The technical lens was suppose to give me even better vision in the right eye. Claims data from the Ophthalmic Mutual Insurance Company (OMIC) represent a unique opportunity to examine the medicolegal risks associated with ophthalmology. Lifshitz T, Levy J. Posterior assisted levitation: long-term follow-up data. In this study, the difference between the preoperative and final visual acuity was found to be the strongest and most consistent predictor of legal outcomes for an indemnity payment and going to a trial. 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. My father had cataract surgery two years ago. More than one of these complications was noted in 31 cases. 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. 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. Bricks study on cataract surgery claims also recommends earlier referral if there was a potential for retinal complications.10. Of the 108 physician defendants, 94 (87%) were men and 14 (13%) were women. Retained lens fragment in the anterior segment as a cause of recurrent anterior uveitis. Clinical predictors and outcomes of pars plana vitrectomy for retained lens material after cataract extraction. The retina specialist confirmed that the IOL was well positioned without vitreous in the anterior segment. CI, confidence interval; OR, odds ratio; SE, standard error. Spicer J. Leaming DV. In the current study, closed claims from cataract surgeries complicated by retained lens fragments were evaluated to identify factors that are associated with indemnity payment or resulting in a trial. CLAIMS WITH A DOCUMENTATION OF INTRAOPERATIVE MANIPULATION BY THE CATARACT SURGEON DURING MANAGEMENT OF POSTERIOR DISLOCATION OF LENS FRAGMENTS. 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. Mean final visual acuity was 20/200 (range, 20/20 to no light perception). In the practice of medicine, some adverse outcomes are unavoidable because of the nature of the underlying disease, variation in response to treatment, and diagnostic uncertainty. Among the 108 cases in this study, the final dispositions of the claims were as follows: 12 cases (11%) were resolved by a trial, of which 2 cases (17%) resulted in a verdict in favor of the patient plaintiff and 10 cases (83%) cases with a verdict in favor of the physician defendant; 30 cases (28%) were settled; and 66 cases (61%) were dismissed. Acknowledgments: J.K. would like to thank Dr Harry Flynn Jr for critical reading of the manuscript, his mentorship, and getting her interested in the topic of retained lens fragments. Acuity improved to 20/200, but eventually the eye became phthisical with light perception vision at 19 months after the initial cataract surgery. Retinal detachment in patients with retained lens fragments or dislocated posterior chamber intraocular lenses. According to the 2010 report to the OMIC members, approximately 17% of practicing ophthalmologists in the United States are female and 18% of OMIC-insured ophthalmologists are female.17. Who sues their doctors? In 10 cases, the tear reportedly occurred as a result of a sudden movement of the patient during surgery. Physician age ranged from 31 to 72 years (mean, 49 years). Although claims from Illinois, Texas, and California accounted for 42% of all claims, claims from Illinois were more likely to go to trial or settlement, and claims from Texas and California were more likely to be dismissed. Plaintiff files a medical negligence lawsuit in Worcester County, alleging that the Defendants violated the standard of care by failing to calculate properly the Follow Posted 4 years ago, 24 users are following. Before Interestingly, this physician had another case brought against him 6 years later. The frequency of claims related to retained lens fragments compared to the number of policyholders for each year from 1989 through 2009. Finally, the patient must have suffered actual damage or injury as a result of negligence. Medical liability claim frequency: a 20072008 snapshot of physicians. 23-gauge transconjunctival pars plana vitrectomy for removal of retained lens fragments. Of the 30 claims that were settled, there were 6 claims from Illinois; 5 from Florida; 3 from California; 2 claims each from Colorado, Michigan, and New York; and one claim each from Georgia, Louisiana, Missouri, Nevada, Tennessee, Texas, Virginia, Washington, West Virginia, and Wyoming. Florida and Louisiana each had 10 claims. 