These transformed variables were used in further analyses. 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. The plaintiffs expert stated that it is below the standard of care to not notice the posterior tear during cataract surgery and the retained cortex was not removed at the time of surgery. The .gov means its official. Smiddy WE, Guererro JL, Pinto R, Feuer W. Retinal detachment rate after vitrectomy for retained lens material after phacoemulsification. Kim JE, Flynn HW, Jr, Rubsamen PE, Murray TG, Davis JL, Smiddy WE. More than one of these complications was noted in 31 cases. 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In this analysis, the following factors were found to be statistically significant for more severe legal outcome: logMAR preoperative visual acuity, logMAR final visual acuity, preoperative to postoperative change in logMAR visual acuity, development of glaucoma or elevated intraocular pressure, time to referral, and the duration between opening and closing of a 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. This is understandable, since the impact of poor final visual acuity would be greater for the patients who began with a reasonably good baseline visual acuity, and the degree of dissatisfaction would be greater as well. Because the patient was receiving warfarin therapy, pneumatic retinopexy was performed. Merani R, Hunyor AP, Playfair TJ, et al. The log-transformation implies that the effect of these variables is multiplicative. The mean age was 69 years (range, 4090 years). One of the most devastating complications after any ophthalmic surgical procedure that can result in profound visual loss is endophthalmitis. The mean defense costs were significantly lower in cases that were dismissed but were considerably higher in cases that went on to a trial, even when there was no indemnity paid. Vanner EA, Stewart MW. Cases to be included in the study were identified based on OMIC coding for claims resulting from complications related to cataract surgery. 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. Greven CM, Piccione K. Delayed visual loss after pars plana vitrectomy for retained lens fragments. In all cases, final visual acuity was 20/200 or worse, including 2 cases of no light perception. In 3 cases, malfunctioning or unavailability of necessary equipment resulting in prolonged cataract surgery time was thought to have contributed to the patient movement and complication of capsular tear. Can I sue a doctor for a botched cataract surgery? Of the 108 defendants, 105 (97%) were cataract surgeons and only 3 (3%) were retinal surgeons. Although there were no cases involving residents, there was one claim against a policyholder ophthalmologist who was overseeing a colleagues attempt at learning cataract surgery. 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. Why do people sue doctors? Accessibility In 11 eyes, the operated eye was the better eye. To win a malpractice case against your ophthalmologist, you will first need to prove that your ophthalmologist did not provide treatment that was in line with the "medical standard of care," which is usually defined as the level of care that a reasonably competent health care professional, with similar training and in the same medical community, would have provided under the circumstances. Timing of referral and elevated intraocular pressure (IOP) were statistically significant in univariate analyses but not in multivariate analyses for a trial. Olsson RB, Ritland JS, Bjrnsson OM, Syrdalen P, Eide N, Overgrd R. A retrospective study of patients with retained nuclear fragments after cataract extraction. Boscher C, Lebuisson DA, Lean JS, Nguyen-Khoa JL. Colyer MH, Berinstein DM, Khan NJ, et al. Cataracts cause foggy or blurred vision that makes it hard to do everything from reading to Before 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). 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. Lifshitz T, Levy J. Posterior assisted levitation: long-term follow-up data. The patient claimed that the physician should have The overwhelming majority of the referrals were to a retina specialist, but referrals also included cornea and glaucoma specialists. Aasuri MK, Kompella VB, Majji AB. Duty to treat means that a doctor-patient relationship must be established prior to the alleged negligent act. 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. 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. 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 all cases, the case file opened within 2 weeks of the insureds reporting of receiving a claim or a suit. Malpractice trends: viewing the data and avoiding the hot seat of litigation. Vitrectomy for removal of retained lens material. In these early referral cases, the claim was more likely to be dismissed. 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). CLAIMS WITH A DOCUMENTATION OF INTRAOPERATIVE MANIPULATION BY THE CATARACT SURGEON DURING MANAGEMENT OF POSTERIOR DISLOCATION OF LENS FRAGMENTS. 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.). There were also cases where the defense experts felt that the case was less defensible due to poor office visit documentations that did not include or had illegible notations regarding visual acuity, intraocular pressure, or dilated fundus examination in the setting of declined visual acuity. The time between the date of cataract surgery and the date of evaluation by a specialist to further manage the complications of retained lens fragments was a median of 7 days (range, same day to 15 months) in this study. In one additional case, observation was recommended without further surgery because the retina specialist felt that the retinal detachment was inoperable. Vincent C, Young M, Phillips A. An official website of the United States government. Vitrectomy timing for retained lens fragments after surgery for age-related cataracts: a systemic review and meta-analysis. Time to additional surgical procedures such as vitrectomy was at the discretion of the subspecialist. Furthermore, there was a wide variation in the size of indemnity payment (payment to a plaintiff) across specialties, and the specialties that were most likely to face indemnity claims were often not those with the highest average payments.5 For example, pediatrics was 24th among 25 specialties with regard to proportion of physicians facing a malpractice claim annually, but it had the highest mean amount of indemnity payment. Ways to reduce significant vision loss, including improved management of corneal edema and IOP, and timely referral to a subspecialist should be considered. CI, confidence interval; OR, odds ratio; SE, standard error. 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). Smiddy WE, Flynn HW, Jr, Kim JE. All variables significant in the univariate analyses were included in a multivariate logistic regression model. The cataract surgeon felt strongly that he was not at fault and wished to go to a trial rather than settle. WebCataract surgery injury occurs in approximately 12% of cases. 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. Physician-patient communication. Postoperatively, the patient developed hypotony and fibrin reaction. Factors that prompted families to file malpractice claims following perinatal injuries. Therefore, it appears that earlier referral is one of the ways a cataract surgeon can improve risk management. She underwent pars plana vitrectomy, scleral buckling procedure, membrane peeling, removal of IOL, endolaser, and gas-fluid exchange. 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