cataract surgery wrong lens lawsuit

Standard of care is what a reasonable physician would do in similar circumstances. WebMedical board investigations are now often triggered by mandatory reports from surgery centers and hospitals. Physician surveys and actuarial data show that one risk factor for lawsuit is the area of specialty, where surgeons, obstetricians, and gynecologists are sued more often than physicians from nonsurgical specialties.25,82 Other studies have shown that the claim frequencies increase with increasing age of the physician, physicians with higher clinical activity, male gender, a previous claims history, and higher frequency of patient complaints. Merani R, Hunyor AP, Playfair TJ, et al. Estimated fees to plaintiffs attorneys were $2 billion, which was included in indemnity payments. 0 likes, 62 replies Report / Delete New discussion Reply 62 Replies Additionally, there can be surprises in post-penetrating keratoplasty patients and in cases where the anterior segment of the eye is disproportionately sized compared to the overall length of the eye. All variables significant in the univariate analyses were included in a multivariate logistic regression model. Claims were separated into regions of the United States as seen in Figure 4. The doctor used a technical lens for my right eye and a standard lens for the left one. The median time to referral was 1 week in this study. This division allowed additional information regarding the duration between opening and closing of the claim and legal expenses for each group. There was additional $103,000 in legal expenses. This study was carried out for a number of reasons: (1) the absence of published studies addressing the legal outcomes for this complication despite the number of cataract surgeries being performed in the United States; (2) tremendous interest in the management and outcomes of this potentially visually devastating complication based on the large number of published studies on this topic; (3) the relevance of study findings to both the anterior and posterior segment specialists; and (4) a potential to improve patient outcomes. If you have experienced complications after cataract surgery because of surgical error, consult with the St. Louis surgical error attorneys at Zevan and Davidson Law Firm, LLC at (314) 588-7200. There were also cases where the defense experts felt that the case was less defensible due to poor office visit documentations that did not include or had illegible notations regarding visual acuity, intraocular pressure, or dilated fundus examination in the setting of declined visual acuity. Both univariate analyses and multivariate analyses were performed using data collected for possible outcomes or final disposition of the claim. Claims data from the Ophthalmic Mutual Insurance Company (OMIC) represent a unique opportunity to examine the medicolegal risks associated with ophthalmology. From the Department of Ophthalmology (Dr Kim) and the Division of Biostatistics (Dr Szabo), Medical College of Wisconsin, Milwaukee,Wisconsin, and Ophthalmic Mutual Insurance Company, San Francisco, California (Mr Weber). Furthermore, these malpractice claims data can be used to identify ways to improve patient safety, develop risk management programs, and provide an excellent opportunity to enhance patient care related to an ophthalmic subspecialty or an ophthalmic procedure. In one case, the surgical technician failed to securely attach the cystotome to the needle, and the cystotome shot off during injection of the viscoelastic material. ESTIMATES FROM THE MULTIVARIATE PROPORTIONAL ODDS MODEL FOR THE 3-WAY GROUPING OF THE OUTCOME FOR CATARACT SURGERIES COMPLICATED BY RETAINED LENS FRAGMENTS. Federal government websites often end in .gov or .mil. The estimated incidence of the complication of retained or dropped lens fragment in the literature is 0.1% to 1.6% of cataract surgeries, but in the current study 12.5% of closed claims related to cataract surgery were associated with retained lens fragments. The number of cases in each visual acuity grouping for claims with payment and no payment is also shown. Tackling the dropped nucleus. Currently OMIC is the largest insurer of ophthalmologists, with 40% of the market share, and has twice as many ophthalmologists as policyholders as the next largest insurer of ophthalmologists.17 Claims data from OMIC has been utilized in other previous studies related to ophthalmology.911 The OMIC Risk Management Committee gave approval for this study and granted access to the data under agreements protecting the identities of the patients, surgeons, and institutions. Among 117 closed claims that were related to cataract surgery complicated by retained lens fragments, 9 cases had multiple claims, including 8 cases where both the physician and the OMIC-insured entity were named in the suit and one case where two OMIC-insured physicians were named. The estimates show the odds ratio of being in a more severe category as opposed to less severe category when the predictor is changed by one unit; for categorical variables (corneal edema and elevated intraocular pressure), it means a change