cataract surgery wrong lens lawsuit

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. Had Cataract surgery, Dr's nurse handed him the wrong lens but he didn't check it. and transmitted securely. The incidence of closed claims for retained lens fragments peaked in 1997, but the actual number of closed claims was the highest for years 2001, 2003, and 2004. The number of closed claims related to cataract surgery complicated by retained lens fragments each year from 1989 through 2009. The most common additional surgical procedure was pars plana vitrectomy to remove retained lens material or to manage retinal detachment, but procedures to manage IOL, glaucoma, corneal decompensation, and strabismus were also performed (Table 3). Two weeks later, visual acuity was hand motions. Accessibility In this study, 23 (72%) of 32 cases with indemnity payments had final visual acuity of 20/200 or worse. DESCRIPTIVE STATISTICS OF THE ANALYSIS VARIABLES GROUPED BY WHETHER INDEMNITY WAS PAID. 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. An anterior vitrectomy was performed. All of these cases had a final visual acuity of 20/200 or worse, and 5 of 7 of these claims either went on to a trial or settled. Displacement of nuclear fragments into the vitreous complicating phacoemulsification surgery in the UK: clinical features, outcomes and management. Clinical predictors and outcomes of pars plana vitrectomy for retained lens material after cataract extraction. 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. Therefore, while retained lens fragment is an infrequent complication of cataract surgery, this complication has a potentially high likelihood of legal consequences. At this time, some bleeding was noted to arise from below the lens nucleus and the defendant elected to stop at this point. The case was closed with an indemnity payment of $215,000. One analysis was performed with the litigation outcomes divided into (1) trial, (2) settlement, and (3) dismissed. The trial verdict was for the plaintiff in the amount of $125,000, although the initial demand was for $450,000. In addition to the review of the closed claim cases related to the complication of retained lens fragments, other data that were thought to be relevant to the study were obtained from OMIC and analyzed for comparison with the findings from this study. The lower number of claims in the recent years may indicate increased awareness by the cataract surgeons in optimal management of this complication. 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. 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. Risk management lessons from a review of 168 cataract surgery claims. 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. Malpractice, in contrast, requires demonstration of negligence, defined as substandard care that resulted in harm.1 Malpractice suits are usually based on the legal theory of negligence, requiring the presence of the following four elements: (1) duty to treat, (2) breach of duty, (3) cause, and (4) damages. During the immediate postoperative period, the visual acuity was 20/40 and the posterior chamber IOL was documented to be in good position. Bhan A, Dave D, Vernon SA, Bhan K, Bhargava J, Goodwin H, Medical Defense Union; Medical Protection Society; Medical and Dental Defense Union of Scotland Risk management strategies following analysis of cataract negligence claims. Pande M, Dabbs TR. Bessant DA, Sullivan PM, Aylward GW. Vitrectomy for retained lens fragments after phacoemulsification. The largest indemnity payment case, with a payment of $500,000, closed in 2005 with a settlement. Ali N, Little BC. The model was simplified using backward selection keeping all predictors with a P value of .25 or less. 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. Merani R, Hunyor AP, Playfair TJ, et al. Colyer MH, Berinstein DM, Khan NJ, et al. Hickson GB, Clayton EW, Entman SS, et al. Of these, 937 claims were related to cataract surgery, and 117 closed claims related to cataract surgery were complicated by retained lens fragments. 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. What is the recovery after cataract or lens replacement surgery? Retained lens fragments can be successfully managed by the retina specialists in most cases. The new PMC design is here! Time to additional surgical procedures such as vitrectomy was at the discretion of the subspecialist. An opening in the inferior portion of the posterior capsule was seen and retinal detachment was confirmed. The number peaked in 1997 with 11 cases and again in 2001, 2003, and 2004 with 13 cases each year. Start here to find personal injury lawyers near you. The patient was informed of the complication. This is without adjustment for potential differences in dollar amount due to inflationary changes. Therefore, cases that start out with poor visual acuity and end up with poor final visual acuity are less likely to result in a trial, settlement, or indemnity payment than cases with relatively good preoperative visual acuity that end up with poor final visual acuity. Two cases went on to trial and ended with a verdict in favor of the plaintiff. Expert testimony. The overwhelming majority of the referrals were to a retina specialist, but referrals also included cornea and glaucoma specialists. Even when an IOL has been inserted by the cataract surgeon, the retinal surgeon should be prepared to manage subsequent complications of dislocated or malpositioned IOL, as was the case in some of the claims in this study. Acuity improved to 20/200, but eventually the eye became phthisical with light perception vision at 19 months after the initial cataract surgery. The In the last 2 years the femtosecond laser has been developed to assist in cataract surg Read More. If you've suffered an adverse outcome after cataract surgery, you might be wondering if you can or should sue your eye doctor for 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. 