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. 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. Claims were separated into regions of the United States as seen in Figure 4. The claimant was a 74-year-old woman who had been a patient of the plaintiff for 2 years. After doing an investigation we discovered that ophthalmologists used the wrong replacement lens. Among these 10 cases, general anesthesia was not cleared, and the surgery was performed under monitored sedation in 1 case, the patient woke up suddenly during surgery in 2 cases, and the patient reportedly moved suddenly during the cataract surgery in 4 cases. Oruc S, Kaplan HJ. Management of dislocated lens fragments following phacoemulsification surgery. A study on causes of cataract surgery malpractice claims in England showed that claims relating to biometry errors and wrong IOL power were the second most frequent cause of claims and resulted in payment of damages in 62% of cases.73 In 9% of claims related to retained lens fragments, the capsular tear apparently was due to a sudden or uncontrollable movement of the patient during surgery. The model was simplified using backward selection keeping all predictors with a P value of .25 or less. Teo L, Chee SP. A study based on a survey of retina specialists recommended that vitreoretinal surgeons should place an increased importance on the informed consent process and the patient/doctor relationship in order to improve risk management.16 Informed consent is a process rather than a form. The complication of capsular tear and retained lens fragments was further aggravated by development of corneal wound dehiscence, corneal ulcer, and endophthalmitis. 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. Had Cataract surgery, Dr's nurse handed him the wrong lens but he didn't check it. The mean defense costs per claim were $30,692. 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. Risk factors for and management of dropped nucleus during phacoemulsification. WebThere has been a large interest over the years in clinical outcomes and management of retained lens fragments as evidenced by the substantial number of articles continuing to Four patients declined any further surgery. 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 needle impaled the lens and tore the lens capsule. Day S, Menke AM, Abbott RL. The issue of malpractice has wide-ranging stakeholders, including our society. Acuity improved to 20/200, but eventually the eye became phthisical with light perception vision at 19 months after the initial cataract surgery. government site. National costs of the medical liability system. The retina initially attached and intraocular pressure improved to 10 mm Hg, but the retina detached again 5 months later and corneal decompensation developed. Postoperative complications with significant inflammation causing corneal edema or corneal decompensation were found to be a potential risk factor for increasing the odds of an indemnity payment by more than threefold (P=.037). 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. Ali N, Little BC. Bethesda, MD 20894, Web Policies 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. May M, Stengel B. Both of these were defined as glaucoma, and there were a total of 31 cases. When intraocular pressure or inflammation cannot be managed adequately or cystoid macular edema is detected, the patient should be definitely referred to a specialist. Bricks study on cataract surgery claims also recommends earlier referral if there was a potential for retinal complications.10. Mean change in visual acuity between preoperative visual acuity and final visual acuity for all patients was a worsening of 2 lines. Miller KP. Bessant DA, Sullivan PM, Aylward GW. Expert testimony. ACOG Committee Opinion No.374. Some cases that opened in more recent years are still open and are not a part of this study. Schaal S, Barr CC. Financial Disclosures: Mr Weber is an employee of Ophthalmic Mutual Insurance Company. In 11 eyes, the operated eye was the better eye. 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. To be insured by OMIC, an ophthalmologist must be a member of the American Academy of Ophthalmology. However, when refractive surprises occur with no warning after routine cataract surgery, it is important to stay calm. Professional liability insurance: II The legal environment. The current study found that the amount of difference between the preoperative visual acuity and the final visual acuity was a more significant predictor of legal outcomes than the final visual acuity alone. Light sensitivity after cataract surgery After cataract removal, a little bit of light sensitivity is expected due to dryness in the eye. 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. Seven hundred medicolegal cases in ophthalmology. Leaming DV. Obstetricians prior malpractice experience and patients satisfaction with care. Vanner EA, Stewart MW. Arbisser LB, Charles S, Howcroft M, Werner L. Management of vitreous loss and dropped nucleus during cataract surgery. 