from the unlisted group to the listed one, whereas for continuous variables (visual acuity and time to referral), it means an increase in one unit. Kageyama T, Ayaki M, Ogasawara M, Asahiro C, Yaguchi S. Results of vitrectomy performed at the time of phacoemulsification complicated by intravitreal lens fragments. The relationship between physicians malpractice claims history and later claims: does the past predict the future? Rofagha S, Bhisitkul RB. Factors that prompted families to file malpractice claims following perinatal injuries. Brazitikos PD, Androudi S, Alexandridis A, Ekonomidis P, Papadopoulos NT. Pars plana vitrectomy in the management of retained intravitreal lens fragments after cataract surgery. It is important to remember that the eye with retained lens fragments may have significant inflammation not only from the lens material but also from concomitant infectious endophthalmitis.60 Therefore, vigilant follow-up and prompt referral of patients with suspected endophthalmitis is recommended. Ho LY, Doft BH, Wang L, Bunker CH. This trend may reflect increased popularity and adaptation of phacoemulsification by cataract surgeons in the mid-1990s and increased complication rates during transition period from extracapsular cataract surgery. If you've suffered an adverse outcome after cataract surgery, you might be wondering if you can or should sue your eye doctor for medical malpractice. This article discusses the most common risks of cataract surgeries, how to prove medical malpractice, and the challenges you will face in a cataract surgery medical malpractice lawsuit. Another possibility for lower mean and median indemnity payments for retained lens fragments in this study may be the use of OMIC data, since mean and median payments for all closed claims are lower for OMIC-insured physicians compared to others. The vitrectomy probe was inserted in an attempt to aspirate the lens, but the lens could not be aspirated to be removed. Vitrectomy for removal of retained lens material. Removal of retained lens fragments after phacoemulsification reverses secondary glaucoma and restores visual acuity. To review malpractice claims associated with retained lens fragments during cataract surgery to identify ways to improve patient outcomes. After the trial, the jurors were polled. The difference between the preoperative visual acuity and the final visual acuity was predictive of an indemnity payment (odds ratio [OR], 2.28; P=.001) and going to a trial (OR, 2.93; P<.001). Created for people with ongoing healthcare needs but benefits everyone. On 5/20/14, the patient was admitted to Cataract & Laser Center West, in W. Springfield, Massachusetts, for right eye phacoemulsification with implantation of posterior chamber intraocular lens. Pande M, Dabbs TR. Benson JS, Coogan CL. The negligent act must be a proximate cause of the plaintiffs injuries, which means the act was necessary for the injury when and in the manner it occurred, and the injury must be a foreseeable consequence of the negligent act. Boscher C, Lebuisson DA, Lean JS, Nguyen-Khoa JL. Cheney FW, Posner K, Caplan RA, Ward RJ. The .gov means its official. Ho SF, Zaman A. Given this time lag between the cataract surgery and beginning of litigation and the long duration to resolve a claim, the documentation is the most important supporting material to any case. Retained lens fragments in resident-performed cataract extractions. In 91 eyes, preoperative visual acuity was recorded for both eyes. Learn more Most previous studies on malpractice claims compared only the groups that went on to indemnity payment vs no payment. 19851989. The Oruc S, Kaplan HJ. In the multivariate analysis, two factors were found to be associated with indemnity payment: (1) the difference between preoperative visual acuity and final visual acuity and (2) the development of corneal edema or corneal decompensation. What is the recovery after cataract or lens replacement surgery? Cataract surgery involves removing a cloudy lens from the patient's eye and replacing it with a clear, artificial lens. Financial Disclosures: Mr Weber is an employee of Ophthalmic Mutual Insurance Company. Gonzalez ML. Retinal detachment in patients with retained lens fragments or dislocated posterior chamber intraocular lenses. The data collected were chosen based on the review of the literature to have a potential relevance to the outcome of litigations in ophthalmology916 or to the clinical outcomes2065 and were obtainable from the available documents from OMIC. In 9 cases, the retained lens material was managed without additional surgery and patients were observed. Complications of retained nuclear fragments in the anterior chamber after phacoemulsification with posterior chamber lens implant. In the multivariate analysis, only the amount of change between preoperative and final visual acuity ( logMAR visual acuity) was found to be statistically significant in predicting more severe legal outcome. Review of the literature indicates that complications associated with retained lens material include inflammation, corneal edema, elevated intraocular pressure, hypotony, subluxation or