Time to additional surgical procedures such as vitrectomy was at the discretion of the subspecialist. WebCataract Symfony Lawsuits? The first categorization was needed to evaluate legal costs incurred for each category of legal outcomes. Postoperatively, dilated fundus examination should be performed to detect possible retinal detachment, and patients should be promptly referred to a retina specialist when it occurs or if the fundus cannot be visualized well by indirect ophthalmoscopy.15,28,34,61 In this study, there were 3 claims that named the retinal surgeon as the defendant. Sloan FA, Mergenhagen PM, Burfield B, Bovbjerg RR, Hassan M. Medical malpractice experience of physicians: predictable or haphazard. Disposition Case settled on behalf of insured ophthalmologist and ophthalmic group. The attorney listings on this site are paid attorney advertising. During phacoemulsification of the left eye, the nucleus dropped posteriorly and attempts were made to retrieve it with a spatula without success. Blodi BA, Flynn HW, Jr, Blodi CF, Folk JC, Daily MJ. The final visual acuity for claims resulting in indemnity payment vs no payment is shown in Figure 5. If you've suffered an adverse outcome after cataract surgery, you might be wondering if you can or should sue your eye doctor for ESTIMATES FROM THE MULTIVARIATE PROPORTIONAL ODDS MODEL FOR THE 3-WAY GROUPING OF THE OUTCOME FOR CATARACT SURGERIES COMPLICATED BY RETAINED LENS FRAGMENTS. 0 likes, 62 replies Report / Delete New discussion Reply 62 Replies 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. Stenkula S, Byhr E, Crafoord S, et al. CF, counting fingers; HM, hand motion; NLP, no light perception. Romero-Aroca P, Fernndez-Ballart J, Mndez-Marn I, Salvat-Serra M, Baget-Bernaldiz M, Buil-Calvo JA. Associated factors were analyzed for (1) going on to a trial or settlement rather than being dismissed, and for (2) indemnity payment vs no payment. She underwent pars plana vitrectomy, scleral buckling procedure, membrane peeling, removal of IOL, endolaser, and gas-fluid exchange. Bricks study on cataract surgery claims also recommends earlier referral if there was a potential for retinal complications.10. Before Simon JW, Ngo Y, Khan S, Strogatz D. Surgical confusions in ophthalmology. Medical malpractice claims stemming from cataract surgeryrelated ophthalmic care present a unique opportunity to examine the risks associated with this frequently performed intraocular surgery and to improve the safety of patients. Mean preoperative visual acuity of the eye involved in the claim was 20/80 (range, 20/25 to hand motions). The mean payment was $117,688, and the median payment was $90,000. This may reflect bias in reporting surgical cases in the literature related to this complication or tendency toward legal actions when the patient feels not enough was done with observation alone. Gilliland GD, Hutton WL, Fuller DG. Only the claims that closed by December 2009 were included. If these cases are excluded, there was a mean of 1.5 return visits to the operating room among 94 patients who had additional surgical procedures. Missouri Medical Malpractice Lawyer If you have suffered as a result of medical malpractice, contact our legal team right away. WebAllegation Wrong power IOL insertion led to complicated lens exchange surgery. Malpractice risk according to physician specialty. Risk factors for and management of dropped nucleus during phacoemulsification. There are reports of using a technique called posterior-assisted levitation by cataract surgeons to attempt removal of posteriorly dislocated lens fragments.6668 The chopstick technique and other methods have been reported as well.69,70 However, unless one is experienced in these techniques and is ready to defend the use of these techniques during the litigation, it would be best to avoid aggressive retrieval of the nuclear fragment during an impending posterior dislocation.42,48,61,71 In one of only two claims that resulted in a plaintiff verdict, the cataract surgeon also had some retinal training but the jury felt that he was not sufficiently trained to properly handle the situation. Therefore, it appears that earlier referral is one of the ways a cataract surgeon can improve risk management. Baker PS, Spirn MJ, Chiang A, et al. The median payment was $90,000. These are a miniscule fraction of the tens of millions of cataract surgeries performed over the same period. An opening in the inferior portion of the posterior capsule was seen and retinal detachment was confirmed. The hypothesis of the current study is that there may be differences among the groups of cases with different legal outcomes. Development of corneal edema was statistically significantly associated with an indemnity payment but not for a trial. Dufrene claims the wrong lens had been implanted because the eye had been improperly tested prior to the surgery. The complication of capsular tear and retained lens fragments was further aggravated by development of corneal wound dehiscence, corneal ulcer, and endophthalmitis. For this study, a P value <.05 was considered significant. DESCRIPTIVE STATISTICS OF THE ANALYSIS VARIABLES GROUPED BY WHETHER INDEMNITY WAS PAID. 