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. Margherio RR, Margherio AR, Pendergast SD, et al. Final visual acuity was the last recorded visual acuity. According to the Physician Insurers Association of America (PIAA), a large multispecialty liability insurance carrier, the following occurred in 2008: 65% of claims were dropped, dismissed, or withdrawn; 25.7% were settled; 4.5% were decided by alternative dispute mechanism; and 5% were resolved by trial, with the defendant prevailing in 90% of those tried cases.79, It is important to point out that the claim frequency should not be used as an estimate of the error rate or malpractice rate in medicine. 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 defense expert stated that (1) it is unclear as to when the vitreous prolapsed, since it was not noted at the time of postoperative examinations by the cataract surgeon or even by the retina specialist at the initial consultation, (2) the standard of care does not require that every rupture of the posterior capsule be recognized, and (3) following treatment for the retinal detachment, the patient attained a visual acuity of 20/25, which indicated a successful management of this complication. The remaining 76 claims (70%) closed without any payments. Do Not Sell or Share My Personal Information, Do Not Sell or Share My Personal Information, improper application of anesthesia, such as globe perforation, and, a variety of post-operative complications, such as swelling, Pre-suit requirements like screening panels, advance notice of the lawsuit, mandatory settlement negotiations and ", Expert witnesses experienced in the particular field of health care must testify on behalf of either, The total amount a plaintiff can recover from a health care provider might be limited by a ". The majority of eyes developed one or more ocular complications following surgery, many of which contributed to poor visual outcome. One unit change between preoperative and final visual acuity ( logMAR visual acuity) resulted in a 2.30-fold increase in likelihood of indemnity payment (P=.001). 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. Timing of referral and elevated intraocular pressure (IOP) were statistically significant in univariate analyses but not in multivariate analyses for a trial. Estimated fees to plaintiffs attorneys were $2 billion, which was included in indemnity payments. 8600 Rockville Pike Physicians with higher frequency of patient complaints may indicate less attention to interpersonal or technical aspects of patient care.2,8691 Interestingly, a physicians credentials, such as board certification, ranking of medical school attended, and foreign medical school graduate vs US graduate, did not have a significant impact on whether a physician was more likely to get sued or not.4 However, various studies indicate that the risk of being sued appears to be related to patients dissatisfaction, which may be related to their physicians ability to establish rapport, provide access, administer care consistent with expectations, and communicate effectively and in a timely fashion.4, 8791 Other physicians who subsequently manage the patient may also have a role in the patients decision to bring a claim.91. The number peaked in 1997 with 11 cases and again in 2001, 2003, and 2004 with 13 cases each year. A cataract is a clouding of the natural lens inside the eye due to many different causes, like aging, toxic exposures, or injury. The third claim alleged decreased vision following negligent vitrectomy surgery to manage retained lens fragment. AC IOL, anterior intraocular lens; OD, right eye; OMIC, Ophthalmic Mutual Insurance Company; OS, left eye; PC IOL, posterior intraocular lens; VA, visual acuity. Kraushar MF, Robb JH. CF, counting fingers; HM, hand motions; LP, light perception; MVR, microvitreoretinal; NLP, no light perception; PPL, pars plana lensectomy; PPV, pars plana vitrectomy; RD, retinal detachment; VA, visual acuity. Associated factors were analyzed for (1) going on to a trial or settlement rather than being dismissed, and for (2) indemnity payment vs no payment. 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. Retinal detachment in patients with retained lens fragments or dislocated posterior chamber intraocular lenses. Whether the findings of this study are representative depends on whether physicians who were covered by the insurance carrier of this study were more or less likely to be sued than physicians who were insured elsewhere. Therefore, appropriate management of elevated intraocular pressure is necessary to reduce poor patient outcome. My vision actually was worse after the lens placement. Brick DC. Note that time to referral was log2-transformed, so an increase of one unit means doubling of time. A retinal surgeon who was called into the operating room was able to remove the nucleus using 3-port pars plana vitrectomy. All 3 claims were dismissed due to lack of prosecution and closed without payment. Among the 108 cases, two physicians had multiple claims relating to retained lens fragments, with 2 claims each. Retrospective, noncomparative, consecutive case series. Since it takes over 44 months on average between cataract surgery and close of a claim, there still may be open claims from years 2006 and forward. The patient was informed of the complication. The number of policyholders doubled between years 2000 and 2009. 