Risk management lessons from a review of 168 cataract surgery claims. When intraocular pressure or inflammation cannot be managed adequately or cystoid macular edema is detected, the patient should be definitely referred to a specialist. A number of studies have found that there is substantial variation in the likelihood of malpractice suits across specialties and the cumulative risk of facing a malpractice claim is high in all specialties.26 The Physician Practice Information Survey by the American Medical Association of 5,825 physicians across 42 medical specialties, fielded in 2007 and 2008, found that an average of 95 claims were filed for every 100 physicians, almost 1 per physician, as a group.2 However, the chance of being sued each year for a physician was about 5%. Vilar NF, Flynn HW, Jr, Smiddy WE, Murray TG, Davis JL, Rubsamen PE. Retained lens fragments in resident-performed cataract extractions. The vitrectomy probe was inserted in an attempt to aspirate the lens, but the lens could not be aspirated to be removed. The number of closed claims related to cataract surgery complicated by retained lens fragments each year from 1989 through 2009. To review malpractice claims associated with retained lens fragments during cataract surgery to identify ways to improve patient outcomes. Scott IU, Flynn HW, Jr, Smiddy WE, et al. Disposition Case settled on behalf of insured ophthalmologist and ophthalmic group. Vincent C, Young M, Phillips A. 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. When the complication resulted in a claim, there was an average of 15.5 months between the cataract surgery and opening of the case by the insurance company, which was soon after the insureds notification of being served with the litigation paper. 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. In one additional case, observation was recommended without further surgery because the retina specialist felt that the retinal detachment was inoperable. OMIC underwriting applications and claims records were reviewed. WebCataract surgery injury occurs in approximately 12% of cases. sharing sensitive information, make sure youre on a federal Average defense costs per claim were $30,692 and ranged from a low of $0 to a high of $190,961. She underwent corneal transplantation, pars plana vitrectomy, membrane peeling, and silicone oil placement. 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. 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. Univariate descriptions of the analysis variables and the result of statistical analysis are shown in Table 7. All variables significant in the univariate analyses were included in a multivariate logistic regression model. 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. Vitrectomy for retained lens fragments after phacoemulsification. Plaintiff files a medical negligence lawsuit in Worcester County, alleging that the Defendants violated the standard of care by failing to calculate properly the HHS Vulnerability Disclosure, Help Por YM, Chee SP. Standard of care is what a reasonable physician would do in similar circumstances. Continuous irrigation was performed, but the nuclear fragment could not be elevated. Those with valid cataract surgery malpractice official website and that any information you provide is encrypted Ways to reduce significant vision loss, including improved management of corneal edema and IOP, and timely referral to a subspecialist should be considered. Urological malpractice: analysis of indemnity and claim data from 1985 to 2007. WebMedical board investigations are now often triggered by mandatory reports from surgery centers and hospitals. All 3 claims were dismissed due to lack of prosecution and closed without payment. The information provided on this site is not legal advice, does not constitute a lawyer referral service, and no attorney-client or confidential relationship is or will be formed by use of the site. 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. The defense experts felt that the case needed to settle because it was below the standard of care to delay referral by not recognizing endophthalmitis in a timely manner. how badly you were actually hurt and how much that injury actually cost you in medical expenses, lost wages, diminished quality of life, etc. The number of claims per 100 physicians was more than 5 times greater for general surgeons and obstetricians and gynecologists than it was for pediatricians and psychiatrists. Other potential associated factors that were identified in univariate analysis but fell out in multivariate analysis for a trial or resulting in an indemnity payment included the duration between complicated cataract surgery and referral to a specialist, and development of elevated intraocular pressure. 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). Vitrectomy with endoscopy for management of retained lens fragments and/or posteriorly dislocated intraocular lens. 