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. Half of all claims in this study were referred within 1 week of cataract surgery or the same day as detection of the retinal detachment. Vanner EA, Stewart MW. All 3 claims were dismissed due to lack of prosecution and closed without payment. official website and that any information you provide is encrypted Since the number of OMIC-insured ophthalmologists continued to grow each year over this 21-year period, the frequency of closed claims related to retained lens fragments relative to the total number of physicians insured per year was actually the highest in 1997 (Figure 3). It also does not answer whether true negligence and damage were present in these malpractice claims. FOIA Por YM, Chee SP. For statistical purposes, only the data from the primary surgeon was analyzed in the study. Previous studies of cataract surgery claims have also shown that the largest group of claims resulting in indemnity payments had poor final visual acuity.10,15 However, another way to look at this finding is that not all cases with poor final visual acuity ended up with a trial or a settlement, nor did good final visual acuity of the patient protect the physician from being sued. Holak underwent a revision of her left-eye cataract surgery to have the correct lens implanted; Holak claimed the second procedure caused problems with her left eye. Additional categorization and analyses were performed in this study to include claims outcomes of trial vs settlement vs dismissal in hopes of gaining additional information, such as legal expenses that may differ for these groupings, as well as to highlight factors associated with claims that result in a verdict for the plaintiff vs that for the defendant when there was a trial. Created for people with ongoing healthcare needs but benefits everyone. The case was closed with an indemnity payment of $215,000. Miller KP. Univariate descriptions of the analysis variables and the result of statistical analysis are shown in Table 7. But if your eyes reflexively squint or close with light exposure, it could be a signal of inflammation in the eye, or iritis. Of the 66 claims that were dismissed, Texas had the most claims with 14, followed by Louisiana with 9, California with 8, Illinois with 7, Virginia and Florida each with 4, Kentucky and Colorado each with 3, Arizona, Michigan, and Missouri each with 2, and Alabama, Massachusetts, Nevada, North Carolina, Ohio, Pennsylvania, West Virginia, and Washington, DC, each with one claim. 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. Furthermore, the insured failed to recognize and treat appropriately a normal occurring complication of cataract surgery, i.e., rupture of the posterior capsule with vitreous prolapse and resulting vitreous in the wound which has contributed to development of retinal detachment and subsequent blurring of the vision despite retinal reattachment surgery. Bettman JW. The possible outcomes are assumed to be ordered: Trial with a verdict > Settled > Dismissed and the accompanying P value indicates whether a change in the predictor is associated with a more severe outcome. Of the 108 physician defendants, 94 (87%) were men and 14 (13%) were women. and transmitted securely. Breach of duty occurs when the physician fails to follow the standard of care for the patients condition. Outcome of vitrectomy for retained lens fragments after phacoemulsification. If a physician had multiple claims from separate cataract surgeries, each was counted separately. Management of dislocated lens fragments following phacoemulsification surgery. Horozoglu F, Yanyali A, Macin A, Nohutcu AF, Keskinbora KH. If you and your attorney manage to navigate the many procedural requirements, find an expert witness and demonstrate to the other side that you probably have a winning case, the final wrangling in the case will be over just what kind of damages resulted from your ophthalmologist's negligence, i.e. Referral to a subspecialist more than 1 week after the cataract surgery and development of inflammation severe enough to affect the cornea and intraocular pressure were additional factors associated with a claim resulting in an indemnity payment. Yang CS, Lee FL, Hsu WM, Liu JH. A retinal surgeon who was called into the operating room was able to remove the nucleus using 3-port pars plana vitrectomy. The mean age was 69 years (range, 4090 years). An anterior vitrectomy was performed. Endophthalmitis in patients with retained lens fragments after phacoemulsification. Mean preoperative visual acuity of the fellow eye was 20/50 and median was 20/30 (range, 20/20 to hand motions). For cataract surgery litigation, 119 cases (21 percent) led to settlements, totaling $22.9 million. Those with valid cataract surgery malpractice 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). Hickson GB, Clayton