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%. The estimated incidence of the complication of retained or dropped lens fragment in the literature is 0.1% to 1.6% of cataract surgeries, but in the current study 12.5% of closed claims related to cataract surgery were associated with retained lens fragments. The retina successfully reattached with a final visual acuity of 20/25. 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. On average, a claim took 28.8 21.2 months to close. 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. 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. Retained lens fragments after phacoemulsification. 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. In the multivariate analysis, only the amount of change between preoperative and final visual acuity ( logMAR visual acuity) was found to be statistically significant in predicting more severe legal outcome. The number of Ophthalmic Mutual Insurance Company policyholders from years 1989 through -2009. From 1989 through December 2009, OMIC had a total of 2,854 closed claims. Author Contributions: Design and conduct of the study (J.K.); Collection, management, analysis, and interpretation of the data (J.K., P.W., A.S.); Preparation, review, and approval of the manuscript (J.K., P.W., A.S.). Liability claims and costs before and after implementation of a medical error disclosure program. Physician-patient communication. Horozoglu F, Yanyali A, Macin A, Nohutcu AF, Keskinbora KH. She underwent corneal transplantation, pars plana vitrectomy, membrane peeling, and silicone oil placement. National Library of Medicine This gender spread was compared with OMIC data on demographics. The first case closed in 1992 for $125,000, and the second case closed in 2002 for $250,000. However, as consultants, vitreoretinal surgeons should remember that they are still at a risk for being included in lawsuits directed toward other physicians and may be named as primary defendants due to significant potential for severe visual impairment among the conditions they manage.16. The trial verdict was for the plaintiff in the amount of $125,000, although the initial demand was for $450,000. Also, claims with worse final visual acuity tended to have higher indemnity payments (Figure 6). The mean age was 69 years (range, 4090 years). 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. Hickson GB, Federspiel CF, Pichert JW, Miller CS, Gauld-Jaeger J, Bost P. Patient complaints and malpractice risk. and transmitted securely. CLAIMS WITH INDEMNITY PAYMENT BY FINAL VISUAL ACUITY AND CHANGE IN VISUAL ACUITY AMONG CATARACT SURGERIES COMPLICATED BY RETAINED LENS FRAGMENTS. WebMedical board investigations are now often triggered by mandatory reports from surgery centers and hospitals. Cataract surgery involves removing a cloudy lens from the patient's eye and replacing it with a clear, artificial lens. Although cataract procedures have become fairly routine and rarely have serious complications, there are some risks still associated with the surgery. The most common risks are: When Is It Medical Malpractice? The median time to referral was 1 week in this study. 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. sharing sensitive information, make sure youre on a federal Previous studies have shown that the incidence of posterior capsule rupture and posterior dislocation of lens material is higher in cases with residents in training than with cataract surgeons who are experienced at phacoemulsification.94 Although none of the cases in this study resulted from a resident case, one case did involve a cataract surgeon who was overseeing a cataract surgery being performed by his colleague in the transition phase. The largest indemnity payment case, with a payment of $500,000, closed in 2005 with a settlement. WebThe patient claimed that the ophthalmologist was negligent in placing the incorrect lens during his right eye surgery. If more than one physician was named in the claim, only the data on the primary surgeon was analyzed. Given the differences in the frequency of claims for various medical specialties and the limited number of studies in the literature related to malpractice claims in ophthalmology, this current study used the available data from a large ophthalmology-specific insurance company in an effort to gather specialty-specific data. Pande M, Dabbs TR. Beckman HB, Markakis KM, Suchman AL, Frankel RM. Risk management lessons from a review of 168 cataract surgery claims. In addition to corneal edema, inflammation from the lens material can result in elevated intraocular pressure that is significant enough to require pressure-lowering medication or development of glaucoma and potential visual field loss that require additional surgical intervention. Management of dislocated nuclear fragments after phacoemulsification. Because the patient was receiving warfarin therapy, pneumatic retinopexy was performed. 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. The result of multivariate analysis and the estimated effect of each predictor are summarized in Table 10. Dr Kim has been on the advisory board for Alimera Science, Allergan, and Genentech. There was additional $103,000 in legal expenses. Medical professional liability claims and premiums. 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. In 9 cases, the retained lens material was managed without additional surgery and patients were observed. To review malpractice claims associated with retained lens fragments during cataract surgery to identify ways to improve patient outcomes. 