Rossetti A, Doro D. Retained intravitreal lens fragments after phacoemulsification: complications and visual outcome in vitrectomized and nonvitrectomized eyes. The patient was informed of the complication. The patient was released to a general ophthalmologist. It involved a 70-year-old female patient who went from preoperative visual acuity of 20/60 to final visual acuity of no light perception. They ranged from a low of $7,500 to a high of $500,000. Florida and Louisiana each had 10 claims. The OMIC Professional Liability Policy defines a claim as a written notice or demand for money or services by the patient (plaintiff) to the insured (physician or entity) for compensation from a medical incident. 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. The first case closed in 1992 for $125,000, and the second case closed in 2002 for $250,000. WebHe noted that an error can occur in two ways: 1) The surgeon simply makes an incorrect calculation by selecting a stronger power for the anterior chamber lens rather than a Romero-Aroca P, Fernndez-Ballart J, Mndez-Marn I, Salvat-Serra M, Baget-Bernaldiz M, Buil-Calvo JA. Malpractice trends: viewing the data and avoiding the hot seat of litigation. Bricks study on cataract surgery claims also recommends earlier referral if there was a potential for retinal complications.10. The issue of malpractice has wide-ranging stakeholders, including our society. Sufficient and legible documentations, including visual acuity, intraocular pressure, status of the cornea, IOL position, and dilated fundus examination, are essential for risk management purposes. This is without adjustment for potential differences in dollar amount due to inflationary changes. More than 50% of obstetricians and gynecologists have already been sued before they reached the age of 40 years, and 90% of general surgeons aged 55 years and older have been sued. For cataract surgery litigation, 119 cases (21 percent) led to settlements, totaling $22.9 million. This gender spread was compared with OMIC data on demographics. Claims that settled during the trial or prior to the start date of the trial were included in the settlement group. Socioeconomic Characteristics of Medical Practice 1997/98. The patient was referred the same day as the complicated cataract surgery to the retina specialist, who performed pars plana vitrectomy on the following day without any complications. Estimated fees to plaintiffs attorneys were $2 billion, which was included in indemnity payments. ACOG Committee Opinion No.374. Also, claims with worse final visual acuity tended to have higher indemnity payments (Figure 6). WebCataract surgery injury occurs in approximately 12% of cases. Conservative management could be considered for eyes with good baseline visual acuity. Retrospective, noncomparative, consecutive case series. The documentation includes informed consent, office examination notes, operative notes, any conversation with the patient before or after the cataract surgery, as well as any discussions with a specialist. Levinson W, Roter DL, Mullooly JP, et al. The number of cases in each visual acuity grouping for claims with payment and no payment is also shown. 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. Every year, millions of people have routine surgery to replace a cataract that is, a lens in the eye that has become clouded. Michels RG, Shacklett DE. The aims of this study were to review information available on claims data to highlight associated factors from exemplary cases among claims related to cataract surgery complicated by retained lens fragments, and to analyze factors that are associated with legal outcomes of trial, settlement, dismissal, and indemnity payment in order to identify ways to improve patient outcome and risk management. bill1952 Has anyone who experienced a negative result from the Symfony lens brought a product liability lawsuit against Johnson and Johnson or a malpractice lawsuit against their eye surgeon? Schutz JS, Mavrakanas NA. The final visual acuity for claims resulting in indemnity payment vs no payment is shown in Figure 5. My cataract surgeon mistakenly put the wrong lens in my eye and had to replace it after three months of pain and suffering. Author Contributions: Design and conduct of the study (J.K.); Collection, management, analysis, and interpretation of the data (J.K., P.W., A.S.); Preparation, review, and approval of the manuscript (J.K., P.W., A.S.). In one of the claims, the cataract surgeon, who had some retinal training, attempted retrieval of the posteriorly dislocated lens material. 5.3k views Reviewed >2 years ago. Therefore, while retained lens fragment is an infrequent complication of cataract surgery, this complication has a potentially high likelihood of legal consequences. Ho LY, Doft BH, Wang L, Bunker CH. 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. Therefore, it appears that earlier referral is one of the ways a cataract surgeon can improve risk management. The retina successfully reattached with a final visual acuity of 20/25. Therefore, appropriate management of elevated intraocular pressure is necessary to reduce poor patient outcome. Gilliland GD, Hutton WL, Fuller DG. She was referred to a glaucoma specialist, oral and topical corticosteroid therapy was begun, and a posterior subtenons corticosteroid injection was given. One of the ways to reduce the complication of retained lens fragments could be monitoring and reducing the possibility of a sudden patient movement during surgery. Therefore, while retained lens fragment is an infrequent complication of cataract surgery, this complication has a potentially high likelihood of legal consequences. The Clinical features and outcomes of pars plana vitrectomy in patients with retained lens fragments. This current study did not ask which physicians are more likely to get sued when the cataract surgery is complicated by the retained lens fragment, since all cases in this study were closed claims and do not have a comparison group that encountered the complication but were not sued. WebIt was discovered that a 23-power lens was inserted in the left eye, instead of the intended 20-power lens. 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. 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. 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. The doctor used a technical lens for my right eye and a standard lens for the left one. In addition to corneal edema, inflammation from the lens material can result in elevated intraocular pressure that is significant enough to require pressure-lowering medication or development of glaucoma and potential visual field loss that require additional surgical intervention. During the surgery, the new lens was too small due to a The doctor-patient relationship and malpractice: lessons from plaintiff depositions. Duty to treat means that a doctor-patient relationship must be established prior to the alleged negligent act. The claim alleged that the physician was inappropriately aggressive in attempting to retrieve the nucleus and that he was not qualified to do so. He was referred to a retina specialist, who saw him the next day. Start here to find personal injury lawyers near you. 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. Brick DC. Lu H, Jiang YR, Grabow HB. Intraocular lens was implanted in 85 (90%) of 94 cases where this was recorded, with 63 (67%) being posterior chamber IOL and 22 (23%) being anterior chamber IOL. 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. Average defense costs per claim were $30,692 and ranged from a low of $0 to a high of $190,961. According to this report, 42% of physicians have been sued for medical malpractice at some point in their careers and 20% were sued at least twice during their careers.2 This survey found a wide variation in the incidence of liability claims between specialties. If a surgeon and the hospital or the practice (entity) were named in the claim, only the surgeons data was analyzed to avoid duplicity. 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. Among 108 patient claimants, 54 were men and 54 were women. 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). The mean age was 69 years (range, 4090 years). The mean payment was $117,688, and the median payment was $90,000. Learn how we can help. Claims, errors, and compensation payments in medical malpractice litigation. 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. Claims were excluded when found not to pertain to retained lens fragments but were due to dislocated intraocular lens (IOL), wrong intraocular lens, endophthalmitis, or retinal detachment following cataract surgery. how badly you were actually hurt and how much that injury actually cost you in medical expenses, lost wages, diminished quality of life, etc.
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