cataract surgery wrong lens lawsuit

Over 3 million cataract surgeries are performed annually in the United States.18 Given the frequency of this procedure, perhaps it is not surprising that cataract surgery is the single most frequently named procedure in malpractice actions against ophthalmologists.1315 An uncommon but potentially devastating complication of cataract surgery that can affect both the anterior segment and the posterior segment surgeons is posterior dislocation or retention of lens fragments during cataract surgery. Day S, Menke AM, Abbott RL. Early vitrectomy was considered to be between days 3 and 7 after the cataract surgery in their study. Indemnity payment occurred in those claims that went on to a trial and a verdict in favor of the plaintiff was made or in claims that settled. Therefore, it would be interesting to continue to monitor closed claim incidence trends of this complication. 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. Regan JJ, Regan WM. The frequency of claims related to retained lens fragments compared to the number of policyholders for each year from 1989 through 2009. All 3 claims were dismissed due to lack of prosecution and closed without payment. Retained nuclear fragments in the anterior chamber after phacoemulsification with an intact posterior capsule. In 94 cases, a referral was made to a subspecialist. Clinical features and outcomes of pars plana vitrectomy in patients with retained lens fragments. 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. Their analysis also found that vitrectomy on the same day and up to 2 days after the cataract surgery had poorer visual outcome. 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. 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. Monshizadeh R, Samiy N, Haimovici R. Management of retained intravitreal lens fragments after cataract surgery. Since corneal edema is a common finding in eyes with retained lens fragments, close postoperative monitoring and appropriate treatment are advised.2022,27 Furthermore, the cataract surgeon should minimize significant trauma to the cornea intraoperatively during an effort to handle posterior dislocation of the lens material. WebCataract Symfony Lawsuits? In this study, 23 (72%) of 32 cases with indemnity payments had final visual acuity of 20/200 or worse. Por YM, Chee SP. 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. 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. Causes of cataract surgery malpractice claims in England 19952008. As noted already, the majority of claims are dropped, dismissed, or closed without payment. Dr. Poole performed cataract surgery on DeFrankos eyes over the course of one month. The attorney listings on this site are paid attorney advertising. Management of dislocated lens fragments following phacoemulsification surgery. However, all claims with a record of aggressive intraoperative manipulation by the cataract surgeon resulted in retinal detachment. Lu H, Jiang YR, Grabow HB. The difference between the mean and median payment reflects the right-skewed payment distribution. The costs including indemnity payments and defense costs are summarized in Table 5. Male physicians may have a higher likelihood of being sued because male physicians are historically concentrated in the specialties with the highest levels of claim incidence, such as surgery, and female physicians in those with the lowest incidences, such as pediatrics. Of the 108 defendants, 105 (97%) were cataract surgeons and only 3 (3%) were retinal surgeons. 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. Twelve (11%) of 108 claims were resolved by a trial, 30 (28%) were settled, and 66 (61%) were dismissed. 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 government site. WebIt was discovered that a 23-power lens was inserted in the left eye, instead of the intended 20-power lens. Design/methodology/approach In this mixed-methods study, the SEIPS framework was used to analyse a series of (near) misses of IOL Physician age ranged from 31 to 72 years (mean, 49 years). 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. Liability claims and costs before and after implementation of a medical error disclosure program. Sponsored by the American Academy of Ophthalmology, OMIC is the largest professional liability insurer for ophthalmologists in the United States, currently insuring over 4,300 ophthalmologists throughout the 49 states (all states except Wisconsin). Another possibility for lower mean and median indemnity payments for retained lens fragments in this study may be the use of OMIC data, since mean and median payments for all closed claims are lower for OMIC-insured physicians compared to others. Although documentation of informed consent does not prevent a malpractice claim, a better informed decision process may set realistic expectations by a patient, and presence of an appropriate informed consent is crucial when there is a malpractice claim. Final visual acuity was the last recorded visual acuity. Of the 12 claims that went on to a trial, there were 5 claims from Illinois, 2 claims from Arizona, and 1 claim each from Colorado, Florida, Kentucky, Rhode Island, and Texas. When intraocular pressure or inflammation cannot be managed adequately or cystoid macular edema is detected, the patient should be definitely referred to a specialist. 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. Medical liability claim frequency: a 20072008 snapshot of physicians. 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. Schutz JS, Mavrakanas NA. 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. In the first case, the cataract surgery was performed in 1989. Before The technical lens was suppose to give me even better vision in the right eye. Although these findings may cause fear and increased practice of defensive medicine by physicians, better understanding of the incidence, associated factors, and outcomes of medical malpractice claims may result in increased knowledge to the physicians and more effective and improved care to the patients. There was a trend toward significance for increasing time to referral, but this was not statistically significant (P=.053). Retinal detachment in patients with retained lens fragments or dislocated posterior chamber intraocular lenses. The complication of capsular tear and retained lens fragments was further aggravated by development of corneal wound dehiscence, corneal ulcer, and endophthalmitis. There were 25 cases of retinal detachment, 21 cases of corneal edema or corneal decompensation, and 18 cases of cystoid macular edema. Other studies also found that good visual outcomes do not prevent legal actions.10,92. Retained lens fragments in resident-performed cataract extractions. Every year, millions of people have routine surgery to replace a cataract that is, a lens in the eye that has become clouded. Small lens fragments can reabsorb over time and can be monitored by the cataract surgeon or managed medically as long as further complications do not occur.23,32,35,64 Interestingly, systematic review by Vanner and Stewart78 found that only 2% of cases in the literature were medically managed, whereas 9% of claims in the current study had been observed. The median payment was $90,000. Displacement of nuclear fragments into the vitreous complicating phacoemulsification surgery in the UK: clinical features, outcomes and management. 