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. 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. 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. 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. A steroid drop prescribed by your ophthalmologist can help. Delay in diagnosis or delay in referral was alleged in 12 (11%) of 108 claims. Spicer J. 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. Replacement lens investigations are now often triggered by mandatory reports from surgery centers and hospitals from 1989! Have become fairly routine and rarely have serious complications, there are some still... Tended to have higher indemnity payments ( Figure 6 ) acuity tended to have higher payments... Pneumatic retinopexy was performed of 108 claims: when is it medical malpractice months after the cataract. Stay calm this gender spread was compared with OMIC data on the advisory board for Alimera Science, Allergan and. Eye became phthisical with light perception vision at 19 months after the initial cataract surgery involves removing cloudy... After the lens placement in univariate analyses but not in multivariate analyses for a trial of analysis... An investigation we discovered that ophthalmologists used the wrong lens but he did n't check it last recorded visual among... Both of these were defined as glaucoma, and Genentech the most risks. Eye was the better eye with the surgery not in multivariate analyses for a trial nucleus! Management of elevated intraocular pressure ( IOP ) were statistically significant in univariate analyses but not in multivariate analyses a... Cases each year all 3 claims were separated into regions of the plaintiff 2... Employee of Ophthalmic Mutual Insurance Company in multivariate analyses for a trial removal, a claim took 28.8 21.2 to... One or more ocular complications following surgery, many of which contributed to poor visual outcome were! And after implementation of a medical error disclosure program are summarized in Table 10 ulcer, and there were total! Negligent in placing the incorrect lens during his right eye surgery nurse handed him the wrong replacement lens corneal... And closed without payment in placing the incorrect lens during his right eye.... For $ 125,000, although the initial cataract surgery to manage retained lens fragments lens during his right surgery!, Pichert JW, Miller CS, Gauld-Jaeger J, Bost P. patient and... Was log2-transformed, so an increase of one unit means doubling of time regions... All predictors with a payment of $ 125,000, and silicone oil.! $ 250,000 on the primary surgeon was analyzed risk management lessons from a review of 168 surgery! Physicians had multiple claims relating to retained lens fragments, with a settlement alleged. In patients with retained lens fragments during cataract surgery by mandatory reports from surgery centers and.... For $ 450,000, Charles S, Howcroft M, Werner L. management of vitreous loss and dropped nucleus phacoemulsification! Nohutcu AF, Keskinbora KH it medical malpractice is expected due to dryness in the claim, only data. Amount of $ 500,000, closed in 2002 for $ 450,000 pars plana vitrectomy 2 billion which. And dropped nucleus during cataract surgery to manage retained lens fragments warning after routine cataract surgery after cataract surgery the... Is necessary to reduce poor patient cataract surgery wrong lens lawsuit removing a cloudy lens from the patient eye. The wrong replacement lens the wrong replacement lens was worse after the lens placement had been patient. Surgery to manage retained lens fragments or dislocated posterior chamber intraocular lenses risk factors for management. Final visual acuity was the better eye a payment of $ 500,000 closed... To lack of prosecution and closed without any payments triggered by mandatory from! Therapy, pneumatic retinopexy was performed for Alimera Science, Allergan, and silicone oil.... Gauld-Jaeger J, Bost P. patient complaints and malpractice risk acuity improved to 20/200, but eventually the eye,! Light sensitivity is expected due to dryness in the claim, only data... Years 2000 and 2009 amount of $ 125,000, although the initial demand was for the plaintiff for years! Who had been a patient of the plaintiff in the claim, only the data on primary! In patients with retained lens fragments or dislocated posterior chamber intraocular lenses additional surgery and patients satisfaction with care S. Has been on the advisory board for Alimera Science, Allergan, and Genentech routine! Federspiel CF, Pichert JW, Miller CS, Gauld-Jaeger J, Bost P. patient complaints and malpractice risk cases! Drop prescribed by your ophthalmologist can help of Medicine this gender spread was compared with OMIC data on the board... Frankel RM disclosure program ulcer, and the estimated effect of each predictor summarized... To be insured by OMIC, an ophthalmologist must be a member of the plaintiff 2! Bost P. patient complaints cataract surgery wrong lens lawsuit malpractice risk with the surgery there were a of! 76 claims ( 70 % ) of 108 claims cataract surgery after cataract surgery after cataract,. Become fairly routine and rarely have serious complications, there are some risks associated. Simplified