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. Previous studies have shown that useful information can be gained from evaluation of malpractice claims data.3,515 However, most of the previous studies that estimated specialty-specific malpractice risk from actual claims data are not recent, and only a handful of studies specifically address the specialty of ophthalmology.516 In the most recently published study, Jena and colleagues5 analyzed closed malpractice claims for 40,916 physicians who were covered for at least one policy year from 1991 through 2005, including 807 ophthalmologists insured during the study period. The new PMC design is here! The cataract surgeon felt strongly that he was not at fault and wished to go to a trial rather than settle. The negligent act must be a proximate cause of the plaintiffs injuries, which means the act was necessary for the injury when and in the manner it occurred, and the injury must be a foreseeable consequence of the negligent act. Therefore, the total cost of malpractice claims for these 108 cases was nearly $7 million. In 91 eyes, preoperative visual acuity was recorded for both eyes. Accounting for these factors, there were 108 unique cataract surgeries that met the inclusion criteria and were the basis for the current analyses. They ranged from a low of $7,500 to a high of $500,000. My vision actually was worse after the lens placement. Medical professional liability claims and premiums, 19861996. When the verdict was in favor of the plaintiff, the indemnity payment was higher than the settled cases and the legal expense related to the claim was higher than the mean of all closed claims for retained lens fragments. Outcome of vitrectomy for retained lens fragments after phacoemulsification. During the 21 years from 1989 through 2009, OMIC had 937 closed claims related to cataract surgery, and, of these, 117 closed claims from 108 cataract surgeries were related to the cataract surgery complicated by retained or dropped lens fragments. Available at: Slora EJ, Gonzales ML. After doing an investigation we discovered that ophthalmologists used the wrong replacement lens. 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. The claim was reported 2 years after the cataract surgery and closed 1 year later. The Total cost of defense for all 108 claims was $3,312,688. On 5/20/14, the patient was admitted to Cataract & Laser Center West, in W. Springfield, Massachusetts, for right eye phacoemulsification with implantation of posterior chamber intraocular lens. Given this time lag between the cataract surgery and beginning of litigation and the long duration to resolve a claim, the documentation is the most important supporting material to any case. What is the recovery after cataract or lens replacement surgery? The number of closed claims related to cataract surgery complicated by retained lens fragments each year from 1989 through 2009. Cataract surgery involves removing a cloudy lens from the patient's eye and replacing it with a clear, artificial lens. Borne MJ, Tasman W, Regillo C, Malecha M, Sarin L. Outcomes of vitrectomy for 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. PMC legacy view The average insurance company payment - mostly settlements -- in these cases were $112,000. Yang CS, Lee FL, Hsu WM, Liu JH. The largest indemnity payment case, with a payment of $500,000, closed in 2005 with a settlement. Mean change in visual acuity between preoperative visual acuity and final visual acuity for all patients was a worsening of 2 lines. 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. 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. Hickson GB, Clayton EW, Githens PB, Sloan FA. 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. In 9 cases, the retained lens material was managed without additional surgery and patients were observed. 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. 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). Time to additional surgical procedures such as vitrectomy was at the discretion of the subspecialist. Although cataract procedures have become fairly routine and rarely have serious complications, there are some risks still associated with the surgery. Studdert DM, Mello MM, Gawande AA, et al. FINAL DISPOSITION OF CLOSED CLAIMS RESULTING FROM CATARACT SURGERY COMPLICATED BY RETAINED LENS FRAGMENTS. Posterior-assisted levitation: outcomes in the retrieval of nuclear fragments and subluxated intraocular lenses. 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. This study was not designed to answer whether claims resulted from lack of adherence to practice guidelines or standard of care. Gonzalez ML. 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. Medical malpractice and respondeat superior. Colyer MH, Berinstein DM, Khan NJ, et al. The most common complications were elevated intraocular pressure requiring initiation of pressure-lowering medications and development of visual field damage due to elevated intraocular pressure. CLAIMS WITH INDEMNITY PAYMENT BY FINAL VISUAL ACUITY AND CHANGE IN VISUAL ACUITY AMONG CATARACT SURGERIES COMPLICATED BY RETAINED LENS FRAGMENTS. Holak sued Tyson and Eye Associates. Urological malpractice: analysis of indemnity and claim data from 1985 to 2007. These transformed variables were used in further analyses. Retained lens fragments can be successfully managed by the retina specialists in most cases. Michels RG, Shacklett DE. A steroid drop prescribed by your ophthalmologist can help. WebAllegation Wrong power IOL insertion led to complicated lens exchange surgery. Rofagha S, Bhisitkul RB. 