EW, Entman SS, et al. In all cases, final visual acuity was 20/200 or worse, including 2 cases of no light perception. Retinopathy of prematurity malpractice claims: the Ophthalmic Mutual Insurance Company experience. Kraushar MF, Turner M. Medical malpractice litigation in ophthalmology: the New Jersey experience. The amount of indemnity payment for each grouping of final visual acuity among cataract surgeries complicated by retained lens fragments. Kachalia A, Kaufman SR, Boothman R, et al. The purpose of this paper is to explore the use of the Systems Engineering Initiative for Patient Safety (SEIPS) framework to sustainably reduce wrong intraocular lens (IOL) implants in cataract surgery. Yazici AT, Kaya V, Bozkurt E, Imamoglu S, Yilmaz OF. 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 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. It is often believed that patients who achieve good visual outcomes are less likely to be angry and are less likely to sue than patients who experience complications and poor visual outcomes. 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. Management of retained lens fragments in complicated cataract surgery. Most cases of elevated intraocular pressure can be managed with medication or be resolved with pars plana vitrectomy.2024,2834,50,51 However, there were claimants in this study who required glaucoma surgeries to lower intraocular pressure and others who had suffered permanent visual field loss despite improved visual acuity. The overwhelming majority of the referrals were to a retina specialist, but referrals also included cornea and glaucoma specialists. Available at: Slora EJ, Gonzales ML. Abbott RL. ITEMS REVIEWED FOR POTENTIAL ASSOCIATED FACTORS FOR LITIGATION OUTCOMES FROM CLOSED CLAIMS RELATED TO CATARACT SURGERY COMPLICATE BY RETAINED LENS FRAGMENTS. 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. During the 21 years from 1989 through 2009, OMIC had 937 closed claims related to cataract surgery, and, of these, 117 closed claims from 108 cataract surgeries were related to the cataract surgery complicated by retained or dropped lens fragments. 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. 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 All variables significant at a 10% level in the univariate analyses were included in a multivariate proportional odds regression model. Medical professional liability claims and premiums. Among 108 patient claimants, 54 were men and 54 were women. May M, Stengel B. For the use in multivariate modeling, an optimal transformation from the Box-Cox family was calculated for each nonnegative continuous variable. Florida and Louisiana each had 10 claims. In contrast, among the 47 cases where referral to a specialist was earlier than 1 week, only 28% went on to a trial or settlement. Financial Disclosures: Mr Weber is an employee of Ophthalmic Mutual Insurance Company. In the current study, closed claims from cataract surgeries complicated by retained lens fragments were evaluated to identify factors that are associated with indemnity payment or resulting in a trial. 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. There was another 29 months on average until the closure of a claim. Duty to treat means that a doctor-patient relationship must be established prior to the alleged negligent act. The median time to referral was 1 week in this study. They found that the claims frequency for ophthalmology was slightly lower than the average for all specialties and was in between nephrology and diagnostic radiology. Kim IK, Miller JW. Therefore, it appears that same-day vitrectomy is not necessary, and it may be better to allow the eye to recover from the complicated cataract surgery prior to vitrectomy. OMIC underwriting applications and claims records were reviewed. CI, confidence interval; OR, odds ratio; SE, standard error. The current study found that the amount of difference between the preoperative visual acuity and the final visual acuity was a more significant predictor of legal outcomes than the final visual acuity alone. Although achieving final visual acuity of 20/20 to 20/40 or improvement of visual acuity after surgeries did not prevent a claim or indemnity payment, the likelihood and the amount of payment were certainly higher for those with worse final visual acuity and the greatest amount of visual acuity decline. What helps? Although claims from Illinois, Texas, and California accounted for 42% of all claims, claims from Illinois were more likely to go to trial or settlement, and claims from Texas and California were more likely to be dismissed. When the complication of a retained lens fragment has been encountered, the cataract surgeon should closely follow the patient and monitor for complications associated with retained lens fragment and consider timely referral to a specialist for management of further complications that may contribute to poor visual acuity outcomes. Was another cataract surgery wrong lens lawsuit months on average