Abstract

FLORES-SANDI, Grettchen. Relevance of informed consent in iatrogenic ulnar injury associated with contraceptive implant removal. Vive Rev. Salud [online]. 2025, vol.8, n.22, pp.304-312.  Epub Jan 22, 2025. ISSN 2664-3243.  https://doi.org/10.33996/revistavive.v8i22.377.

Contraceptive implant removal procedures are designed to be performed safely, by trained personnel, in the outpatient setting under local anesthesia, but difficult removals can occur that increase the risk of neurologic, muscular, or vascular injury, and adequate informed consent for the procedure is key to the patient's understanding of what has occurred. It should be kept in mind that the criteria by which an iatrogenic injury is considered negligent depends on accepted standards of medical practice and what might be expected of a physician's actions given the availability of guidelines and evidence, as well as accepted standards of care. Case description: Patient who manifested an iatrogenic reaction characterized by abnormal uterine bleeding associated with etonogestrel implant, and in the absence of informed consent for the procedure presented with ulnar nerve injury during the failed attempt at deep implant removal, was referred eight months later for formal surgical exploration for removal of the implant and evaluation of the ulnar nerve. Discussion: Ulnar nerve injury is a serious and uncommon complication of these implant removal procedures. It is important to document its precise location before the procedure to minimize the risk, as well as to perform an informed consent that includes rare risks and contributes to avoid unnecessary litigation. Adequate training of the professionals who administer and remove these devices is important in their prevention, as well as early referral to a specialized center to prevent permanent damage.

Keywords : Iatrogenic Disease; Ulnar Nerve; Contraceptive Devices; Informed Consent.

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