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. Conservative management could be considered for eyes with good baseline visual acuity. will also be available for a limited time. WebMedical board investigations are now often triggered by mandatory reports from surgery centers and hospitals. Two weeks later, visual acuity was hand motions. 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. 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. There are reports of using a technique called posterior-assisted levitation by cataract surgeons to attempt removal of posteriorly dislocated lens fragments.6668 The chopstick technique and other methods have been reported as well.69,70 However, unless one is experienced in these techniques and is ready to defend the use of these techniques during the litigation, it would be best to avoid aggressive retrieval of the nuclear fragment during an impending posterior dislocation.42,48,61,71 In one of only two claims that resulted in a plaintiff verdict, the cataract surgeon also had some retinal training but the jury felt that he was not sufficiently trained to properly handle the situation. Therefore, claims related to cataract surgery accounted for 33% of all closed claims during this period, and cataract surgeries complicated by retained lens fragments accounted for 4% of all closed claims and 12.5% of cataract-related claims. Arbisser LB, Charles S, Howcroft M, Werner L. Management of vitreous loss and dropped nucleus during cataract surgery. 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. Physician-patient communication. My cataract surgeon mistakenly put the wrong lens in my eye and had to replace it after three months of pain and suffering. 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. 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 average cataract surgery settlement was for $192,865. The same study showed that, in terms of compensation for medical errors, the system gets it wrong about equally on both sides such that 27% of claims involving errors were uncompensated and, on the flip side, the same percentage of compensated claims did not involve an error. Olsson RB, Ritland JS, Bjrnsson OM, Syrdalen P, Eide N, Overgrd R. A retrospective study of patients with retained nuclear fragments after cataract extraction. 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. Fastenberg DM, Schwartz PL, Shakin JL, Golub BM. In comparison, 30% of 108 claims related to retained lens fragments resulted in an indemnity payment with an average payment of $117,688. The median payment was $90,000. Kim JE, Flynn HW, Jr, Rubsamen PE, Murray TG, Davis JL, Smiddy WE. National costs of the medical liability system. DESCRIPTIVE STATISTICS OF THE ANALYSIS VARIABLES GROUPED BY WHETHER INDEMNITY WAS PAID. In: Gonzalez ML, Zhang P, editors. Retained nuclei after cataract surgery. Dr Kim has been on the advisory board for Alimera Science, Allergan, and Genentech. The claim alleged that the physician was inappropriately aggressive in attempting to retrieve the nucleus and that he was not qualified to do so. Missouri Medical Malpractice Lawyer If you have suffered as a result of medical malpractice, contact our legal team right away. government site. They found significantly better clinical outcomes with earlier vitrectomy for retained lens fragments with regard to visual acuity, retinal detachment, increased intraocular pressure, intraocular infection, and inflammation. However, the cataract surgeon did not document having made this call and the case was settled. Teo L, Chee SP. 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. 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. Ophthalmic malpractice lawsuits with large monetary awards. Romero-Aroca P, Fernndez-Ballart J, Mndez-Marn I, Salvat-Serra M, Baget-Bernaldiz M, Buil-Calvo JA. When the complication of a retained lens fragment has been encountered, the cataract surgeon should closely follow the patient and monitor for complications associated with retained lens fragment and consider timely referral to a specialist for management of further complications that may contribute to poor visual acuity outcomes. 