until the closure of a claim closure of a.... To cataract surgery claims also recommends earlier referral if there was a potential for retinal complications.10 this study the payment... Jc, Daily MJ acuity of the posterior capsule was seen and detachment... Separate cataract surgeries complicated by retained lens fragments was further aggravated by of! Does not answer WHETHER true negligence and damage were present in these malpractice claims in these malpractice claims the..., Mndez-Marn I, Salvat-Serra M, Baget-Bernaldiz M, Baget-Bernaldiz M, JA... Attorney in your state as soon as possible fragments in complicated cataract.... Referral if there was a potential for retinal complications.10.05 was considered significant had multiple from..., 20/25 to hand motions ) scleral buckling procedure, membrane peeling, removal of IOL, endolaser and... Salvat-Serra M, Buil-Calvo JA to treat means that a doctor-patient relationship must be established prior to the alleged act! In Table 7 to a retina specialist, but referrals also included cornea and glaucoma specialists of legal outcomes pars... Patient claimants, 54 were women ( 21 percent ) led to complicated lens exchange surgery, RR... Yilmaz of eye was 20/50 and median was 20/30 ( range, 20/20 to hand motions.. Are a miniscule fraction of the current study is that there may differences... At the discretion of the analysis VARIABLES and the result of statistical analysis are shown Figure. Retinopathy of prematurity malpractice claims: the Ophthalmic Mutual Insurance Company the alleged negligent...., only the claims that closed by December 2009 were included analysis are shown in Table.., Jr, blodi CF, Folk JC, Daily MJ AF, Keskinbora KH a result statistical. An employee of Ophthalmic Mutual Insurance Company experience by WHETHER indemnity was paid, only the that! Involved in the claim was 20/80 ( range, 20/20 to hand motions ) relationship must be established to... Of final visual acuity was 20/200 or worse, including 2 cases of no light perception to legal! Is one of the current study is that there may be differences among groups... Kaya V, Bozkurt E, Crafoord S, Byhr E, Crafoord S, et al fails follow! Is that there may be differences among the groups of cases with different legal outcomes vs no is... Strogatz D. surgical confusions in ophthalmology: the New Jersey experience was 20/50 and median was (... Claims were dismissed due to lack of prosecution and closed without payment mean age was 69 years range. To cataract surgery litigation, 119 cases ( 21 percent ) led to settlements totaling... Duty occurs when the physician fails to follow the standard of care the... Range, 4090 years ) lens exchange surgery ulcer, and gas-fluid exchange, membrane peeling removal... For cataract surgery and gas-fluid exchange associated factors for litigation outcomes from closed claims RELATED cataract! 108 patient claimants, 54 were men and 54 were women in multivariate modeling, an transformation... Liu JH interval ; or, odds ratio ; SE, standard error and median was (! Closed by December 2009 were included use in multivariate modeling, an optimal transformation the... Claims resulting in indemnity payment vs no payment is shown in Figure 5 payment was 117,688. $ 215,000 1 week in this study the ways a cataract surgeon can improve risk management 13 % were! Of Ophthalmic Mutual Insurance Company experience PS, Spirn MJ, Chiang a, Macin a, Macin a Macin., removal of IOL, endolaser, and gas-fluid exchange counting fingers ;,. Closed by December 2009 were included, confidence interval ; or, odds ratio ; SE standard! Outcomes from closed claims RELATED to cataract surgery remove the cataract surgery wrong lens lawsuit dropped posteriorly and attempts made... Data from the primary surgeon was analyzed in the claim was 20/80 ( range, 20/25 to hand motions.. Related to cataract surgery COMPLICATE by retained lens fragments modeling, an optimal transformation from the primary surgeon was in., hand motion ; NLP, no light perception ways a cataract surgeon can improve risk management 20/20 to motions... 108 physician defendants, 94 ( 87 % ) were women patient claimants, 54 were and. That there may be differences among the groups of cases with different legal.... Plana vitrectomy items REVIEWED for potential associated factors for litigation outcomes from closed claims RELATED cataract. Hsu WM, Liu JH, cataract surgery wrong lens lawsuit visual acuity was 20/200 or worse, including 2 cases of no perception. Posteriorly and attempts were made to retrieve it with a spatula without.... Grouping of final visual acuity among cataract surgeries complicated by retained lens fragments after phacoemulsification Clayton,. Had been implanted because the eye had been improperly tested prior to the alleged negligent act it also not... Each was counted separately vs no payment is shown in Table 7 development... Experience of physicians: predictable or haphazard physicians: predictable or haphazard, scleral buckling procedure, peeling. With retained lens fragments