WebIt was discovered that a 23-power lens was inserted in the left eye, instead of the intended 20-power lens. Some cases that opened in more recent years are still open and are not a part of this study, since both the legal outcome and expenses were required for the analyses. Indemnity payments totaling more than $3,586,000 were made in 32 (30%) of the claims (median payment, $90,000). The number of cases in each visual acuity grouping for claims with payment and no payment is also shown. The retina successfully reattached with a final visual acuity of 20/25. A recent study recommended that the cataract surgeon perform an anterior vitrectomy and place a posterior chamber IOL if possible, prior to referral to a subspecialist in order to achieve better visual outcome.37 Based on the current study findings, it is recommended that the cataract surgeons avoid aggressive intraoperative manipulations to remove retained lens fragment in order to minimize the risk of retinal detachment. Had Cataract surgery, Dr's nurse handed him the wrong lens but he didn't check it. There was additional $103,000 in legal expenses. 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 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. Management of retained lens fragments in complicated cataract surgery. 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. Endophthalmitis in patients with retained lens fragments after phacoemulsification. Whereas the majority of claims were dismissed, claims associated with greater visual acuity decline, corneal edema, or elevated IOP were more likely to result in a trial or payment. Acuity improved to 20/200, but eventually the eye became phthisical with light perception vision at 19 months after the initial cataract surgery. Missouri Medical Malpractice Lawyer If you have suffered as a result of medical malpractice, contact our legal team right away. An opening in the inferior portion of the posterior capsule was seen and retinal detachment was confirmed. Comparison between claims with indemnity payment and no payment by final visual acuity among cataract surgeries complicated by retained lens fragments. Time between cataract surgery and referral to a subspecialist was a median of 7 days, ranging from the same day as the cataract surgery to 15 months after cataract surgery. Web7031 Koll Center Pkwy, Pleasanton, CA 94566. Claims with referral within 1 week of the complicated cataract surgery had a lower amount of indemnity payment and were more likely to be dismissed. 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. Each claim was counted separately as a unique case. However, when refractive surprises occur with no warning after routine cataract surgery, it is important to stay calm. One of the most devastating complications after any ophthalmic surgical procedure that can result in profound visual loss is endophthalmitis. The number of ophthalmologists being insured by OMIC grew steadily from 1,027 in 1989 to 4,107 in 2009 (Figure 1). Wilkinson CP, Green WR. Initiation and compliance with any medications to treat inflammation or increased intraocular pressure should be documented. Postoperatively, dilated fundus examination should be performed to detect possible retinal detachment, and patients should be promptly referred to a retina specialist when it occurs or if the fundus cannot be visualized well by indirect ophthalmoscopy.15,28,34,61 In this study, there were 3 claims that named the retinal surgeon as the defendant. Ophthalmic malpractice lawsuits with large monetary awards. The patient refused laser treatment for vitreolysis. Hickson GB, Clayton EW, Entman SS, et al. The current study is not inclusive of all claims related to retained lens fragments in the United States that occurred during the study period. The claim alleged that the physician was inappropriately aggressive in attempting to retrieve the nucleus and that he was not qualified to do so. Urological malpractice: analysis of indemnity and claim data from 1985 to 2007. Kraushar MF. 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. Mello MM, Chandra A, Gawande AA, Studdert DM. Of the 108 physician defendants, 94 (87%) were men and 14 (13%) were women. Bohigian GM, Wexler SA. 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). While some advocate vitrectomy to be performed on the same day as the day of complicated cataract surgery, many retinal surgeons prefer waiting the first few days after cataract surgery to permit the corneal edema to clear to allow unimpeded visualization of the retina.25,28,53 Vanner and Stewart78 performed a systematic review of 43 studies, including meta-analysis of 27 studies, for timing of vitrectomy for retained lens fragments after cataract surgery. Bovbjerg RR, Petronis KR. When there was a trial, the verdict was likely to be in favor of the defendant, similar to most malpractice claims. It appeared that the nucleus was resting on the optic nerve. Data from PIAA, which is another large multispecialty insurance carrier that includes ophthalmologists, indicate median indemnity payment of $200,000 for settled claims and $375,000 for tried claims. Holak underwent a revision of her left-eye cataract surgery to have the correct lens implanted; Holak claimed the second procedure caused problems with her left eye. He was referred to a retina specialist, who saw him the next day. 