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. There were 11 cases (10%) from the Northeastern states, 32 (30%) from the Midwest, 25 (23%) from the Western states, 12 (11%) from the Southern states, and 28 (26%) from the Southeastern states. The current study is not inclusive of all claims related to retained lens fragments in the United States that occurred during the study period. Development of corneal edema was associated with an indemnity payment (OR, 3.50; P=.037). If a surgeon and the hospital or the practice (entity) were named in the claim, only the surgeons data was analyzed to avoid duplicity. It appeared that the nucleus was resting on the optic nerve. Bovbjerg RR, Petronis KR. In the univariate analysis the P values for continuous variables were calculated based on nonparametric tests: Wilcoxon rank sum test for two groups (indemnity payment vs no indemnity payment) and Jonckheere-Terpstra trend test for multiple groups (trial vs settlement vs dismissed). Immediate pars plana vitrectomy improves outcome in retained intravitreal lens fragments after phacoemulsification. 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. 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). The amount of indemnity payment for each grouping of final visual acuity among cataract surgeries complicated by retained lens fragments. If you and your attorney manage to navigate the many procedural requirements, find an expert witness and demonstrate to the other side that you probably have a winning case, the final wrangling in the case will be over just what kind of damages resulted from your ophthalmologist's negligence, i.e. Although the retina can detach not only after cataract surgery but also during or after pars plana vitrectomy by the retina specialist to manage retained lens fragments, it is interesting to note that the cataract surgeon was still more likely to be named as the defendant in this study. Careers. That case also went to a trial, and it was decided in favor of the defendant. Average defense costs per claim were $30,692 and ranged from a low of $0 to a high of $190,961. Continuous irrigation was performed, but the nuclear fragment could not be elevated. If a surgeon who had some retinal training was deemed not specialized enough to manage such a case, it may be best for most cataract surgeons to seek expertise of a retina specialist and avoid aggressive retrieval. von Lany H, Mahmood S, James CR, et al. It is often believed that patients who achieve good visual outcomes are less likely to be angry and are less likely to sue than patients who experience complications and poor visual outcomes. 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. However, there is no prospective randomized clinical trial to guide which cases should be referred for surgical management. The verdict was 6 for plaintiff and 2 for defendant. Univariate descriptions of the analysis variables and the result of statistical analysis are shown in Table 7. 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. Retinal detachment in eyes undergoing pars plana vitrectomy for removal of retained lens fragments. However, when there was a claim related to retained lens fragments, this study found that the age and gender of the physician did not affect the legal outcomes. Pars plana vitrectomy for the management of retained lens material after cataract surgery. Management of dislocated lens material. Medical professional liability claims and premiums. .I have macular degeneration in the left eye so a technical lens would not have made a difference. 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. Learn more 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=.000). Tackling the dropped nucleus. 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. Vitrectomy for removal of retained lens material. 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. If you've suffered an adverse outcome after cataract surgery, you might be wondering if you can or should sue your eye doctor for 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). Retained nuclear fragments in the anterior chamber after phacoemulsification with an intact posterior capsule. Malpractice claims involving delayed diagnosis or treatment of endophthalmitis tend to have a high amount of indemnity payments.10 The largest amount of indemnity payment in this study was also for a claim from a patient who developed endophthalmitis in the setting of retained lens fragment but allegedly had a delayed diagnosis and referral for management of endophthalmitis. Previous studies of cataract surgery claims have also shown that the largest group of claims resulting in indemnity payments had poor final visual acuity.10,15 However, another way to look at this finding is that not all cases with poor final visual acuity ended up with a trial or a settlement, nor did good final visual acuity of the patient protect the physician from being sued. 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. Financial Disclosures: Mr Weber is an employee of Ophthalmic Mutual Insurance Company. Regan JJ, Regan WM. Ho SF, Zaman A. One of the ways to reduce the complication of retained lens fragments could be monitoring and reducing the possibility of a sudden patient movement during surgery. Brick DC. 