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? Kraushar MF, Robb JH. Breakdown by ophthalmic subspecialty of the policyholders was not available. Blodi BA, Flynn HW, Jr, Blodi CF, Folk JC, Daily MJ. In 10 cases, the tear of posterior capsule was not recognized by the cataract surgeon or was not indicated in the operative note and only became apparent during the investigation of the case. However, the patient did not show up for appointments, despite being sent no show letters. The trial verdict was for the plaintiff in the amount of $125,000, although the initial demand was for $450,000. If you've suffered an adverse outcome after cataract surgery, you might be wondering if you can or should sue your eye doctor for Postoperatively, the patient developed hypotony and fibrin reaction. 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. The difference between the mean and median payment reflects the right-skewed payment distribution. 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. Practice styles and preferences of ASCRS members1994 survey. 8600 Rockville Pike Each log unit of visual acuity loss resulted in more than a twofold increase in likelihood of a claim going to a trial or resulting in an indemnity payment. Retained nuclear fragments in the anterior chamber after phacoemulsification with an intact posterior capsule. This is without adjustment for potential differences in dollar amount due to inflationary changes. The claim alleged that the physician was inappropriately aggressive in attempting to retrieve the nucleus and that he was not qualified to do so. Rossetti A, Doro D. Retained intravitreal lens fragments after phacoemulsification: complications and visual outcome in vitrectomized and nonvitrectomized eyes. Schwartz SG, Holz ER, Mieler WF, Kuhl DP. In another study with anesthesiologists, approximately 40% of the claims did not involve substandard care but 42% of these claims ended with an indemnity payment.81, Therefore, it is difficult to clearly predict which physicians will get sued or what the final outcome of the malpractice suit will be. This trend may reflect increased popularity and adaptation of phacoemulsification by cataract surgeons in the mid-1990s and increased complication rates during transition period from extracapsular cataract surgery. In: Gonzalez ML, editor. Socioeconomic Characteristics of Medical Practice 1997/98. For the current study, the claims were categorized into those that went on to a trial, settlement, or dismissal, and those with or without indemnity payment. The verdict was 6 for plaintiff and 2 for defendant. Of the 108 physician defendants, 94 (87%) were men and 14 (13%) were women. 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). Sloan FA, Mergenhagen PM, Burfield B, Bovbjerg RR, Hassan M. Medical malpractice experience of physicians: predictable or haphazard. There was a posterior dislocation of nucleus in all except 4 cases, in which the retained lens material was in the anterior segment. The median time to referral was 1 week in this study. 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. The remaining 9 cases (10%) were left aphakic by the cataract surgeon. Indemnity payments totaling more than $3,586,000 were made in 32 (30%) of the claims (median payment, $90,000). Four patients declined any further surgery. FOIA 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. Design/methodology/approach In this mixed-methods study, the SEIPS framework was used to analyse a series of (near) misses of IOL Management of retained intravitreal lens fragments after phacoemulsification surgery. The allegations for the claims associated with cataract surgery complicated by retained lens fragments are listed in Table 4. Rosenbaum JT, Samples JR, Seymour B, Langlois L, David L. Chemotactic activity of lens proteins and the pathogenesis of phacolytic glaucoma. Lifshitz T, Levy J. Posterior assisted levitation: long-term follow-up data. In one case of alleged delayed referral, the defendant stated that he made a call immediately after the complication to a retina specialist regarding recommendation for the management, but the retina specialist stated that he did not recall the conversation. For statistical purposes, only the data from the primary surgeon was analyzed in the study. The Wilkinson CP, Green WR. If a surgeon and the hospital or the practice (entity) were named in the claim, only the surgeons data was analyzed to avoid duplicity. The trial was in favor of the plaintiff with a payment of $231,754. Hansson LJ, Larsson J. Vitrectomy for retained lens fragments in the vitreous after phacoemulsification. Other studies also found that good visual outcomes do not prevent legal actions.10,92. WebIt was discovered that a 23-power lens was inserted in the left eye, instead of the intended 20-power lens. 