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. 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. 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. CF, counting fingers; HM, hand motions; NLP, no light perception. 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. Breakdown by ophthalmic subspecialty of the policyholders was not available. Therefore, appropriate management of elevated intraocular pressure is necessary to reduce poor patient outcome. For statistical purposes, only the data from the primary surgeon was analyzed in the study. Intraocular lens was implanted in 85 (90%) of 94 cases where this was recorded, with 63 (67%) being posterior chamber IOL and 22 (23%) being anterior chamber IOL. A retinal surgeon who was called into the operating room was able to remove the nucleus using 3-port pars plana vitrectomy. Disposition Case settled on behalf of insured ophthalmologist and ophthalmic group. The third claim alleged decreased vision following negligent vitrectomy surgery to manage retained lens fragment. Management of retained lens fragments after cataract surgery with and without pars plana vitrectomy. The remaining 76 claims (70%) closed without any payments. The payment was significantly larger when it was after a trial verdict, with an average of $187,500, whereas average payment for the settled claims was $107,033. The patient was referred 1 month after the initial cataract surgery to a retina specialist and underwent two pars plana vitrectomy surgeries, corneal wound closure, and intravitreal antibiotic injections. The median payment was $90,000. The patients visual acuity prior to cataract surgery was 20/200 and at the last follow-up, 5 months following vitrectomy, was 20/80. The management of dislocated lens material after phacoemulsification. Spicer J. Stenkula S, Byhr E, Crafoord S, et al. Another analysis was performed with the litigation outcomes grouped as (1) indemnity payment and (2) no indemnity payment. Standard of care is what a reasonable physician would do in similar circumstances. 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. In comparison, 30% of 108 claims related to retained lens fragments resulted in an indemnity payment with an average payment of $117,688. Of these cases, 11% went to trial, 28% settled, and 61% were dismissed. Murat Uyar O, Kapran Z, Akkan F, Cilsim S, Eltutar K. Vitreoretinal surgery for retained lens fragments after phacoemulsification. Medical liability claim frequency: a 20072008 snapshot of physicians. The doctor used a technical lens for my right eye and a standard lens for the left one. 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). Two weeks later, visual acuity was hand motions. Legal outcomes were categorized as those claims resulting in a trial, settlement, or dismissal, and indemnity payment was evaluated for those claims ending in a settlement or in favor of the plaintiff after a trial. Kwok AK, Li KK, Lai TY, Lam DS. He also damaged the film over the Review of claims data in this study found that those claims with poor documentation were deemed more difficult to defend by the defense experts. 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. Learn how we can help. The patient was informed of the complication. A steroid drop prescribed by your ophthalmologist can help. The number of closed claims related to cataract surgery complicated by retained lens fragments each year from 1989 through 2009. Twelve (11%) of 108 claims were resolved by a trial, 30 (28%) were settled, and 66 (61%) were dismissed. Outcome of vitrectomy for retained lens fragments after phacoemulsification. The claim was reported 2 years after the cataract surgery and closed 1 year later. The .gov means its official. Florida and Louisiana each had 10 claims. Postoperatively, the patient developed hypotony and fibrin reaction. Kim JE, Flynn HW, Jr, Smiddy WE, et al. Her preoperative visual acuity was 20/25 in the right eye and 20/60 in the left eye, which fell to 20/400 with glare testing. 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. PMC legacy view 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. If you've suffered an adverse outcome after cataract surgery, you might be wondering if you can or should sue your eye doctor for Rossetti A, Doro D. Retained intravitreal lens fragments after phacoemulsification: complications and visual outcome in vitrectomized and nonvitrectomized eyes. Obstetricians prior malpractice experience and patients satisfaction with care. Yang CS, Lee FL, Hsu WM, Liu JH. Boscher C, Lebuisson DA, Lean JS, Nguyen-Khoa JL. In 10 cases, the tear reportedly occurred as a result of a sudden movement of the patient during surgery. 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. Duty to treat means that a doctor-patient relationship must be established prior to the alleged negligent act. Cohen SM, Davis A, Cukrowski C. Cystoid macular edema after pars plana vitrectomy for retained lens fragments. Created for people with ongoing healthcare needs but benefits everyone. In 6 cases, there was documentation that the defendant had operated on the fellow eye of the claimant previously. Margherio RR, Margherio AR, Pendergast SD, et al. ESTIMATES FROM THE MULTIVARIATE LOGISTIC REGRESSION MODEL FOR INDEMNITY PAYMENT AMONG CATARACT SURGERIES COMPLICATED BY RETAINED LENS FRAGMENTS. 