dislocation of IOL, retinal tears or detachments, vitreous hemorrhage, choroidal hemorrhage, cystoid macular edema, epiretinal membrane, and endophthalmitis. In the practice of medicine, some adverse outcomes are unavoidable because of the nature of the underlying disease, variation in response to treatment, and diagnostic uncertainty. Socioeconomic Characteristics of Medical Practice 1990/1991. Baker PS, Spirn MJ, Chiang A, et al. Although cataract procedures have become fairly routine and rarely have serious complications, there are some risks still associated with the surgery. Vitrectomy for retained lens fragments after phacoemulsification. If more than one physician was named in the claim, only the data on the primary surgeon was analyzed. Therefore, claims related to cataract surgery accounted for 33% of all closed claims during this period, and cataract surgeries complicated by retained lens fragments accounted for 4% of all closed claims and 12.5% of cataract-related claims. Furthermore, certain eyes are known to have an increased risk for developing this complication, including eyes with prior trauma, pseudoexfoliation, dense cataract, and history of having had prior vitrectomy surgery.42,49 Therefore, additional care should be taken during the cataract surgery in these eyes. For cataract surgery litigation, 119 cases (21 percent) led to settlements, totaling $22.9 million. In 3 cases, malfunctioning or unavailability of necessary equipment resulting in prolonged cataract surgery time was thought to have contributed to the patient movement and complication of capsular tear. Transactions of the American Ophthalmological Society, http://www.amaassn.org/ama1/pub/upload/mm/363/prp-201001-claim-freq.pdf, http://www.omic.com/about/financial_info/members_rpt.cfm, MVR blade to impale the fragment that landed on optic nerve, Duration of claim opening to closing (months), Duration between surgery and claim occurring (months), Duration of claim opening to closing (Months). Careers. Because visual acuity outcomes are often poor in eyes with associated retinal detachment, and the degree of loss of visual acuity is found to be a significant risk factor for a claim resulting in a trial or a payment, it is important to minimize retinal detachment by avoiding aggressive measures to handle dislocated lens material by the cataract surgeon. The mean payment was $117,688, and the median payment was $90,000. Furthermore, a review of closed claims by Studdert and colleagues80 showed that no injury had occurred in 3% of malpractice claims, and there had been no error in another 37% of claims. Kraushar MF. One month later, she developed a tractional retinal detachment, ciliochoroidal detachment, and hypotony. The patients visual acuity prior to cataract surgery was 20/200 and at the last follow-up, 5 months following vitrectomy, was 20/80. This is understandable, since the impact of poor final visual acuity would be greater for the patients who began with a reasonably good baseline visual acuity, and the degree of dissatisfaction would be greater as well. Kim JE, Flynn HW, Jr, Smiddy WE, et al. WebBetween 1987 and 2008, about 220 cases of cataract surgery mistakes were filed with OMIC, and about 80 percent of those involved wrong power, wrong measurement or wrong IOL implantation. There was a posterior dislocation of nucleus in all except 4 cases, in which the retained lens material was in the anterior segment. However, the cataract surgeon did not document having made this call and the case was settled. Vitrectomy for retained lens material after cataract extraction: the relationship between histopathologic findings and the time of vitreous surgery. Among the 108 cases in this study, the final dispositions of the claims were as follows: 12 cases (11%) were resolved by a trial, of which 2 cases (17%) resulted in a verdict in favor of the patient plaintiff and 10 cases (83%) cases with a verdict in favor of the physician defendant; 30 cases (28%) were settled; and 66 cases (61%) were dismissed. National Library of Medicine Scott IU, Flynn HW, Jr, Smiddy WE, et al. Another analysis was performed with the litigation outcomes grouped as (1) indemnity payment and (2) no indemnity payment. In these early referral cases, the claim was more likely to be dismissed. Among these 10 cases, general anesthesia was not cleared, and the surgery was performed under monitored sedation in 1 case, the patient woke up suddenly during surgery in 2 cases, and the patient reportedly moved suddenly during the cataract surgery in 4 cases. The Bohigian GM, Wexler SA. Claims that were dismissed, dropped, or closed without compensation were combined as dismissed, and the term dismissed was used interchangeably with closed without compensation, dropped, and withdrawn, unless specified. You should consult with an attorney in your state as soon as possible. Time limitations apply so be aware of them. Check Avvo for a listing of atto The hypothesis of the current study is that there may be differences among the groups of cases with different legal outcomes. Gedde SJ, Karp CL, Budenz DL. 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