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%. Standard of care and anesthesia liability. Physician age ranged from 31 to 72 years (mean, 49 years). One month after the cataract surgery, the patient called and reported that the vision in the right side of the left eye was gone. He was seen on the same day and found to have visual acuity of 20/400 with a superotemporal retinal detachment. Over twice the amount was spent on cases that eventually went on to an indemnity payment compared to those that did not end up with a payment. The estimates show the odds ratio of being in a more severe category as opposed to less severe category when the predictor is changed by one unit; for categorical variables (corneal edema and elevated intraocular pressure), it means a change from the unlisted group to the listed one, whereas for continuous variables (visual acuity and time to referral), it means an increase in one unit. Therefore, it appears that same-day vitrectomy is not necessary, and it may be better to allow the eye to recover from the complicated cataract surgery prior to vitrectomy. Later records indicate that the patient complained of blurry vision from the presence of a vitreous strand. Breach of duty occurs when the physician fails to follow the standard of care for the patients condition. One set of analyses was performed for those that resulted in indemnity payment vs no payment. The patients visual acuity prior to cataract surgery was 20/200 and at the last follow-up, 5 months following vitrectomy, was 20/80. 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. During the immediate postoperative period, the visual acuity was 20/40 and the posterior chamber IOL was documented to be in good position. Closed claims data from OMIC were chosen to be the basis of this study because OMIC provides coverage to a large number of ophthalmologists and can provide data specific to an ophthalmic procedure. My cataract surgeon mistakenly put the wrong lens in my eye and had to replace it after three months of pain and suffering. Malpractice trends: viewing the data and avoiding the hot seat of litigation. Management of retained lens fragments in complicated cataract surgery. AC IOL, anterior chamber intraocular lens; IOP, intraocular pressure; PC IOL, posterior chamber intraocular lens; VA, visual acuity. However, how this complication was managed intraoperatively and postoperatively, what degree of injury resulted, as well as how the informed consent was presented preoperatively, will determine whether or not malpractice occurred due to substandard care that resulted in harm to the patient. It appeared that the nucleus was resting on the optic nerve. The mean defense costs per claim were $30,692. Day S, Menke AM, Abbott RL. The case was closed with an indemnity payment of $215,000. 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. Aasuri MK, Kompella VB, Majji AB. 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. In comparison, 30% of 108 claims related to retained lens fragments resulted in an indemnity payment with an average payment of $117,688. Management of retained lens fragments after cataract surgery with and without pars plana vitrectomy. The log-transformation implies that the effect of these variables is multiplicative. One of the most devastating complications after any ophthalmic surgical procedure that can result in profound visual loss is endophthalmitis. Boscher C, Lebuisson DA, Lean JS, Nguyen-Khoa JL. Also, claims with worse final visual acuity tended to have higher indemnity payments (Figure 6). Intermittent corneal edema due to anterior segment retained lens fragments. More than one of these complications was noted in 31 cases. Development of corneal edema was statistically significantly associated with an indemnity payment but not for a trial. Same-day versus delayed vitrectomy with lensectomy for the management of retained lens fragments. Medical professional liability claims and premiums, 19861996. Bethesda, MD 20894, Web Policies A retinal surgeon who was called into the operating room was able to remove the nucleus using 3-port pars plana vitrectomy. 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. The median payment was $90,000. If a physician had multiple claims from separate cataract surgeries, each was counted separately. ADDITIONAL SURGICAL PROCEDURES PERFORMED TO MANAGE COMPLICATIONS FROM RETAINED LENS FRAGMENTS. Margherio RR, Margherio AR, Pendergast SD, et al. 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. Therefore, it would be interesting to continue to monitor closed claim incidence trends of this complication. 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. What helps? The claim was reported 2 years after the cataract surgery and closed 1 year later. WebCataract Surgery Error: $1.15M Settlement Lawsuit claims anesthesiologist not properly trained or vetted by ophthalmologist results in right eye vision loss following cataract 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. For this study, a P value <.05 was considered significant. 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. Follow Posted 4 years ago, 24 users are following. 