Louisiana Administrative Code

A.1. First time applicants applying for a hang tag for mobility impairment must include: a. a currently dated medical examiner's certification of mobility impairment form (DPSMV 1966). A medical examiner is defined as: i. a person licensed to practice medicine in Louisiana or any…

A. The hang tags are designed to be hung from the vehicle's front windshield rear view mirror. When there is no rear view mirror, the hang tag may be displayed on the vehicle's dashboard.

A. First time applicants: 1. a currently dated medical examiner's certification form or, in the case of a disabled veteran, proof of a special disabled veteran license plate, a decision letter or an affidavit from the Office of Veteran Affairs and a separate medical examiner's ce…

A. The department may deny, cancel or revoke a hang tag or mobility impaired identification card for any of the following reasons. 1. The applicant made a misstatement of fact in his/her application for a hang tag or mobility impaired identification card, or the applicant omitted…

A. Pursuant to R.S. 40:1299.40E, the Louisiana Medical Disclosure Panel recommends use of the following general form, or use of a substantially similar form, for disclosure of risks and hazards related to medical care and surgical procedures. PATIENT CONSENT TO MEDICAL TREATMENT …

A. Abdominal Hysterectomy (Removal of Womb Resulting in Sterility) 1. uncontrollable leakage of urine; 2. injury to bladder; 3. death; 4. injury to the tube (ureter) between the kidney and the bladder; 5. injury to the bowel and/or intestinal obstruction; 6. infection; 7. damage …

A. Delivery (Vaginal) 1. injury to bladder and/or rectum, including a hole (fistula) between bladder and vagina and/or rectum and vagina; 2. hemorrhage possibly requiring blood administration and/or hysterectomy and/or artery ligation to control; 3. sterility; 4. brain damage, in…

A. Arterial Catheterization 1. decrease in blood flow to area supplied by the artery; 2. nerve damage; 3. loss of or loss of function of the limb or portion of the limb supplied by the artery. B. Central Venous and Pulmonary Artery Catheterization 1. hemorrhage (bleeding) into th…

A. Allergic, abnormal or hypersensitivity reaction to drugs or equipment, which may be fatal. B. Aspiration (inhalation) into the bronchi (airway) or lungs of stomach contents, stomach acids and foreign objects. C. Laryngeal and/or vocal cord trauma or edema (injury to or swellin…

A. List of complications which have occurred to an unborn child in association with obstetrical anesthesia includes: 1. hypoxia or anoxia (deprivation of sufficient amounts of oxygen which, if prolonged, can cause death or brain damage); 2. cardiac and/or respiratory depression (…

A. Thyroidectomy 1. injury to the nerves resulting in hoarseness or impairment of speech; 2. injury to parathyroid glands resulting in low blood calcium levels that require extensive medication to avoid serious degenerative conditions, such as cataracts, brittle bones, muscle wea…

A. Spine Operation, including Laminectomy, Decompression, Fusion, Internal Fixation, or Procedures for Nerve Root or Spinal Cord Compression; Spine Operations for: Diagnosis; Pain, Deformity; Mechanical Instability; Injury; Removal of Tumor, Abscess, or Hematoma (Excluding Coccyg…

A. Removal of Tooth (including Impacted Tooth) (an impacted tooth is under the gum or bone) 1. infection; 2. bleeding; 3. failure of wound to heal; 4. injuries to adjacent teeth and/or hard or soft tissues; 5. paresthesia or numbness of face and/or mouth; 6. fracture of mandible …

A. Cholecystectomy (Removal of the Gallbladder) with or without Common Bile Duct Exploration 1. pancreatitis (inflammation of the gland that produces insulin); 2. injury to the tube (common bile duct) between the liver and the bowel; 3. retained stones in the tube (common bile du…

A. Transfusion of Blood and Blood Components 1. fever; 2. transfusion reaction which may include kidney failure or anemia; 3. heart failure; 4. hepatitis; 5. AIDS (acquired immune deficiency syndrome); 6. other infections.

A. Radical or Modified Radical Mastectomy (Simple Mastectomy Excluded) 1. limitation of movement of shoulder and arm; 2. swelling of the arm; 3. loss of the skin of the chest requiring skin graft; 4. failure to completely eradicate the malignancy; 5. decreased sensation or numbne…

A. Cerebral Angiography 1. injury to the artery entered or studied; 2. swelling, pain, tenderness or bleeding at the blood vessel entrance by catheter or needle; 3. stroke; 4. death; 5. blindness; 6. brain damage; 7. aggravation of the condition that necessitated the procedure; 8…

A. Quadriplegia B. Paraplegia (Paralysis of Both Legs or Both Arms) C. Permanent Hoarseness D. Chylothorax (Leakage of Chyle, the White Body Fluid from Intestines Carried by the Lymphatic Vessels, into the Chest Cavity) E. Loss of Bowel and/or Bladder Function F. Impotence in a M…

A. Stroke B. Renal Failure C. Bowel Infarction D. Paraplegia (Paralysis of Both Legs or Both Arms) E. Death

A. Prolonged Air Leak B. Empyema (Collection of Pus) C. Need for Additional Surgery to Control Infection, Bleeding or Air Leak.