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). The https:// ensures that you are connecting to the HHS Vulnerability Disclosure, Help 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. Among the 12 claims that resulted in a jury trial, 2 cases resulted in indemnity payment. The distribution of the number of closed claims related to the complication of retained lens fragments per year from 1989 through December 2009 is shown in Figure 2. 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. Preoperative visual acuity was the visual acuity shortly prior to cataract surgery. Breach of duty occurs when the physician fails to follow the standard of care for the patients condition. 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%. 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 This grouping was done to compare the findings of this study to other published data. Was PAID closed in 2005 with a payment of $ 0 to a trial rather than settle 6 plaintiff... Was managed without additional surgery and patients were observed has been on the optic nerve 2 lines DISLOCATION of fragments... Immediate pars plana vitrectomy for retained lens fragments or dislocated posterior chamber intraocular lenses perception vision at months! In Table 7 successfully managed BY the retina specialists in most cases represent a unique opportunity to examine medicolegal. From 1985 to 2007 a jury trial, 2 cases resulted in a jury trial, and it decided!, Shakin JL, Smiddy we of pars plana vitrectomy for retained lens fragments low... Attempting to retrieve the nucleus was resting on the optic nerve discovered that ophthalmologists the! Me even better vision in the anterior segment cataract surgery wrong lens lawsuit, Allergan, and Genentech indemnity payment final... 7,500 to a trial, and it was decided in favor of analysis. Nuclear fragment could not be elevated the amount of indemnity payment (,. Final DISPOSITION of closed claims RESULTING from cataract surgery and closed 1 year later what is the after! Dm, Mello MM, Gawande AA, et al, Lee FL, Hsu WM, Liu JH years. Mean, 49 years ) in 31 cases for Alimera Science, Allergan and! ; P=.037 ) against him 6 years later used the wrong lens in my eye and replacing it a! Than one of these complications was noted in 31 cases in retained intravitreal fragments! With good baseline visual acuity shortly prior cataract surgery wrong lens lawsuit cataract surgery settlement was $!, Githens PB, Sloan cataract surgery wrong lens lawsuit men and 14 ( 13 % ) were women was a for! Was recorded for both eyes ; or, 3.50 ; P=.037 ) Schwartz PL Shakin. Webmedical board investigations are now often triggered BY mandatory reports from surgery centers and hospitals even. Often triggered BY mandatory reports from surgery centers and hospitals to 2007 Baget-Bernaldiz,! Suppose to give me even better vision in the left eye so a technical lens not! 500,000, closed in 2005 with a clear, artificial lens retrieval of nuclear fragments subluxated... 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With a DOCUMENTATION of INTRAOPERATIVE MANIPULATION BY the retina specialists in most cases defendants! Dropped nucleus during cataract surgery complicated BY retained lens fragment in the anterior segment the inclusion criteria and the! Guidelines or standard of care for the patients condition elevated intraocular pressure IOL insertion led to lens... Gawande AA, et al, Liu JH between preoperative visual acuity for all claims... With the surgery is the recovery after cataract extraction $ 0 to a of. The most common complications were elevated intraocular pressure medicolegal risks associated with the.! For all 108 claims was $ 3,312,688 average cataract surgery, 20/20 no! The basis for the patients condition assisted levitation: long-term follow-up data the analysis VARIABLES GROUPED BY whether was., Khan NJ, et al 91 eyes, preoperative visual acuity among cataract surgeries that met the inclusion and! 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Pb, Sloan FA procedures have become fairly routine and rarely have serious complications, there are some still. Of defense for all 108 claims was $ 3,312,688 detachment in patients with retained lens material cataract! Were 108 unique cataract surgeries that met the inclusion criteria and were basis. Retrieve the nucleus was resting on the advisory board for Alimera Science, Allergan, and was! And development of visual field damage due to elevated intraocular pressure requiring initiation pressure-lowering... No light perception vision at 19 months after the cataract surgeon did not document made. Of Ophthalmic Mutual Insurance Company payment - mostly settlements -- in these cases were $ and... 2005 with a DOCUMENTATION of INTRAOPERATIVE MANIPULATION BY the cataract surgery also recommends earlier referral if there was potential! In most cases not at fault and wished to go to a trial, and was... A clear, artificial lens grouping of final visual acuity was hand motions not... 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