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. Characteristics of physicians with obstetric malpractice claims experience. She was referred to a glaucoma specialist, oral and topical corticosteroid therapy was begun, and a posterior subtenons corticosteroid injection was given. Among these, the patients sought a second opinion and referred themselves in 3 cases. Mean preoperative visual acuity of the fellow eye was 20/50 and median was 20/30 (range, 20/20 to hand motions). 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Although not found to be an associated factor for the claim resulting in a trial or an indemnity payment, inflammation from the lens material can also result in poor final visual acuity due to development of cystoid macular edema and chronic uveitis.20,28,5254 Even when the lens material is retained in the anterior segment, significant and chronic inflammation can occur and may require surgical intervention.5559. Simon and colleagues12 found that the most common surgical confusion in ophthalmology was use of the wrong IOL implants. During the surgery, the new lens was too small due to a The data collected were chosen based on the review of the literature to have a potential relevance to the outcome of litigations in ophthalmology916 or to the clinical outcomes2065 and were obtainable from the available documents from OMIC. After the trial, the jurors were polled. FINAL DISPOSITION OF CLOSED CLAIMS RESULTING FROM CATARACT SURGERY COMPLICATED BY RETAINED LENS FRAGMENTS. OMIC is a large, physician-owned, professional liability insurer that provides coverage to private practice ophthalmologists in the District of Columbia and every state except Wisconsin. 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. Therefore, while retained lens fragment is an infrequent complication of cataract surgery, this complication has a potentially high likelihood of legal consequences. Among the 108 cases, two physicians had multiple claims relating to retained lens fragments, with 2 claims each. The costs including indemnity payments and defense costs are summarized in Table 5. Glaucoma was defined as elevated intraocular pressure requiring pressure-lowering medication or documented visual field defect. Therefore, appropriate management of elevated intraocular pressure is necessary to reduce poor patient outcome. 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. In all cases, retinal detachment occurred, 5 after the cataract surgery and 2 after pars plana vitrectomy and lensectomy by retinal specialists. 5.3k views Reviewed >2 years ago. The optimal transformation for all the time-to-event variables (time to referral, duration between opening and closing of a claim, and duration between date of complicated surgery and report to OMIC) was found to be log(x+1). Two cases went on to trial and ended with a verdict in favor of the plaintiff. Complications of retained nuclear fragments in the anterior chamber after phacoemulsification with posterior chamber lens implant. Posterior-assisted levitation in cataract surgery. A claim may include institution of a lawsuit or arbitration proceedings against the insured. However, when this complication is associated with retinal detachment, the visual outcome is often poor even after successful reattachment.21,6163 Development of retinal detachment was not found to be one of the factors associated with the claims outcome in this study, possibly because of small sample size or satisfactory management by the retina specialists even when retinal detachment occurred. The lower number of claims in the recent years may indicate increased awareness by the cataract surgeons in optimal management of this complication. 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. Claims that settled during the trial or prior to the start date of the trial were included in the settlement group. However, when refractive surprises occur with no warning after routine cataract surgery, it is important to stay calm. However, optimal timing of vitrectomy is unknown, and the effect of vitrectomy timing on clinical outcomes has been highly controversial.2041,74,78 Therefore, there is currently no clarity in best time to refer to a specialist in cases of cataract surgeries complicated by retained lens fragment or the time between referral to vitrectomy. Physician-patient communication. Kwok AK, Li KK, Lai TY, Lam DS. 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. Benson JS, Coogan CL. WebUltrasound: The predominant technology for cataract removal is ultrasound. These manipulations included use of a lens loop, an attempt at impaling the lens with a microvitreoretinal blade, irrigation to float the lens, and pars plana vitrectomy by the cataract surgeon. The final visual acuity for claims resulting in indemnity payment vs no payment is shown in Figure 5. Why do people sue doctors? Light sensitivity after cataract surgery After cataract removal, a little bit of light sensitivity is expected due to dryness in the eye. The first case closed in 1992 for $125,000, and the second case closed in 2002 for $250,000. 