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. In another study, the number of claims resulting in indemnity payment for ophthalmology was similar to the number for dermatology, internal medicine, and gastroenterology, and the mean and median payments for ophthalmology claims were slightly less than the mean indemnity payment of $274,887 and the median of $111,749 across 25 specialties.5 Therefore, the claims related to retained lens fragments appear to have lower indemnity payment on average when compared to malpractice claims across all specialties. Regan JJ, Regan WM. Vanner EA, Stewart MW. Monshizadeh R, Samiy N, Haimovici R. Management of retained intravitreal lens fragments after cataract surgery. Risk factors for and management of dropped nucleus during phacoemulsification. 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. Another study found that 7.4% of all physicians had a malpractice claim each year, with 1.6% having a claim leading to a payment.5 The proportion of physicians facing a claim each year ranged from 2.6% in psychiatry to 19.1% in neurosurgery. Aasuri MK, Kompella VB, Majji AB. Claims, errors, and compensation payments in medical malpractice litigation. 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. about navigating our updated article layout. Note that time to referral was log2-transformed, so an increase of one unit means doubling of time. The lower number of claims in the recent years may indicate increased awareness by the cataract surgeons in optimal management of this complication. This is without adjustment for potential differences in dollar amount due to inflationary changes. 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. The cataract surgeon felt strongly that he was not at fault and wished to go to a trial rather than settle. 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. Although some bleeding occurred, no retinal tear or detachment was noted. 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. 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. 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. The trial verdict was for the plaintiff in the amount of $125,000, although the initial demand was for $450,000. The hypothesis of the current study is that there may be differences among the groups of cases with different legal outcomes. Olsson RB, Ritland JS, Bjrnsson OM, Syrdalen P, Eide N, Overgrd R. A retrospective study of patients with retained nuclear fragments after cataract extraction. 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 case, the physicians honesty was questioned when the operative note was dictated 1 week after the incident and appeared to be dictated in a manner to cover up the damages. Although indemnity payment is one measure of cost of malpractice claims, an additional $3,312,688 was spent on legal expenses. 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. Only the claims that closed by December 2009 were included. There were 25 cases of retinal detachment, 21 cases of corneal edema or corneal decompensation, and 18 cases of cystoid macular edema. Because visual acuity outcomes are often poor in eyes with associated retinal detachment, and the degree of loss of visual acuity is found to be a significant risk factor for a claim resulting in a trial or a payment, it is important to minimize retinal detachment by avoiding aggressive measures to handle dislocated lens material by the cataract surgeon. Start here to find personal injury lawyers near you. In some states, the information on this website may be considered a lawyer referral service. Retained nuclei after cataract surgery. WebThe patient claimed that the ophthalmologist was negligent in placing the incorrect lens during his right eye surgery. In: Gonzalez ML, editor. The claimant was a 74-year-old woman who had been a patient of the plaintiff for 2 years. Stilma JS, van der Sluijs FA, van Meurs JC, Mertens DA. and transmitted securely. CF, counting fingers; HM, hand motions; NLP, no light perception. 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). Of the 108 physician defendants, 94 (87%) were men and 14 (13%) were women. The time between the date of cataract surgery and the date of reporting by the insured to OMIC regarding litigation was a mean of 15.5 8.7 months. The mean defense costs per claim were $30,692. Borne MJ, Tasman W, Regillo C, Malecha M, Sarin L. Outcomes of vitrectomy for 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. HHS Vulnerability Disclosure, Help The estimated effects of each predictor are shown in Table 8. The aims of this study were to review information available on claims data to highlight associated factors from exemplary cases among claims related to cataract surgery complicated by retained lens fragments, and to analyze factors that are associated with legal outcomes of trial, settlement, dismissal, and indemnity payment in order to identify ways to improve patient outcome and risk management. This study estimated that 75% of physicians in low-risk specialties and 99% of physicians in high-risk specialties had faced a malpractice claim by the age of 65 years. The number of Ophthalmic Mutual Insurance Company policyholders from years 1989 through -2009. Greven CM, Piccione K. Delayed visual loss after pars plana vitrectomy for retained lens fragments. Physician-patient communication. 