A. Stroke B. Respiratory Complications (Including Need for Prolonged Ventilatory Support) C. Kidney Failure D. Death E. Bleeding Requiring Reoperation

A. Paraplegia (Paralysis of Both Legs or Both Arms) B. Loss of Extremity C. Bowel Infarction D. Renal Failure

A. Head and Neck 1. Early Reactions a. reduced and sticky saliva, loss of taste and appetite, altered sense of smell, nausea; b. sore throat, difficulty swallowing, weight loss, fatigue; c. skin changes; redness, irritation, scaliness, blistering or ulceration, color change, thic…

NOTE: Itemization of the procedures and risks under a particular specialty does not preclude other qualified practitioners from using those risks identified for that particular procedure. A. A surgical procedure upon, or even a closed manipulation of an extremity, entails risk to…

NOTE: Itemization of the procedures and risks under a particular specialty does not preclude other qualified practitioners from using those risks identified for that particular procedure. A. Failure to improve the condition or symptoms. B. Injury to underlying nerve(s) of plexus …

NOTE: Itemization of the procedures and risks under a particular specialty does not preclude other qualified practitioners from using those risks identified for that particular procedure. A. Carotid Endarterectomy 1. thrombosis of repair (clotting); 2. bleeding/hematoma (accumula…

NOTE: Itemization of the procedures and risks under a particular specialty does not preclude other qualified practitioners from using those risks identified for that particular procedure. A. Death B. Paralysis or Stroke C. Infection or Meningitis D. Seizure or Epilepsy E. Loss of…

NOTE: Itemization of the procedures and risks under a particular specialty does not preclude other qualified practitioners from using those risks identified for that particular procedure. A. Death B. Quadriplegia C. Paraplegia D. Increased Pain and Numbness E. Hoarseness F. Failu…

A. Facelift and Coronal Lift 1. bleeding or hematoma (blood clot) that may need to be evaluated; 2. infection, skin loss, poor healing that may require prolonged treatment; 3. hypertrophic (thick) scars that may need to be revised and injected to soften them; 4. discoloration and…

A. Arterial Line Insertion 1. swelling, pain, tenderness or bleeding at blood vessel entrance by catheter or needle; 2. injury to artery or vein entered or studied; 3. decrease in blood flow to area supplied by the artery; 4. nerve damage; 5. loss or loss of function of an arm or…

A. Loss of Vision or Decrease in Vision B. Loss of Eye C. Infection D. Bleeding inside or behind the Eye E. Uncomfortable or Painful Eye F. Continued Need for Glasses G. Less Attractive Appearance, i.e., Droopy Eyelid H. Need for Laser Surgery to Correct Clouding of Vision I. Nee…

A. Loss of Vision or Decrease in Vision B. Loss of Eye C. Infection D. Bleeding inside or behind the Eye E. Uncomfortable or Painful Eye F. Less Attractive Eye G. Unsuccessful or Temporary Control of Glaucoma or Worsening of Glaucoma H. Cataract Formation or Progression I. Need f…

A. Loss of Vision or Decrease in Vision B. Loss of Eye C. Infection D. Bleeding inside or behind the Eye E. Uncomfortable or Painful Eye F. Increased Eye Pressure G. Less Attractive Eye H. Need for Additional Treatment and/or Surgery

A. Loss of Vision or Decrease in Vision B. Failure to Improve Vision C. Glaucoma (increased eye pressure) D. Retinal Detachment (separation of nerve layers of eye) E. Dislocation of Lens Implant

A. Bleeding B. Infection C. Chronic Discomfort or Pain D. Less Attractive Appearance E. Need for Additional Treatment and/or Surgery

A. Loss of Vision or Decrease in Vision B. Loss of Eye C. Infection D. Variable Vision E. Radiating Images around Lights F. Over Correction, under Correction or Distortion of Vision G. Cataract Formation or Progression H. Retained Need for Glasses I. Inability to Wear Contact Len…

A. Loss of Vision or Decrease in Vision B. Loss of Eye C. Double Vision D. Need for Additional Eye Muscle Surgery E. Infection F. Less Attractive Appearance

A. Loss of Vision or Decrease in Vision B. Increase in Eye Pressure (Glaucoma) C. Visual Distortion D. Need for Surgery Inside of the Eye E. Need for Additional Repeat Laser Treatment to Correct Clouding of Vision

A. Loss of Vision B. Loss of Eye C. Infection D. Bleeding E. Uncomfortable or Painful Eye F. Double Vision G. Cataract Formation or Progression H. Need for Additional Treatment and/or Surgery

A. Persistent Infection B. Perforation of Eardrum or Cyst behind the Eardrum Requiring Surgical Repair C. Need to Surgically Remove Tubes

A. Bleeding B. Nasal Speech C. Nasal Regurgitation of Food or Liquids

A. Bleeding B. Injury to Nerves to Tongue C. Nasal Speech

A. Bleeding B. Infection C. Injury to Nerve(s) of Upper Teeth D. Septal Perforation E. Spinal Fluid Leak

A. Infection B. Scarring with Obstruction of Breathing C. Dryness of Nose

A. Bleeding B. Infection C. Disappointing Cosmetic Result or Failure to Achieve Desired Result D. Impaired Breathing through Nose E. Septal Perforation

A. Bleeding B. Infection C. Scar Formation D. Spinal Fluid Leak with Possible Infection of Brain Tissue E. Injury to Eye, Including Blindness F. Injury to Sense of Smell G. Injury to Tear Duct Drainage.

A. Bleeding Requiring Transfusion B. Injury to Nerves of Shoulder Resulting in Numbness, Pain or Loss of Function C. Injury to Voice Box Resulting in Hoarseness or Speech Impairment D. Injury to Nerve of Diaphragm with Possible Impairment of Breathing E. Injury to Nerve of Tongue…

A. Bleeding B. Infection C. Injury to Nerve of Lip or Tongue

A. Infection B. Injury to Nerve of Tongue Causing Loss of Taste C. Loss of Hearing D. Perforation (Non-Healing) E. Ringing in Ears F. Dizziness G. Graft Failure

A. Infection B. Injury to Nerves of Tongue Causing Loss of Taste C. Injury to Nerves of Face Causing Paralysis D. Loss of Hearing E. Ringing in Ears F. Dizziness G. Hole in Eardrum H. Graft Failure