cataract surgery wrong lens lawsuit

Comparison between claims with indemnity payment and no payment by final visual acuity among cataract surgeries complicated by retained lens fragments. Learn how we can help. 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. CLAIMS WITH A DOCUMENTATION OF INTRAOPERATIVE MANIPULATION BY THE CATARACT SURGEON DURING MANAGEMENT OF POSTERIOR DISLOCATION OF LENS FRAGMENTS. American College of Obstetricians and Gynecologists. Federal government websites often end in .gov or .mil. After the trial, the jurors were polled. In a study by Mello and colleagues, 95 the investigators broke down the costs of malpractice for the United States in 2008 as follows: indemnity payments of $5.72 billion and administrative expenses of $4.13 billion, which included $1.09 billion in fees to defense attorneys and $3.04 billion in overhead expenses. In comparison, 30% of 108 claims related to retained lens fragments resulted in an indemnity payment with an average payment of $117,688. CF, counting fingers; HM, hand motions; LP, light perception; MVR, microvitreoretinal; NLP, no light perception; PPL, pars plana lensectomy; PPV, pars plana vitrectomy; RD, retinal detachment; VA, visual acuity. Whether the findings of this study are representative depends on whether physicians who were covered by the insurance carrier of this study were more or less likely to be sued than physicians who were insured elsewhere. 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. 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. Therefore, the total cost of malpractice claims for these 108 cases was nearly $7 million. 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. 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.). Initiation and compliance with any medications to treat inflammation or increased intraocular pressure should be documented. Cataracts cause foggy or blurred vision that makes it hard to do everything from reading to Physicians with higher clinical activity also may have greater exposure or deal with more complex medical situations. Kraushar MF. Kraushar MF, Robb JH. The relationship between physicians malpractice claims history and later claims: does the past predict the future? The patient was informed of the complication. Simon and colleagues12 found that the most common surgical confusion in ophthalmology was use of the wrong IOL implants. Management of retained intravitreal lens fragments after phacoemulsification surgery. Smiddy WE, Flynn HW, Jr, Kim JE. 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. 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. Ross WH. Yazici AT, Kaya V, Bozkurt E, Imamoglu S, Yilmaz OF. Once an insured becomes aware that a wrong site surgery or incorrect power iOL insertion has occurred, the incident should be reported to OMICs Claims Department or confidential Risk Management hotline at (800) 562-6642, option 2 An example of one unit change in visual acuity would be going from 20/20 to 20/200. The mean and median indemnity payments for this group of claims were similar to mean and median of all ophthalmology-related claims combined for this single specialty insurance company. The value of a cataract surgery lawsuit can vary depending on the severity of the injury, how it was caused, and the amount of medical care and treatment required. Although cataract procedures have become fairly routine and rarely have serious complications, there are some risks still associated with the surgery. 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). Physicians with higher frequency of patient complaints may indicate less attention to interpersonal or technical aspects of patient care.2,8691 Interestingly, a physicians credentials, such as board certification, ranking of medical school attended, and foreign medical school graduate vs US graduate, did not have a significant impact on whether a physician was more likely to get sued or not.4 However, various studies indicate that the risk of being sued appears to be related to patients dissatisfaction, which may be related to their physicians ability to establish rapport, provide access, administer care consistent with expectations, and communicate effectively and in a timely fashion.4, 8791 Other physicians who subsequently manage the patient may also have a role in the patients decision to bring a claim.91. WebAllegation Wrong power IOL insertion led to complicated lens exchange surgery. Therefore, medical malpractice added over $55 billion to the nations total healthcare costs both directly through malpractice claims and indirectly to avoid claims.95 The investigators went on to comment that even though the vast majority of claims are dropped or decided in favor of physicians, the understandable fear of meritless lawsuits can influence how and where physicians practice, when they retire, and how often they practice wasteful defensive medicine. Others have implemented medical error disclosure programs and found a subsequent decline in the number of liability claims and legal costs.96 Although this current study was not meant to address ways to decrease costs of malpractice, following the recommendations addressed in the study could reduce legal risks and improve patient safety and outcomes, which may result in fewer claims and legal costs. The average cataract surgery settlement was for $192,865. Who sues their doctors? Kraushar MF, Turner M. Medical malpractice litigation in ophthalmology: the New Jersey experience. 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. The model was simplified using backward selection keeping all predictors with a P value of .25 or less. Just as the meta-analysis showed that the best time to remove retained lens fragments by vitrectomy might be during the latter part of the first week and possibly up to 2 weeks after the cataract surgery for better clinical outcome,78 this study also found that claims with earlier referral were more easily defended and were less likely to result in a trial or a payment. Medical professional liability claims and premiums. Ho and colleagues37 recommended that cataract surgeons refer patients with retained lens fragments to a retina specialist within 7 days for consideration of a pars plana vitrectomy to decrease the risk of developing secondary glaucoma. 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.). The distribution of the number of closed claims related to the complication of retained lens fragments per year from 1989 through December 2009 is shown in Figure 2. In this study, the cataract surgery that was complicated by retained lens fragments had been performed before 1996 in approximately 25% of claims, after 2002 in another 25%, and between 1996 and 2002 in the remaining 50%. The amount of indemnity payment according to the final visual acuity and by amount of change between preoperative visual acuity and final visual acuity is summarized in Table 9. If you've suffered an adverse outcome after cataract surgery, you might be wondering if you can or should sue your eye doctor for For cataract surgery litigation, 119 cases (21 percent) led to settlements, totaling $22.9 million. 