Moore JK, Scott IU, Flynn HW, Jr, et al. WebSurgery for cataracts involves removing the cataract-ridden lens of the eye and either replacing it with an artificial lens called an IOL implant or compensating for its absence with eyeglasses or contact lenses. Yazici AT, Kaya V, Bozkurt E, Imamoglu S, Yilmaz OF. There appeared to be differences in legal outcomes depending on the state where the physician practiced, such that claims from Louisiana were most likely to be dismissed. Because the patient was receiving warfarin therapy, pneumatic retinopexy was performed. Cataract surgery with phacoemulsification is a procedure that has an initial steep learning curve, and the complication of retained lens fragment is more likely with phacoemulsification than with extracapsular cataract extraction. Of the 108 defendants, 105 (97%) were cataract surgeons and only 3 (3%) were retinal surgeons. Clinical predictors and outcomes of pars plana vitrectomy for retained lens material after cataract extraction. Furthermore, they estimated that an additional $45.59 billion was spent on defensive medicine, most of which went to pay for tests, procedures, and treatments associated with defensive medicine. WebThe plaintiff, a 56-year-old man, suffered permanent right eye vision loss following cataract surgery. She was referred to a glaucoma specialist, oral and topical corticosteroid therapy was begun, and a posterior subtenons corticosteroid injection was given. 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. Although some bleeding occurred, no retinal tear or detachment was noted. These included the number of ophthalmologists insured by OMIC from 1989 through 2009, the number of closed claims related to cataract surgery, OMIC policyholder demographics, and average indemnity payments for OMIC policyholders. Cheney FW, Posner K, Caplan RA, Ward RJ. Another study found that 7.4% of all physicians had a malpractice claim each year, with 1.6% having a claim leading to a payment.5 The proportion of physicians facing a claim each year ranged from 2.6% in psychiatry to 19.1% in neurosurgery. i'm sorry to read of your troubles and I know enough as a practicing physician for 20 years that your course has deviated from the typical cataract Careers. Ways to reduce significant vision loss, including improved management of corneal edema and IOP, and timely referral to a subspecialist should be considered. Please reference the Terms of Use and the Supplemental Terms for specific information related to your state. According to the 2010 report to the OMIC members, approximately 17% of practicing ophthalmologists in the United States are female and 18% of OMIC-insured ophthalmologists are female.17. American College of Obstetricians and Gynecologists. My cataract surgeon mistakenly put the wrong lens in my eye and had to replace it after three months of pain and suffering. Management of nucleus loss into the vitreous: long term follow up in 63 patients. Given the differences in the frequency of claims for various medical specialties and the limited number of studies in the literature related to malpractice claims in ophthalmology, this current study used the available data from a large ophthalmology-specific insurance company in an effort to gather specialty-specific data. The overwhelming majority of the referrals were to a retina specialist, but referrals also included cornea and glaucoma specialists. Start here to find personal injury lawyers near you. Dr Kim has been on the advisory board for Alimera Science, Allergan, and Genentech. Vanner EA, Stewart MW. The mean defense cost for 12 cases that went on to a trial was $96,464 with a mean defense cost of $97,924 for cases with a defense verdict and $95,004 for cases with a plaintiff verdict; the mean expense for claims that were dismissed was $9,226. Vitrectomy timing for retained lens fragments after surgery for age-related cataracts: a systemic review and meta-analysis. During phacoemulsification of the left eye, the nucleus dropped posteriorly and attempts were made to retrieve it with a spatula without success. 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. However, when there was a claim related to retained lens fragments, this study found that the age and gender of the physician did not affect the legal outcomes. 5.3k views Reviewed >2 years ago. The defendant prevailed in 83% of trials. Initiation and compliance with any medications to treat inflammation or increased intraocular pressure should be documented. Bovbjerg RR, Petronis KR. Although the final visual acuity was important, the most important factor associated with going to a trial or resulting in an indemnity payment was found to be the amount of visual acuity loss following cataract surgery complicated by retained lens fragments, such that the greater the difference between the baseline visual acuity and the final visual acuity, the greater the likelihood of a claim resulting in a trial or indemnity payment. Indemnity payments totaling more than $3,586,000 were made in 32 (30%) of the cases. In another case, the operative note was the usual macro for standard cataract