Reference or download the documents below. Informed consent is available in English, Spanish and Arabic. For other languages ─ as this is a national pandemic and an expanded access protocol ─ it is acceptable for clinicians to have someone verbally translate the information to the patient, then document that process in the medical record. Contact our office with any questions: firstname.lastname@example.org
R Scott Wright, M.D.
Senior Chair and Medical Director, Mayo Clinic Institutional Review Board
Director, Mayo Clinic Human Research Protection Program
Download Protocol & Consent Documents (PDF’s):
Informed consent options
There are 3 options for obtaining informed consent and they should be applied in the following order.
Obtain written informed consent from the patient.
Use a LAR/Authorized Representative to sign the informed consent document if the patient is not able to provide consent because of an impairment or being unable to communicate (i.e., on a ventilator and sedated).
Use only when option 1 or option 2 are NOT feasible
You may utilize an exception for informed consent in an emergency (21 CFR 50.23) which allows you to discuss the participation with a second physician who concurs with your recommendation of enrolling the patient in the Expanded Access Program (EAP). The second physician must put a note in the patient's medical record indicating their concurrence of the patient participating in the EAP. You are also responsible for informing the patient or the LAR, as time progresses, of the patient's enrollment in the study and answer their questions. Patients may elect to withdraw from the study but their data will remain in the databank and you are required to fill out the 4 hour infusion, 7 day and 30 day forms for safety evaluation.
What if I cannot get into the room to consent the patient?
We understand that it may be too difficult or challenging to obtain written informed consent in person, especially if the patient is critically ill and not able to provide consent. If the treating physician/PI is unable to be physically in the room with the patient at the time of written informed consent, they or their designee trained to get informed consent can speak with the patient via a telemedicine or telephone device, and ask the patient to sign the consent form. The patient or his/her family member or health care worker can photograph the consent form and email it with signature to the physician/PI.
What if the LAR/Legal representative is not at the hospital?
If the LAR/designee is unable to be physically in the room with the patient at the time of written informed consent, the Physician/PI or their designee trained to get informed consent can speak with the LAR via a telemedicine or telephone device, and ask them to sign the consent form. They can photograph the consent form and email it with signature to the physician/PI.