration. She had the third and last treatment of her pre-paid package.
We take a lot of care with all of our patients and want them to be satisfied with their treatments. There are risks to every procedure and that is why we have them carefully read and sign the informed consent so that those issues can be discussed.
We welcome the patient to call or return to see us so that we can help her resolve this issue.
Sincerely,
Renee Cobos MD
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