ASPS Patient Safety, Ethics & Management 2 — Questions and Answers
Question 1: Under ASPS ethics guidelines, which practice constitutes an unacceptable conflict of interest for a plastic surgeon?
- Owning a minority stake in a surgery center where the surgeon does not operate
- Accepting gifts from device manufacturers in exchange for preferential implant selection (Correct answer)
- Participating in an IRB-approved industry-sponsored clinical trial
- Serving as a paid consultant for a company after disclosing the relationship
Correct answer: Accepting gifts from device manufacturers in exchange for preferential implant selection
Accepting gifts from manufacturers in exchange for preferential product selection creates a direct conflict of interest that compromises patient-centered decision-making.
Question 2: A patient scheduled for elective rhinoplasty discloses active cocaine use the morning of surgery. The safest immediate action is to:
- Proceed with local anesthesia only to avoid general anesthesia risks
- Administer a reduced dose of intraoperative vasoconstrictors and proceed
- Cancel the procedure and reschedule after a substance-free period (Correct answer)
- Increase intraoperative monitoring frequency and proceed as planned
Correct answer: Cancel the procedure and reschedule after a substance-free period
Active cocaine use causes unpredictable cardiovascular responses and potentiates vasoconstrictors; elective surgery must be postponed until the patient is substance-free.
Question 3: Which element is MOST critical to document in a surgical timeout before a plastic surgery procedure?
- The patient's insurance authorization number
- Confirmation of correct patient, site, side, and procedure (Correct answer)
- The estimated blood loss from prior procedures
- The anesthesiologist's board certification status
Correct answer: Confirmation of correct patient, site, side, and procedure
The Universal Protocol's surgical timeout must confirm correct patient identity, operative site, laterality, and procedure to prevent wrong-site surgery.
Question 4: A plastic surgeon is asked to provide expert testimony in a malpractice case. According to ASPS ethics standards, the surgeon should:
- Testify only for the defense side to support fellow surgeons
- Decline all expert testimony to avoid professional conflicts
- Provide honest, objective testimony based on evidence and accepted standards (Correct answer)
- Align testimony with the position of the hiring attorney
Correct answer: Provide honest, objective testimony based on evidence and accepted standards
ASPS ethics require that expert witnesses provide truthful, evidence-based testimony rather than advocacy for one side.
Question 5: Which patient factor most significantly increases the risk of venous thromboembolism (VTE) in elective cosmetic surgery?
- BMI of 22 kg/m²
- Age under 30 years
- Prior history of deep vein thrombosis (Correct answer)
- Operative time under 60 minutes
Correct answer: Prior history of deep vein thrombosis
A prior history of DVT is one of the strongest independent risk factors for VTE recurrence and mandates aggressive prophylaxis in surgical patients.
Question 6: Informed consent for a breast augmentation procedure is BEST documented by:
- A verbal discussion with a signed operative report
- A standardized consent form signed by the patient after a thorough discussion of risks, benefits, and alternatives (Correct answer)
- A nurse witness signature on the surgeon's procedure notes
- An email confirmation from the patient acknowledging the surgery date
Correct answer: A standardized consent form signed by the patient after a thorough discussion of risks, benefits, and alternatives
Valid informed consent requires a thorough discussion of risks, benefits, and alternatives followed by a signed written consent form.
Question 7: When a plastic surgeon operates in an office-based setting, which safety standard is most directly associated with reduced mortality risk?
- Availability of MRI imaging on-site
- Accreditation by a recognized body such as AAAASF, AAAHC, or JCAHO (Correct answer)
- Use of a single-use surgical drape system
- Performing procedures only during morning hours
Correct answer: Accreditation by a recognized body such as AAAASF, AAAHC, or JCAHO
Office-based surgical facility accreditation is associated with significantly lower complication and mortality rates by enforcing equipment, staffing, and protocol standards.
ASPS Patient Safety, Ethics & Management 2
Under ASPS ethics guidelines, which practice constitutes an unacceptable conflict of interest for a plastic surgeon?