surgery and did not seem to take into account the problems encountered during the surgery. When intraocular pressure or inflammation cannot be managed adequately or cystoid macular edema is detected, the patient should be definitely referred to a specialist. When the verdict was in favor of the plaintiff, the indemnity payment was higher than the settled cases and the legal expense related to the claim was higher than the mean of all closed claims for retained lens fragments. She underwent pars plana vitrectomy, scleral buckling procedure, membrane peeling, removal of IOL, endolaser, and gas-fluid exchange. However, how this complication was managed intraoperatively and postoperatively, what degree of injury resulted, as well as how the informed consent was presented preoperatively, will determine whether or not malpractice occurred due to substandard care that resulted in harm to the patient. Smiddy WE, Guererro JL, Pinto R, Feuer W. Retinal detachment rate after vitrectomy for retained lens material after phacoemulsification. Management of retained intravitreal lens fragments after phacoemulsification surgery. Her preoperative visual acuity was 20/25 in the right eye and 20/60 in the left eye, which fell to 20/400 with glare testing. Oruc S, Kaplan HJ. As noted already, the majority of claims are dropped, dismissed, or closed without payment. However, as consultants, vitreoretinal surgeons should remember that they are still at a risk for being included in lawsuits directed toward other physicians and may be named as primary defendants due to significant potential for severe visual impairment among the conditions they manage.16. They found significantly better clinical outcomes with earlier vitrectomy for retained lens fragments with regard to visual acuity, retinal detachment, increased intraocular pressure, intraocular infection, and inflammation. The new PMC design is here! Medical malpractice cases present a complex interaction between medical and legal issues, and it typically takes an experienced medical malpractice attorney working alongside a well-qualified expert witness to present the best case. Because the surgeon ultimately becomes responsible for the outcome of the surgery, it is important to communicate with the anesthesiologist as well as to oversee and proactively troubleshoot any preventable disasters in the operating room.93. 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. Professional liability insurance: II The legal environment. But if your eyes reflexively squint or close with light exposure, it could be a signal of inflammation in the eye, or iritis. Bohigian GM, Wexler SA. CLAIMS WITH INDEMNITY PAYMENT BY FINAL VISUAL ACUITY AND CHANGE IN VISUAL ACUITY AMONG CATARACT SURGERIES COMPLICATED BY RETAINED LENS FRAGMENTS. Since it takes over 44 months on average between cataract surgery and close of a claim, there still may be open claims from years 2006 and forward. Blodi BA, Flynn HW, Jr, Blodi CF, Folk JC, Daily MJ. Do Not Sell or Share My Personal Information, Do Not Sell or Share My Personal Information, improper application of anesthesia, such as globe perforation, and, a variety of post-operative complications, such as swelling, Pre-suit requirements like screening panels, advance notice of the lawsuit, mandatory settlement negotiations and ", Expert witnesses experienced in the particular field of health care must testify on behalf of either, The total amount a plaintiff can recover from a health care provider might be limited by a ". 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. Financial Disclosures: Mr Weber is an employee of Ophthalmic Mutual Insurance Company. Hickson GB, Clayton EW, Entman SS, et al. Hickson GB, Clayton EW, Githens PB, Sloan FA. To be insured by OMIC, an ophthalmologist must be a member of the American Academy of Ophthalmology. Pars plana vitrectomy for the management of retained lens material after cataract surgery. January 3, 2019 $500,000 Jury Verdict for Injury to Patient Whose Eyesight Was Harmed by Negligent Cataract Surgery by Robert Kreisman Deborah DeFranko was diagnosed by ophthalmologist Dr. Taylor Poole as having cataracts. In the second case, a male patient with advanced posterior subcapsular cataract in the left eye underwent cataract surgery with phacoemulsification in 1996, reportedly without complications. After 2 surgeries within 2 wks on same eye, it is slow to heal, having difficulty seeing, having soreness & pain. Distribution of closed claims related to retained lens fragments by region in the United States. Vincent C, Young M, Phillips A. Funding/Support: Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc, New York, New York (J.K.) and by grant 1UL1RR031973 from the Clinical and Translational Science Award program of the National Center for Research Resources, National Institutes of Health (A.S.). Vitrectomy, scleral buckling procedure, membrane peeling, removal of IOL, endolaser, gas-fluid. Peeling, removal of IOL, endolaser, and gas-fluid exchange injection was given the Supplemental Terms for specific related! 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