Texas Medical Disclosure Panel determines which risks and hazards related to medical care and surgical procedures must be disclosed by health care providers or physicians to their patients or persons authorized to consent for their patients, and establishes the general form and substance of such disclosure.
The Texas Medical Disclosure Panel was established by the 65th Legislature in 1977. The panel is appointed by the HHS executive commissioner and comprises nine members. It includes three members licensed to practice law in Texas and six members licensed to practice medicine in Texas.
The panel identifies and makes a thorough examination of all medical treatments and surgical procedures in which physicians and health care providers may be involved. Their goal is to determine which of those treatments and procedures do and do not require disclosure of the risks and hazards to the patients or persons authorized to consent for the patients.
Members:
| Dr. Noah Appel, M.D. (Chair) Physician (Dallas) Ms. Nneka Egbuniwe, J.D. Dr. Sandra Esquivel, M.D. Dr. John R. Holcomb, M.D. Resigned effective immediately Mr. Wilbert (Will) Hughes, J.D. |
Dr. Chukwusomnazu Nwanze, M.D. Physician (El Paso) Dr. William C. Pederson, M.D. Dr. Jeremie Perry, M.D. Mr. Robert Spurck, J.D. |
- Call to order, logistics, and roll call. The meeting was convened by Noah Appel, Chair. A quorum was present.
- Consideration of October 14, 2025, draft meeting minutes. The minutes were approved as drafted.
- Discuss new member appointments. New panel members will no longer be selected by this panel. A different process will be used.
- Consider amendment of 25 TAC §602.22 and §603.21, Plastic Surgery and Surgery of the Integumentary System Treatments and Procedures. The panel reviewed and discussed revisions to the section on plastic surgery and integumentary procedures, focusing on updated risks and procedural listings. Edit suggestions included updates on breast implant risks (specifically lymphoma) and inclusion of gender affirmation, cancer, and post-trauma procedures involving the genital system. There was specific detailed discussion about:
- Clear and plain-English risk descriptions for each procedure.
- Sensory changes (numbness, tingling, altered sensation) being consistently included where relevant, especially for flap surgeries and breast-related procedures.
- Combining redundant entries (e.g., consolidation of breast reconstruction subsections).
- Removal of unclear or misplaced risks such as persistent leg swelling after panniculectomy and loose skin after liposuction (considered part of unsatisfactory appearance risk).
- Relocation of tendon release/trigger release procedures to the musculoskeletal section.
- Detailed consideration of risks for gender-affirming surgeries, including grouping similar complications and ensuring consistent terminology for nerve injuries and sensory changes.
- Addition of risks like unsatisfactory appearance across more procedures, given previous patient feedback.
- Suggestions to review inclusion or wording of rare but significant risks, such as internal organ injury during flap surgery and the need to ensure layperson-understandable descriptions.
Due to the significant recommended changes, there was agreement to rework several sections and return with updated drafts for future review.
Left Pending
- Consider amendment of 25 TAC §602.14, Radiology Treatments and Procedures The panel reviewed and highlighted plain English updates for various procedures (e.g., chemoembolization, radioembolization, thermal ablation, TIPS, myelography, drainage procedures). Additional risk language was added or old language clarified pertaining to, capturing recurrence of tumors, specifying organs at risk, and noting procedural variants. There was relocation of specific procedures within the document: tear duct imaging (dacryocystography) moved from radiology to ophthalmology section, with reference notes added for cross-referencing.
Changes approved
- Consider amendment of 25 TAC §602.8 and §603.8, Hematic and Lymphatic System Treatments and Procedures The chair presented minor updates and plain English additions to procedures like blood transfusion, splenectomy, lymph node transplant/transfer, and lymphangiography. The panel agreed to add “numbness/tingling” to nerve injury risk and included a new section for lymph node dissection (with risks: lymphedema and nerve injury). They further addressed where axillary/inguinal dissections for melanoma should be referenced, deciding to create a dedicated section for general lymph node dissection.
Typographical errors in code references were made.
Changes approved.
- Consider amendment of 25 TAC §602.6 and §603.6, Eye Treatments and Procedures The panel reviewed plain English edits and worked towards consistent risk phrasing across procedures (e.g., “complications requiring additional treatment and/or surgery,” “partial or total blindness”). They further Discussed placement of tear duct procedures, ultimately adding dacryocystography and stenting to the eye section (list B of the document) and clarified definitions (e.g., pterygium) and standardized terminology (e.g., “eyelid drooping” vs. “drooping eyelid”). There was agreement to move and reference risk language for uniformity.
Changes approved
Previously approved; No discussion
Previously approved; No discussion
- Assign the review of organ system treatments and procedures, under 25 TAC §602 and §603, for the next meeting.
Topics for review include: male genital, maternity, muscular skeletal, pain management. These will be assigned to members to develop after the meeting.
- Public comment. No public comment was offered.
- Announcements and agenda items for next meeting.
The “plastics” still need work and will be held. The above approved 5 items were recommended for publication. There was consensus however to hold off until the plastics is finalized at the next meeting .
Future Meetings:
- Thursday, May 7, 2026, at 1 p.m.
- Thursday, Sept. 17, 2026, at 1 p.m.
- Adjournment. There being no further business, the meeting was adjourned.
***
The information contained in this publication is the property of Texas Insight and is considered confidential and may contain proprietary information. It is meant solely for the intended recipient. Access to this published information by anyone else is unauthorized unless Texas Insight grants permission. If you are not the intended recipient, any disclosure, copying, distribution or any action taken or omitted in reliance on this is prohibited. The views expressed in this publication are, unless otherwise stated, those of the author and not those of Texas Insight or its management.