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. In some states, the information on this website may be considered a lawyer referral service. 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 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. 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 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. The .gov means its official. Retained intravitreal lens fragments after cataract surgery. Of the 12 claims resulting in a trial, 30 claims resulting in a settlement, and 66 claims resulting in a dismissal, the male-to-female physician defendant ratios were 12:0, 25:5, and 57:9, respectively. 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). If any of these associated conditions are present or suspected and cannot be adequately managed by the cataract surgeon, prompt referral is advised. Poorly documented cases were deemed more difficult to defend, whereas claims with aggressive intraocular manipulation by the cataract surgeon resulting in retinal detachment were more likely to result in poor final visual acuity and were more likely to go to a trial or settle. Management of retained lens fragments in complicated cataract surgery. WebBetween 1987 and 2008, about 220 cases of cataract surgery mistakes were filed with OMIC, and about 80 percent of those involved wrong power, wrong measurement or wrong IOL implantation. CF, counting fingers; HM, hand motions; NLP, no light perception. 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 site is secure. The These included the number of ophthalmologists insured by OMIC from 1989 through 2009, the number of closed claims related to cataract surgery, OMIC policyholder demographics, and average indemnity payments for OMIC policyholders. The patients visual acuity prior to cataract surgery was 20/200 and at the last follow-up, 5 months following vitrectomy, was 20/80. Therefore, it appears that earlier referral is one of the ways a cataract surgeon can improve risk management. about navigating our updated article layout. Sloan FA, Mergenhagen PM, Burfield B, Bovbjerg RR, Hassan M. Medical malpractice experience of physicians: predictable or haphazard. Finally, retinal detachment is a frequent adverse event in these eyes and can occur after the complicated cataract surgery or after vitrectomy surgery to remove the lens material.21,28,31,36,38,6165 Therefore, both the cataract surgeon and the retinal surgeon need to closely follow these patients for retinal detachment. Furthermore, this study is limited by retrospective nature and those related to chart review, where not all the data points were recorded in some claim reports. WebThe plaintiff, a 56-year-old man, suffered permanent right eye vision loss following cataract surgery. No indemnity payment was made in claims that went on to a trial but the verdict was in favor of the defendant or in claims that were dismissed or closed without compensation. Disposition Case settled on behalf of insured ophthalmologist and ophthalmic group. 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. The vitrectomy probe was inserted in an attempt to aspirate the lens, but the lens could not be aspirated to be removed. Among the 12 claims that resulted in a jury trial, 2 cases resulted in indemnity payment. In this study, indemnity payments totaling more than $3,586,000 were made in 32 cases (30%) with the mean payment of $117,688 and the median payment of $90,000. 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The plaintiff alleges that on June 17, 2013 she underwent a second surgery on her left eye to install the proper implant and that afterward she continued to have difficulty seeing out of the eye. One of the most devastating complications after any ophthalmic surgical procedure that can result in profound visual loss is endophthalmitis. 0 likes, 62 replies Report / Delete New discussion Reply 62 Replies Risk management lessons from a review of 168 cataract surgery claims. Hickson GB, Clayton EW, Githens PB, Sloan FA. 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. Vitrectomy for removal of retained lens material. I am currently evaluating a similar case in involving a surgeon placing a wrong lens into a patient, however the error was recognized during the su Accounting for these factors, there were 108 unique cataract surgeries that met the inclusion criteria and were the basis for the current analyses. Two weeks later, visual acuity was hand motions. The items collected during the review of the claims are listed in Table 1. 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. From the Department of Ophthalmology (Dr Kim) and the Division of Biostatistics (Dr Szabo), Medical College of Wisconsin, Milwaukee,Wisconsin, and Ophthalmic Mutual Insurance Company, San Francisco, California (Mr Weber). Rosenbaum JT, Samples JR, Seymour B, Langlois L, David L. Chemotactic activity of lens proteins and the pathogenesis of phacolytic glaucoma. In: Gonzalez ML, Zhang P, editors. Estimated fees to plaintiffs attorneys were $2 billion, which was included in indemnity payments. Medical malpractice predictors and risk factors for ophthalmologists performing LASIK and PRK surgery. 8600 Rockville Pike Yet three or four years ago, UCLA surgeons Therefore, the total cost of malpractice claims for these 108 cases was nearly $7 million. 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. The aims of this study were to evaluate the medical malpractice claims resulting from the retained lens fragments during cataract surgery and to identify ways to improve patient outcomes. Whereas indemnity payment is usually associated with all settled claims, claims that go on to a trial may or may not result in an indemnity payment, depending on the verdict. 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