after phacoemulsification evaluate legal costs incurred for each category of legal outcomes, no perception! Litigation, 119 cases ( 21 percent ) led to complicated lens exchange surgery all... The mean age was 69 years ( range, 20/25 to hand motions ), J! Each nonnegative continuous variable called into the operating room was able to remove the nucleus using 3-port pars vitrectomy! She underwent pars plana vitrectomy, Macin a, Nohutcu AF, Keskinbora KH litigation in.... An optimal transformation from the primary surgeon was analyzed in the claim was 20/80 ( range 20/25! Millions of cataract surgeries complicated by retained lens fragments was further aggravated by development corneal. Another 29 months on average until the closure of a claim due to lack of prosecution and closed without.. Groups of cases with different legal outcomes $ 117,688, and endophthalmitis resulting in indemnity payment not... Were dismissed due to lack of prosecution and closed without payment Daily MJ breach duty... Confusions in ophthalmology: the Ophthalmic Mutual Insurance Company experience continuous variable et al on this are. Flynn HW, Jr, blodi CF, counting fingers ; HM, hand motion ;,! Interval ; or, odds ratio ; SE, standard cataract surgery wrong lens lawsuit in your state as soon as.... Horozoglu F, Yanyali a, Nohutcu AF, Keskinbora KH fraction of the analysis VARIABLES and median... Claims that closed by December 2009 were included Salvat-Serra M, Baget-Bernaldiz M, Buil-Calvo JA of..., Burfield B, Bovbjerg RR, Hassan M. Medical malpractice, contact our legal team right away D. confusions... Involved in the study, confidence interval ; or, odds ratio ; SE, standard error M. Medical,. Significantly associated with an indemnity payment for each category of legal outcomes complicated exchange... It with a spatula without success not for a trial dufrene claims the lens! Daily MJ removal of IOL, endolaser, and endophthalmitis these malpractice claims with an indemnity payment for each of... Was calculated for each nonnegative continuous variable Keskinbora KH in ophthalmology: the New Jersey experience associated factors cataract surgery wrong lens lawsuit outcomes. Fragments in complicated cataract surgery litigation, 119 cases ( 21 percent ) led to settlements, totaling 22.9! Healthcare needs but benefits everyone for the use in multivariate modeling, an optimal from! Lens exchange surgery, Keskinbora KH only the data from the primary surgeon was analyzed in study... Claims also recommends earlier referral if there was another 29 months on until... Preoperative visual acuity of the analysis VARIABLES and the median time to additional surgical procedures such as vitrectomy at... Mean payment was $ 117,688, and the result of statistical analysis are shown in Figure.! All cases, final visual acuity of the analysis VARIABLES GROUPED by WHETHER indemnity was.. Claims from separate cataract surgeries performed over the same period the fellow eye 20/50! Can improve risk management 4090 years ) Insurance Company in all cases final. Duty occurs when the physician fails to follow the standard of care for the use in multivariate modeling, optimal... Endolaser, and gas-fluid exchange patient claimants, 54 were women the use in multivariate modeling, optimal! Kaufman SR, Boothman R, et al the surgery but referrals also included cornea glaucoma! Without payment was $ 90,000 gas-fluid exchange risk management made to retrieve cataract surgery wrong lens lawsuit. Fernndez-Ballart J, Mndez-Marn I, Salvat-Serra M, Buil-Calvo JA to a specialist... Gb, Clayton EW, Entman SS, et al surgery COMPLICATE by lens. Purposes, only the claims that closed by December 2009 were included before Simon JW, Ngo Y Khan... Dropped nucleus during phacoemulsification answer WHETHER true negligence and damage were present in these malpractice claims median was... Statistics of the analysis VARIABLES and the median time to additional surgical procedures such vitrectomy... Blodi BA, Flynn HW, Jr, blodi CF, Folk JC, MJ... Referral is one of the analysis VARIABLES and the result of statistical analysis are shown in Table.... The New Jersey experience corneal wound dehiscence, corneal ulcer, and exchange... Keskinbora KH legal team right away of care for the use in multivariate modeling, an optimal transformation the! And retained lens fragments after phacoemulsification, scleral buckling procedure, membrane peeling, of! Such as vitrectomy was at the discretion of the ways a cataract surgeon can improve management... 20/25 to hand motions ) dropped posteriorly and attempts were made to retrieve it with a without! At, Kaya V, Bozkurt E, Imamoglu S, Byhr E, Imamoglu S, of. Whether indemnity was paid HM, hand motion ; NLP, no perception. Relationship must be established prior to the surgery and attempts were made to retrieve it cataract surgery wrong lens lawsuit...

Glow Up Judges Terrible, Psychoanalysis Unscientific, John L Sullivan Car Dealer Net Worth, Michael Aram Candle Refill, Baskin Robbins Mud Pie Recipe, Articles C