Medicolegal warning over iron infusion skin staining

Clinicians have been reminded to ensure that full informed consent is obtained from patients before receiving iron infusions, to avoid being the subject of an official complaint and disciplinary proceedings over unexpected skin staining.

In its latest bulletin the Medical Board of Australia says it has received a recurring number of against medical practitioners from patients whose skin has been permanently stained by an iron infusion.

Investigations by the regulator’s clinical advisors found that in some cases the informed consent process had been inadequate, and practitioners have been required to undertake education in obtaining consent.

The Medical Board said the introduction of ferric carboxymaltose (Ferinject) had made the administration of parenteral iron quicker and more convenient for patients, but with the risk of skin staining side effects.

It cited a typical notification as being from a young woman who went to the doctor concerned about how tired she felt. The doctor found she had severe iron deficiency anaemia and provided ferric carboxymaltose intravenously in the practitioner’s rooms.

“After the procedure, she was shocked to learn that the staining at the site of the infusion was permanent  … she complained to AHPRA that the practitioner did not tell her that this was a potential complication of the treatment and did not give her the opportunity to consider alternative treatments, such as oral iron supplement,” the Medical Board advisory statement said

“It is important for practitioners to give their patients clear and accurate information that patients can understand, so they can make an informed decision about the treatment.”

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