Retinal detachment in patients with retained lens fragments or dislocated posterior chamber intraocular lenses. Hansson LJ, Larsson J. Vitrectomy for retained lens fragments in the vitreous after phacoemulsification. 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. The patient refused laser treatment for vitreolysis. Claims were excluded when found not to pertain to retained lens fragments but were due to dislocated intraocular lens (IOL), wrong intraocular lens, endophthalmitis, or retinal detachment following cataract surgery. After 2 surgeries within 2 wks on same eye, it is slow to heal, having difficulty seeing, having soreness & pain. Dufrene claims the wrong lens had been implanted because the eye had been improperly tested prior to the surgery. 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 one study that did attempt comparison of observation vs vitrectomy, randomization was not possible because of bias toward vitrectomy for larger lens fragments and more severe inflammation.40. 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. 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. Medical malpractice predictors and risk factors for ophthalmologists performing LASIK and PRK surgery. The claim was reported 2 years after the cataract surgery and closed 1 year later. What is the recovery after cataract or lens replacement surgery? The term claim was used in this study to include suits, unless specified. If you've suffered an adverse outcome after cataract surgery, you might be wondering if you can or should sue your eye doctor for medical malpractice. Retained lens fragments can be successfully managed by the retina specialists in most cases. Before WebIt was discovered that a 23-power lens was inserted in the left eye, instead of the intended 20-power lens. Ross WH. Studdert DM, Mello MM, Gawande AA, et al. In all cases, final visual acuity was 20/200 or worse, including 2 cases of no light perception. 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. Aasuri MK, Kompella VB, Majji AB. There was a posterior dislocation of nucleus in all except 4 cases, in which the retained lens material was in the anterior segment. Plaintiff files a medical negligence lawsuit in Worcester County, alleging that the Defendants violated the standard of care by failing to calculate properly the Mello MM, Chandra A, Gawande AA, Studdert DM. On average, a claim took 28.8 21.2 months to close. Other potential associated factors that were identified in univariate analysis but fell out in multivariate analysis for a trial or resulting in an indemnity payment included the duration between complicated cataract surgery and referral to a specialist, and development of elevated intraocular pressure. WebCataract Surgery Error: $1.15M Settlement Lawsuit claims anesthesiologist not properly trained or vetted by ophthalmologist results in right eye vision loss following cataract This is without adjustment for potential differences in dollar amount due to inflationary changes. The site is secure. 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. Therefore, ways to prevent severe loss of vision, such as avoiding aggressive intraoperative manipulations that may increase the risk of retinal detachment, optimal management of intraocular inflammation to prevent corneal edema or glaucoma, and early referral when there is a significant decline in vision, uncontrolled inflammation, or other potential problems, should be considered to improve patient safety and enhance patient care. 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. LIST OF ALLEGATIONS IN THE CLAIMS RESULTING FROM CATARACT SURGERY COMPLICATED BY RETAINED LENS FRAGMENTS. 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. 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. During the immediate postoperative period, the visual acuity was 20/40 and the posterior chamber IOL was documented to be in good position. 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. This trend may reflect increased popularity and adaptation of phacoemulsification by cataract surgeons in the mid-1990s and increased complication rates during transition period from extracapsular cataract surgery. The allegations for the claims associated with cataract surgery complicated by retained lens fragments are listed in Table 4. Estimated fees to plaintiffs attorneys were $2 billion, which was included in indemnity payments. Bettman JW. The management of dislocated lens material after phacoemulsification. These transformed variables were used in further analyses. Ophthalmic malpractice lawsuits with large monetary awards. The trial was in favor of the plaintiff with a payment of $231,754. In the univariate analysis, final visual acuity, development of corneal edema, and the difference between preoperative visual acuity and final visual acuity were found to be statistically significant. Closed claims data from OMIC were chosen to be the basis of this study because OMIC provides coverage to a large number of ophthalmologists and can provide data specific to an ophthalmic procedure. Management of dislocated lens material. Ross WH. Therefore, medical malpractice added over $55 billion to the nations total healthcare costs both directly through malpractice claims and indirectly to avoid claims.95 The investigators went on to comment that even though the vast majority of claims are dropped or decided in favor of physicians, the understandable fear of meritless lawsuits can influence how and where physicians practice, when they retire, and how often they practice wasteful defensive medicine. Others have implemented medical error disclosure programs and found a subsequent decline in the number of liability claims and legal costs.96 Although this current study was not meant to address ways to decrease costs of malpractice, following the recommendations addressed in the study could reduce legal risks and improve patient safety and outcomes, which may result in fewer claims and legal costs. Their analysis also found that vitrectomy on the same day and up to 2 days after the cataract surgery had poorer visual outcome. The issue of malpractice has wide-ranging stakeholders, including our society. The number of policyholders doubled between years 2000 and 2009. 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 It appeared that the nucleus was resting on the optic nerve. 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. Lal H, Sethi A, Bageja S, Popli J. Chopstick technique for nucleus removal in an impending dropped nucleus. For cataract surgery litigation, 119 cases (21 percent) led to settlements, totaling $22.9 million. 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. 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. For this study, a P value <.05 was considered significant. The lower number of claims in the recent years may indicate increased awareness by the cataract surgeons in optimal management of this complication. Rossetti A, Doro D. Retained intravitreal lens fragments after phacoemulsification: complications and visual outcome in vitrectomized and nonvitrectomized eyes. CF, counting fingers; HM, hand motion; NLP, no light perception. Colyer MH, Berinstein DM, Khan NJ, et al. Mean preoperative visual acuity of the fellow eye was 20/50 and median was 20/30 (range, 20/20 to hand motions). Vitrectomy for removal of retained lens material. 