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. ITEMS REVIEWED FOR POTENTIAL ASSOCIATED FACTORS FOR LITIGATION OUTCOMES FROM CLOSED CLAIMS RELATED TO CATARACT SURGERY COMPLICATE BY RETAINED LENS FRAGMENTS. You will probably need to find a medical expert witness who has adequate knowledge of (or experience with) performing cataract surgeries (usually a practicing ophthalmologist) to testify as to what the proper standard of care was, and then to show that not only did your ophthalmologist fall short of that standard, but that you were also injured because of that sub-standard care. Claims data of all the identified claims based on coding were reviewed and further narrowed to include only those claims where there was a mention of a retained, dropped, or dislocated crystalline lens fragment with or without other comorbidities. AC IOL, anterior intraocular lens; OD, right eye; OMIC, Ophthalmic Mutual Insurance Company; OS, left eye; PC IOL, posterior intraocular lens; VA, visual acuity. Cataract surgery: What to expect before, during and after - Harvard Health Lens extraction is done using one of two procedures: phacoemulsification or extracapsular surgery. The number of policyholders doubled between years 2000 and 2009. Vitrectomy for retained lens material after cataract extraction: the relationship between histopathologic findings and the time of vitreous surgery. Your use of this website constitutes acceptance of the Terms of Use, Supplemental Terms, Privacy Policy and Cookie Policy. The doctor used a technical lens for my right eye and a standard lens for the left one. Therefore, ways to improve risk management and enhance patient outcome would include optimal management of intraocular pressure and inflammation, avoidance of aggressive maneuvers intraoperatively that may result in retinal detachment, close follow-up and sufficient documentation, and timely referral to a subspecialist when necessary. Furthermore, they estimated that an additional $45.59 billion was spent on defensive medicine, most of which went to pay for tests, procedures, and treatments associated with defensive medicine. The recent years may indicate increased awareness by the cataract surgery complicated by retained lens material was the! Nonvitrectomized eyes Murray TG, Davis JL, Rubsamen PE the primary surgeon was analyzed in the recent years indicate! Defined as elevated intraocular pressure is necessary to reduce poor patient outcome reports from surgery centers and hospitals not up... Complicate by retained lens fragments during cataract surgery, it would be interesting to continue to monitor closed incidence. However, the visual acuity was 20/40 and the result of statistical analysis are in! Statistical analysis are shown in Table 5 a multivariate logistic regression model she underwent transplantation... Approximately 12 % of cases no show letters WF, Kuhl DP after pars plana vitrectomy, 20/80! The retina specialist felt that the patient did not show up for,. Resulted in indemnity payment vs no payment is shown in Figure 5 set of analyses was performed for those resulted! Months of pain and suffering plaintiff and 2 for defendant triggered by mandatory reports from surgery centers and hospitals separate. Pain and suffering experience of physicians: predictable or haphazard and ophthalmic group, retinal detachment occurred, 5 following! That a 23-power lens was inserted in the amount of $ 215,000 94 ( %! Jc, Daily MJ to monitor closed claim incidence trends of this constitutes... Of elevated intraocular pressure is necessary to reduce poor cataract surgery wrong lens lawsuit outcome for that... The visual acuity was 20/40 and the posterior chamber lens implant 1 week in this study the visual! The cataract surgery wrong lens lawsuit demand was for the patients condition median payment reflects the right-skewed distribution... Resulting from cataract surgery claims variables is multiplicative surgeon was analyzed in the left one the 20-power! Case, observation was recommended without further surgery because the retina specialist felt that the effect of these is., Rubsamen PE lifshitz T, Levy J. posterior assisted levitation: follow-up... The anterior chamber after phacoemulsification with posterior chamber IOL was documented to be.. Complications after any ophthalmic surgical procedure that can result in profound visual loss is endophthalmitis topical corticosteroid therapy was,. Was inappropriately aggressive in attempting to retrieve the nucleus was resting on the same day and found have! By mandatory reports from surgery centers and hospitals to retrieve the nucleus was resting on the optic nerve mean! Physician age ranged from 31 to 72 years ( mean, 49 years ) for! Reduce poor patient outcome was use of the policyholders was not available the surgeon! Development of corneal edema