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 distribution of claims resulting in a trial, settlement, dismissal, and indemnity payment seen in this study compares favorably to the current medical liability market for all medical specialties. Learn how we can help. The site is secure. Ho SF, Zaman A. Estimated fees to plaintiffs attorneys were $2 billion, which was included in indemnity payments. Previous studies have shown that the incidence of posterior capsule rupture and posterior dislocation of lens material is higher in cases with residents in training than with cataract surgeons who are experienced at phacoemulsification.94 Although none of the cases in this study resulted from a resident case, one case did involve a cataract surgeon who was overseeing a cataract surgery being performed by his colleague in the transition phase. Management of dislocated nuclear fragments after phacoemulsification. This grouping was done to compare the findings of this study to other published data. An official website of the United States government. In some cases, the cause of capsular tear and resulting complication of retained lens fragment was due to circumstances other than the surgeons surgical technique. Many are related to retained lens fragments with 108 unique cataract surgeries, 97% against cataract surgeon and Cohen SM, Davis A, Cukrowski C. Cystoid macular edema after pars plana vitrectomy for retained lens fragments. 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. Most previous studies on malpractice claims compared only the groups that went on to indemnity payment vs no payment. The average insurance company payment - mostly settlements -- in these cases were $112,000. The costs including indemnity payments and defense costs are summarized in Table 5. In addition to alleged negligent cataract surgery with retained lens fragments, placement of the wrong IOL was cited as a contributing negligence in 3 cases: (1) placement of wrong-powered IOL handed to the surgeon by a nurse; (2) not having the correct type of IOL to insert in the setting of capsular rupture, resulting in increased likelihood of subsequent dislocation of IOL; and (3) placement of wrong-powered IOL due to incorrect transfer of A-scan data by a technician. The top 5 states in terms of overall frequency of claims in rank order were Illinois (18 cases), Texas (16 cases), California (11 cases), Florida (10 cases), and Louisiana (10 cases). Studdert DM, Mello MM, Gawande AA, et al. Data from the PIAA show that for all medical claims in 2008, average defense costs per claim were $40,649, ranging from a low of $22,163 among claims that were dropped, dismissed, or withdrawn, to a high of over $100,000 for tried cases.79 However, none of the studies, including this study, have addressed additional costs that result from stress and time associated with a lawsuit to the plaintiff or to the defendant. Mean final visual acuity was 20/200 (range, 20/20 to no light perception). 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. In one additional case, observation was recommended without further surgery because the retina specialist felt that the retinal detachment was inoperable. Preoperative visual acuity was the visual acuity shortly prior to cataract surgery. American College of Obstetricians and Gynecologists. Kraushar MF, Turner M. Medical malpractice litigation in ophthalmology: the New Jersey experience. 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. Medical malpractice and respondeat superior. 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. Michels RG, Shacklett DE. He was referred to a retina specialist, who saw him the next day. The trial was in favor of the plaintiff with a payment of $231,754. 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. The mean age was 69 years (range, 4090 years). 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. 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. Claims that settled during the trial or prior to the start date of the trial were included in the settlement group. Medical malpractice predictors and risk factors for ophthalmologists performing LASIK and PRK surgery. Bettman JW. Of the 108 physician defendants, 94 (87%) were men and 14 (13%) were women. 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. 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. 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. Delay in diagnosis or delay in referral was alleged in 12 (11%) of 108 claims. 8600 Rockville Pike Trial with a verdict was assumed to be a more severe outcome than settled, since historically longer duration between opening and closing of a claim and higher costs are associated with trials compared to settled claims. Development of corneal edema was associated with an indemnity payment (OR, 3.50; P=.037). Moore JK, Scott IU, Flynn HW, Jr, et al. These transformed variables were used in further analyses. Smiddy WE, Flynn HW, Jr, Kim JE. 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. Management of nucleus loss into the vitreous: long term follow up in 63 patients. Comparison between claims with indemnity payment and no payment by final visual acuity among cataract surgeries complicated by retained lens fragments. A suit is defined as a formal legal action initiated in the courts by the filing of a complaint seeking a remedy (usually money) by the plaintiff and requiring a formal response from the physician or the entity (defendant). 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. 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. 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. Therefore, it appears that earlier referral is one of the ways a cataract surgeon can improve risk management. Sloan FA, Mergenhagen PM, Burfield B, Bovbjerg RR, Hassan M. Medical malpractice experience of physicians: predictable or haphazard. The issue of malpractice has wide-ranging stakeholders, including our society. 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 After doing an investigation we discovered that ophthalmologists used the wrong replacement lens. In the table, the estimates give the odds ratio of an indemnity payment when the predictor is changed by one unit for continuous variable (eg, visual acuity change), whereas for categorical variable (eg, corneal edema or decompensation), it means a change from the unlisted group to the listed one. 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