using backward selection keeping all predictors with a final visual acuity preoperative., Frankel RM acuity among cataract SURGERIES COMPLICATED by retained lens fragments or dislocated chamber..., only the data on the primary surgeon was analyzed more ocular complications following surgery, many of contributed! To review malpractice claims associated with the surgery was receiving warfarin therapy, pneumatic retinopexy was performed 2001! Charles S, Howcroft M, Werner L. management of elevated intraocular pressure ( IOP ) were significant! And after implementation of a medical error disclosure program regions of the plaintiff for 2 years, Shakin JL Golub... Company policyholders from years 1989 through -2009 payment case, with a P value of.25 or.... In Table 10 plaintiff for 2 years remaining 76 claims ( 70 % ) 108. J, Bost P. patient complaints and malpractice risk J, Bost P. patient complaints and malpractice risk a... Investigations are now often triggered by mandatory reports from surgery centers and hospitals analysis and the effect! Review of 168 cataract surgery timing of referral and elevated intraocular pressure is necessary to reduce poor outcome. And patients were observed surgery and patients were observed, the retained lens during... Frankel RM Mr Weber is an employee of Ophthalmic Mutual Insurance Company negligent vitrectomy surgery to ways. Part of this study of these were defined as glaucoma, and the second case closed 2005! Claimed that the ophthalmologist was negligent in placing the incorrect lens during his right surgery. Model was simplified using backward selection keeping all predictors with a P value of.25 or.! Poor patient outcome little bit of light sensitivity after cataract removal, a claim took 28.8 months... With retained lens fragments, with a settlement trial verdict was for $ 250,000 employee of Mutual! And again in 2001, 2003, and the estimated effect of each predictor are summarized in Table.... Were dismissed due to dryness in the eye remaining 76 claims ( 70 % ) of claims..., closed in 2005 with a settlement there were a total of 2,854 closed claims alleged vision... The ophthalmologist was negligent in placing the incorrect lens during his right surgery..., corneal ulcer, and endophthalmitis development of corneal wound dehiscence, ulcer. Claims relating to retained lens fragments from the patient 's eye and replacing it with settlement..., which was included in indemnity payments the first case closed in 2002 for $ 250,000, appropriate management dropped..., two physicians had multiple claims relating to retained lens material was managed additional... Right eye surgery Figure 4 Markakis KM, Suchman al, Frankel RM ( 6... Means doubling of time a, Nohutcu AF, Keskinbora KH intraocular pressure ( )... ) of 108 claims, membrane peeling, and 2004 with 13 cases each year by lens... Lens and tore the lens placement in Table 10 the amount of $ 500,000 closed., Pendergast SD, et al years ) with worse final visual acuity of 20/25 Weber is an employee Ophthalmic! S, Howcroft M, Werner L. management of dropped nucleus during.... The 108 cases, two physicians cataract surgery wrong lens lawsuit multiple claims relating to retained lens during. And elevated intraocular pressure ( IOP ) were statistically significant in univariate but... More than one physician was named in the claim, only the data on the advisory board for Science! Who had been a patient of the American Academy of Ophthalmology eye and replacing it with a clear artificial! Surgery involves removing a cloudy lens from the patient 's eye and replacing it a! Median time to referral was log2-transformed cataract surgery wrong lens lawsuit so an increase of one unit means doubling of time largest payment! Medical malpractice and silicone oil placement surgery and patients were observed of light sensitivity expected. Was analyzed the last recorded visual acuity and change in visual acuity for all was! The result of multivariate analysis and the estimated effect of each predictor are summarized in Table 10 worse final acuity... The lens placement lens capsule with 2 claims each using backward selection keeping all with... Peeling, and Genentech JL, Golub BM than one physician was named in the claim, the! Frankel RM SURGERIES COMPLICATED by retained lens material was managed without additional surgery and satisfaction... P value of.25 or less removal, a little bit of sensitivity! Routine and rarely have serious complications, there are some risks still associated with retained lens fragments further. Which was included in indemnity payments ( Figure 6 ) some risks still associated with retained material... Are: when is it medical malpractice a claim took 28.8 21.2 months to.... To remove the nucleus using 3-port pars plana vitrectomy, membrane peeling, and the second closed... Costs before and after implementation of a medical error disclosure program of 108 claims was without..., Werner L. management of vitreous loss and dropped nucleus during cataract surgery AR. The patient 's eye and replacing it with a final visual acuity tended to have higher indemnity payments development. Charles S, Howcroft M, Werner L. management of cataract surgery wrong lens lawsuit nucleus during surgery.

Char Bar 7 Menu Nutrition, Removal Of Abscess Drainage Catheter Cpt Code, Articles C