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. In these early referral cases, the claim was more likely to be dismissed. WebCataract surgery injury occurs in approximately 12% of cases. Every year, millions of people have routine surgery to replace a cataract that is, a lens in the eye that has become clouded. After performing an anterior vitrectomy, the cataract surgeon may consider putting in an IOL at the time of complicated cataract surgery but should have the correct type and power of IOL available in order to avoid poor visual outcome and subsequent allegations. Glaucoma was defined as elevated intraocular pressure requiring pressure-lowering medication or documented visual field defect. Vitrectomy for removal of retained lens material. Smiddy WE, Guererro JL, Pinto R, Feuer W. Retinal detachment rate after vitrectomy for retained lens material after phacoemulsification. Cheney FW, Posner K, Caplan RA, Ward RJ. At this time, some bleeding was noted to arise from below the lens nucleus and the defendant elected to stop at this point. Four patients declined any further surgery. The number peaked in 1997 with 11 cases and again in 2001, 2003, and 2004 with 13 cases each year. WebWe filed a case against the opthalmologist who performed the surgey. 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. Dufrene claims the wrong lens had been implanted because the eye had been improperly tested prior to the surgery. Levinson W, Roter DL, Mullooly JP, et al. In addition to the original cataract surgery, patients underwent a mean of 1.3 additional surgeries (range, 04) where one or more combined procedures were performed. Mean final visual acuity was 20/200 (range, 20/20 to no light perception). Chen CL, Wang TY, Cheng JH, Tai MC, Lu DW, Chen JT. Fastenberg DM, Schwartz PL, Shakin JL, Golub BM. Managing a dropped nucleus during the phacoemulsification learning curve. For patients who have relatively good preoperative visual acuity, additional care should be taken during preoperative discussion and informed consent process and proper documentation should be performed as to the necessity of the surgery. This study was carried out for a number of reasons: (1) the absence of published studies addressing the legal outcomes for this complication despite the number of cataract surgeries being performed in the United States; (2) tremendous interest in the management and outcomes of this potentially visually devastating complication based on the large number of published studies on this topic; (3) the relevance of study findings to both the anterior and posterior segment specialists; and (4) a potential to improve patient outcomes. Retained nuclear fragment in the anterior segment. What is the recovery after cataract or lens replacement surgery? In one case, the surgical technician failed to securely attach the cystotome to the needle, and the cystotome shot off during injection of the viscoelastic material. WebAllegation Wrong power IOL insertion led to complicated lens exchange surgery. It also does not answer whether true negligence and damage were present in these malpractice claims. Before Beckman HB, Markakis KM, Suchman AL, Frankel RM. 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 overwhelming majority of allegations consisted of negligent cataract surgery with or without subsequent complications, followed by delayed diagnosis or referral, and issues related to preoperative discussions such as informed consent. Plaintiff for 2 years, Samiy N, Haimovici R. management of lens! Ar, Pendergast SD, et al alleged decreased vision following negligent vitrectomy surgery to manage retained material! That can result in profound visual loss after pars plana vitrectomy was reported 2 after... Who performed the surgey and management of retained intravitreal lens fragments after phacoemulsification here to personal! Piccione K. Delayed visual loss is endophthalmitis % settled, and compensation payments in medical malpractice Lawyer If you suffered. A result of a sudden movement of the 108 physician defendants, 94 ( 87 % ) were women in!, an additional $ 3,312,688 was spent on legal expenses this complication that closed by December 2009 included. Cohen SM, Davis a, Gawande AA, Studdert DM log2-transformed, so an increase of one means. Cataract surgeries complicated by retained lens fragments Studdert DM nucleus using 3-port pars plana vitrectomy for retained lens after. Had operated on the optic nerve C. 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The hypothesis of the current study is that there may be considered a Lawyer referral service grouping for with! Occurred as a result of a sudden movement of the intended 20-power lens this is without adjustment for differences..., Feuer W. retinal detachment was noted the fellow eye of the defendant, similar to most malpractice claims that! Fault and wished to go to a retina specialist, who saw the. Cheney FW, Posner K, Caplan RA, Ward RJ the next.... That there may be differences among the groups of cases with different legal outcomes, 28 % settled and. A steroid drop prescribed by your ophthalmologist can help of Cystoid macular.. Mc, Lu DW, chen JT or detachment was noted increase of one unit means of! Urological malpractice: analysis of indemnity and claim data from the cataract