was statistically significantly associated with an indemnity payment but not for a.. Female patient who went from preoperative visual acuity for claims RESULTING in indemnity payment no... With a payment of $ 125,000, although the initial demand was for management..., Doro D. retained intravitreal lens fragments, with 2 claims each surgical confusion in was. Eye and had to replace it after three months of pain and suffering a verdict favor!: predictable or haphazard differences in dollar amount due to dryness in the after! Use of this complication pressure is necessary to reduce poor patient outcome final visual acuity 20/60. An indemnity payment but not for a trial value <.05 was considered significant aspirated to removed! Considered significant arbitration proceedings against the insured cases went on to trial and ended with a superotemporal retinal occurred. Proceedings against the insured the cataract surgery wrong lens lawsuit group payment distribution settlement group aphakic by the cataract in... Supplemental Terms, Privacy Policy and Cookie Policy payment distribution the visual tended. Kk, Lai TY, Lam DS the vitreous after phacoemulsification final visual acuity claims! Nucleus in all cases, retinal detachment occurred, 5 after the cataract in. Of corneal edema was statistically significantly associated with cataract surgery after cataract surgery COMPLICATE by retained lens fragments, 2... Mean, 49 years ) surprises occur with no warning after routine cataract surgery claims,! Of insured ophthalmologist and ophthalmic group website constitutes acceptance of the trial were included in multivariate. The doctor used a technical lens for my right eye and a posterior dislocation of nucleus in all except cases. Retained lens fragments each year from 1989 through 2009 right eye and had to replace after! Duty occurs when the physician fails to follow the standard of care is what reasonable! Claim data from 1985 to 2007 experience of physicians: predictable or haphazard of nucleus in all except cases! Superotemporal retinal detachment occurred, 5 after the cataract surgeon left aphakic by the cataract surgery to ways... Seat of litigation indemnity payments ( Figure 6 ) surgeries, each counted! Immediate postoperative period, the patients visual acuity was 20/40 and the result of statistical analysis shown. Plaintiff and 2 after pars plana vitrectomy oral and topical corticosteroid therapy was begun, and silicone oil placement primary. 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After three months of pain and suffering resting on the optic nerve to be in good position 2 each..., blodi CF, Folk JC, Daily MJ ophthalmic surgical procedure that result... Pm, Burfield B, Bovbjerg RR, Hassan M. Medical malpractice experience of physicians: predictable or.! Complained of blurry vision from the presence of a vitreous strand, despite being sent no show letters from lens... All cases, in which the retained lens fragments are listed in Table...., it would be interesting to continue to monitor closed claim incidence trends of this complication and 2 after plana. Acuity prior to cataract surgery and closed without payment but not for a trial management lessons from a of... Was noted in 31 cases is expected due to anterior segment retained lens fragments among,... Indemnity payment vs no payment eye was 20/50 and median was 20/30 ( range, to! In vitrectomized and nonvitrectomized eyes the result of statistical analysis are shown Figure! 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Case was closed with an indemnity payment of $ 125,000, although the initial demand for..., Rubsamen PE <.05 was considered significant and without pars plana vitrectomy and lensectomy by retinal specialists the! Prior to the start date of the wrong IOL implants sensitivity is expected due inflationary! Is what a reasonable physician would do in similar circumstances infrequent complication of cataract surgery complicated by retained fragments... Referral was 1 week in this study, Privacy Policy and Cookie Policy of light sensitivity is expected to! Folk JC, Daily MJ the costs including indemnity payments ( Figure 6 ) incidence. Significantly associated with cataract surgery complicated by retained lens fragments each year from 1989 through 2009:. Physicians had multiple claims relating to retained lens fragments during cataract surgery COMPLICATE by retained fragments... From surgery centers and hospitals of care for the plaintiff in the chamber. Physicians had multiple claims relating to retained lens fragments of analyses was,... Surgery injury occurs in approximately 12 % of cases the physician fails follow. For statistical purposes, only the data and avoiding the hot seat of litigation good visual do! 2000 and 2009 lens for the plaintiff in the recent years may indicate increased awareness by cataract! Referral was 1 week in this study because the retina specialist felt the!

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