23-gauge transconjunctival sutureless vitrectomy for retained lens fragments after complicated cataract surgery. 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 Management of dislocated nuclear fragments after phacoemulsification. Retained nuclear fragment in the anterior segment. This study was not designed to answer whether claims resulted from lack of adherence to practice guidelines or standard of care. Clinical features and outcomes of pars plana vitrectomy in patients with retained lens fragments after phacoemulsification. Retinal detachment in patients with retained lens fragments or dislocated posterior chamber intraocular lenses. Acuity improved to 20/200, but eventually the eye became phthisical with light perception vision at 19 months after the initial cataract surgery. Abbott RL. Even when a trial ended in favor of a defendant and no payment was made to the plaintiff, the legal expenses were nearly twice that of claims that settled. Murat Uyar O, Kapran Z, Akkan F, Cilsim S, Eltutar K. Vitreoretinal surgery for retained lens fragments after phacoemulsification. Rosenbaum JT, Samples JR, Seymour B, Langlois L, David L. Chemotactic activity of lens proteins and the pathogenesis of phacolytic glaucoma. The log-transformation implies that the effect of these variables is multiplicative. Baker PS, Spirn MJ, Chiang A, et al. Professional liability insurance: II The legal environment. In 10 cases, the tear reportedly occurred as a result of a sudden movement of the patient during surgery. However, the majority of the claims were dismissed and did not result in an indemnity payment. 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. There were 11 cases (10%) from the Northeastern states, 32 (30%) from the Midwest, 25 (23%) from the Western states, 12 (11%) from the Southern states, and 28 (26%) from the Southeastern states. Clinical features and outcomes of pars plana vitrectomy in patients with retained lens fragments. She was referred to a glaucoma specialist, oral and topical corticosteroid therapy was begun, and a posterior subtenons corticosteroid injection was given. In 94 cases, a referral was made to a subspecialist. 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. Estimated fees to plaintiffs attorneys were $2 billion, which was included in indemnity payments. ESTIMATES FROM THE MULTIVARIATE PROPORTIONAL ODDS MODEL FOR THE 3-WAY GROUPING OF THE OUTCOME FOR CATARACT SURGERIES COMPLICATED BY RETAINED LENS FRAGMENTS. 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. 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 .gov means its official. Therefore, it would be interesting to continue to monitor closed claim incidence trends of this complication. Romero-Aroca P, Fernndez-Ballart J, Mndez-Marn I, Salvat-Serra M, Baget-Bernaldiz M, Buil-Calvo JA. The third claim alleged decreased vision following negligent vitrectomy surgery to manage retained lens fragment. Dufrene claims the wrong lens had been implanted because the eye had been improperly tested prior to the surgery. Moore JK, Scott IU, Flynn HW, Jr, et al. According to the Physician Insurers Association of America (PIAA), a large multispecialty liability insurance carrier, the following occurred in 2008: 65% of claims were dropped, dismissed, or withdrawn; 25.7% were settled; 4.5% were decided by alternative dispute mechanism; and 5% were resolved by trial, with the defendant prevailing in 90% of those tried cases.79, It is important to point out that the claim frequency should not be used as an estimate of the error rate or malpractice rate in medicine. 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The number of Ophthalmic Mutual Insurance Company policyholders from years 1989 through -2009. Among these, the patients sought a second opinion and referred themselves in 3 cases. Some cases that opened in more recent years are still open and are not a part of this study. Created for people with ongoing healthcare needs but benefits everyone. Removal of retained lens fragments after phacoemulsification reverses secondary glaucoma and restores visual acuity. WebWe filed a case against the opthalmologist who performed the surgey. Many are related to retained lens fragments with 108 unique cataract surgeries, 97% against cataract surgeon and 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. Practice styles and preferences of ASCRS members1994 survey. Management of dislocated lens material. Indemnity payments totaling more than $3,586,000 were made in 32 (30%) of the claims (median payment, $90,000). One of the most devastating complications after any ophthalmic surgical procedure that can result in profound visual loss is endophthalmitis. However, he could not complete the surgery and his retinal colleague needed to intervene intraoperatively. Light sensitivity after cataract surgery After cataract removal, a little bit of light sensitivity is expected due to dryness in the eye. A retrospective review was performed of all closed claims during the 21 years from 1989 through 2009 of those insured by OMIC to identify cases associated with cataract surgeries complicated by retained lens fragments (see Inclusion and Exclusion Criteria section that follows). Seven hundred medicolegal cases in ophthalmology. LIST OF ALLEGATIONS IN THE CLAIMS RESULTING FROM CATARACT SURGERY COMPLICATED BY RETAINED LENS FRAGMENTS. Of the 30 claims that were settled, there were 6 claims from Illinois; 5 from Florida; 3 from California; 2 claims each from Colorado, Michigan, and New York; and one claim each from Georgia, Louisiana, Missouri, Nevada, Tennessee, Texas, Virginia, Washington, West Virginia, and Wyoming. Beckman HB, Markakis KM, Suchman AL, Frankel RM. Follow Posted 4 years ago, 24 users are following. Your use of this website constitutes acceptance of the Terms of Use, Supplemental Terms, Privacy Policy and Cookie Policy. CLAIMS WITH INDEMNITY PAYMENT BY FINAL VISUAL ACUITY AND CHANGE IN VISUAL ACUITY AMONG CATARACT SURGERIES COMPLICATED BY RETAINED LENS FRAGMENTS. , oral and topical corticosteroid therapy was begun, and a posterior subtenons corticosteroid injection was given for!, Markakis KM, Suchman al, Frankel RM, Yilmaz of Ophthalmic Insurance. And outcomes of pars plana vitrectomy in patients with retained lens fragments after phacoemulsification INTRAOPERATIVE MANIPULATION BY cataract... 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