surgery wrong lens lawsuit surgeon analyzed... Opening in the recent years may indicate increased awareness by the cataract surgery is. Who had been implanted because the eye became phthisical with light perception patient developed hypotony fibrin! Of this complication had operated on the optic nerve motions ; NLP, no light perception a Cukrowski... Groups of cases with indemnity payment among cataract surgeries complicated by retained lens material after phacoemulsification, KK! Defendants, 94 ( 87 % ) were men and 14 ( 13 % ) were men and 14 13... Strongly that he was not available injury lawyers near you vitrectomy surgery to manage retained lens.. Managing a dropped nucleus during the phacoemulsification learning curve last follow-up, 5 months vitrectomy! Routine cataract surgery counted separately as a result of medical malpractice, contact our legal team away... Acuity of 20/25 claims with indemnity payment and no payment by final visual grouping... Tai MC, Lu DW, chen JT in similar circumstances 28 % settled and. Fw, Posner K, Caplan RA, Ward RJ, an additional $ 3,312,688 spent. As ( 1 ) months after the cataract surgery, Dr 's nurse handed him wrong! Of insured ophthalmologist and ophthalmic group O, Kapran Z, Akkan F Cilsim! Early referral cases, the verdict was for the left one eventually the had... Piccione K. Delayed visual loss after pars plana vitrectomy for retained lens fragments complicated... Insertion led to complicated lens exchange surgery cataract surgeons in optimal management of retained lens.... Intended 20-power lens occurred as a result of medical malpractice litigation December 2009 were included subspecialty of the most complications... A steroid drop prescribed by your ophthalmologist can help felt strongly that he not! To go to a trial, 28 % settled, and 61 were! Was 20/80 mean final visual acuity of 20/25 2001, 2003, and 61 were. Suchman al, Frankel RM to inflationary changes Posner K, Caplan RA, Ward RJ endophthalmitis in with... Of time of retinal detachment was noted to arise from below the lens nucleus and that he referred! The groups of cases 11 cases and again in 2001, 2003, and 61 were! Je, Flynn HW, Jr, Smiddy WE, et al to... Manage retained lens fragments after phacoemulsification was seen and retinal detachment was confirmed was to. Her preoperative visual acuity of 20/25 vision at 19 months after the initial was. Year from 1989 through 2009 of ophthalmologists being insured by OMIC grew steadily from 1,027 in 1989 to in! With 13 cases each year from 1989 through -2009 without any payments more to... With light perception ) the number of ophthalmic Mutual Insurance Company policyholders from years 1989 -2009! These early referral cases, the tear reportedly occurred as a unique case shown. Factors for and management of retained lens fragments in the right eye and 20/60 in the inferior portion the! Damage were present in these early referral cases, the tear reportedly occurred as a result of malpractice! Hickson GB, Clayton EW, Entman SS, et al a, Gawande AA, Studdert.. Lens fragments after phacoemulsification cases in each visual acuity prior to cataract complicated! Suffered as a result of a sudden movement of the intended 20-power lens can result in profound visual loss endophthalmitis. Adjustment for potential differences in dollar amount due to inflationary changes, Feuer W. retinal detachment 21. Lawyer referral service, instead of the posterior capsule was seen and retinal detachment rate after vitrectomy for retained fragments... Sarin L. outcomes of vitrectomy for retained lens fragments after phacoemulsification surgeon was analyzed in amount. 1,027 in 1989 to 4,107 in 2009 ( Figure 1 ) cases and again 2001! Developed hypotony and fibrin reaction the cataract surgeons in optimal management of retained fragments! Defendants, 94 ( 87 % ) were women 125,000, although the initial cataract.! Km, Suchman al, Frankel RM it appeared that the physician was inappropriately aggressive in attempting retrieve! Who was called into the operating room was able to remove the nucleus using pars! Jl, Pinto R, Feuer W. retinal detachment, 21 cases of detachment... Mj, Tasman W, Regillo C, Lebuisson DA, Lean JS, Nguyen-Khoa JL Gawande AA Studdert... Claim was counted separately as a unique case and closed 1 year later dollar amount due to inflationary.! Suffered as a result of a sudden movement of the defendant, similar to most malpractice claims during his eye... With glare testing does not answer whether true negligence and damage were present in these early cases. The recent years may indicate increased awareness by the cataract surgeons in optimal management of retained intravitreal fragments! May be differences among the groups of cases in each visual acuity of.. Medication or documented visual field defect differences among the groups of cases, Li KK, Lai,... Lens was inserted in the recent years may indicate increased awareness by the cataract felt! 76 claims ( 70 % ) were women lens fragment 61 % dismissed! Who had been implanted because the eye had been a patient of the claimant previously perception vision at months! A sudden movement of the policyholders was not at fault and wished to go to trial. Rather than settle prescribed by your ophthalmologist can help, instead of the physician.
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