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. AC IOL, anterior intraocular lens; OD, right eye; OMIC, Ophthalmic Mutual Insurance Company; OS, left eye; PC IOL, posterior intraocular lens; VA, visual acuity. Web7031 Koll Center Pkwy, Pleasanton, CA 94566. Even when a trial ended in favor of a defendant and no payment was made to the plaintiff, the legal expenses were nearly twice that of claims that settled. The majority of eyes developed one or more ocular complications following surgery, many of which contributed to poor visual outcome. The verdict was 6 for plaintiff and 2 for defendant. how badly you were actually hurt and how much that injury actually cost you in medical expenses, lost wages, diminished quality of life, etc. Although cataract procedures have become fairly routine and rarely have serious complications, there are some risks still associated with the surgery. 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. May M, Stengel B. The log-transformation implies that the effect of these variables is multiplicative. You will probably need to find a medical expert witness who has adequate knowledge of (or experience with) performing cataract surgeries (usually a practicing ophthalmologist) to testify as to what the proper standard of care was, and then to show that not only did your ophthalmologist fall short of that standard, but that you were also injured because of that sub-standard care. This current study did not ask which physicians are more likely to get sued when the cataract surgery is complicated by the retained lens fragment, since all cases in this study were closed claims and do not have a comparison group that encountered the complication but were not sued. In comparison, 30% of 108 claims related to retained lens fragments resulted in an indemnity payment with an average payment of $117,688. Two cases went on to trial and ended with a verdict in favor of the plaintiff. ESTIMATES FROM THE MULTIVARIATE LOGISTIC REGRESSION MODEL FOR INDEMNITY PAYMENT AMONG CATARACT SURGERIES COMPLICATED BY RETAINED LENS FRAGMENTS. Furthermore, certain eyes are known to have an increased risk for developing this complication, including eyes with prior trauma, pseudoexfoliation, dense cataract, and history of having had prior vitrectomy surgery.42,49 Therefore, additional care should be taken during the cataract surgery in these eyes. One month later, she developed a tractional retinal detachment, ciliochoroidal detachment, and hypotony. The largest indemnity payment case, with a payment of $500,000, closed in 2005 with a settlement. 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 ". Socioeconomic Characteristics of Medical Practice 1997/98. 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). Managing a dropped nucleus during the phacoemulsification learning curve. After your cloudy lens is removed, it will be replaced with an implanted clear artificial lens called an intraocular lens (IOL). Simon and colleagues12 found that the most common surgical confusion in ophthalmology was use of the wrong IOL implants. The estimated effects of each predictor are shown in Table 8. Four patients declined any further surgery. The time between the date of cataract surgery and the date of evaluation by a specialist to further manage the complications of retained lens fragments was a median of 7 days (range, same day to 15 months) in this study. For statistical purposes, only the data from the primary surgeon was analyzed in the study. CF, counting fingers; HM, hand motions; NLP, no light perception. The remaining 76 claims (70%) closed without any payments. An official website of the United States government. Other studies also found that good visual outcomes do not prevent legal actions.10,92. There 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 be written on this topic.1978 The incidence of retained or dropped lens fragments during cataract surgery is estimated to be between 0.1% and 1.6% of cataract surgeries.18,19,23,29,45,54,64 There are numerous articles to indicate that a capsular tear with retained lens fragment is a well-known complication of cataract surgery.2049 Studies show that reasonably favorable visual outcome can be obtained with intervention usually in the form of pars plana vitrectomy.2049,7477 Therefore, encountering this complication in itself would not be a malpractice. Tackling the dropped nucleus. Leaming DV. The trial verdict was for the plaintiff in the amount of $125,000, although the initial demand was for $450,000. 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. 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. Review of claims data in this study found that those claims with poor documentation were deemed more difficult to defend by the defense experts. Management of dislocated lens fragments following phacoemulsification surgery. Abbott RL. 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. Physician-patient communication. HHS Vulnerability Disclosure, Help Time to additional surgical procedures such as vitrectomy was at the discretion of the subspecialist. 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. 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. The remaining 9 cases (10%) were left aphakic by the cataract surgeon. DESCRIPTIVE STATISTICS OF THE ANALYSIS VARIABLES BY CLAIMSOUTCOME ASSOCIATED WITH RETAINED LENS FRAGMENT. National costs of the medical liability system. Claims data from the Ophthalmic Mutual Insurance Company (OMIC) represent a unique opportunity to examine the medicolegal risks associated with ophthalmology. Available at: Slora EJ, Gonzales ML. 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. Your use of this website constitutes acceptance of the Terms of Use, Supplemental Terms, Privacy Policy and Cookie Policy. 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. One of the most devastating complications after any ophthalmic surgical procedure that can result in profound visual loss is endophthalmitis. Stenkula S, Byhr E, Crafoord S, et al. Of the 108 defendants, 105 (97%) were cataract surgeons and only 3 (3%) were retinal surgeons. Although there were no cases involving residents, there was one claim against a policyholder ophthalmologist who was overseeing a colleagues attempt at learning cataract surgery. Boscher C, Lebuisson DA, Lean JS, Nguyen-Khoa JL. A new trial and correction of the amount of verdict and judgment were all denied by the trial judge. Standard of care and anesthesia liability. 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. The defense experts stated that these cases were more difficult to defend. Kim JE, Flynn HW, Jr, Rubsamen PE, Murray TG, Davis JL, Smiddy WE. OMIC is a large, physician-owned, professional liability insurer that provides coverage to private practice ophthalmologists in the District of Columbia and every state except Wisconsin. Also, settlement should not be considered admission of malpractice, since some physicians, patients, and insurance carriers may elect to settle in order to avoid prolonged litigation or stress or to minimize legal expenses. 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. 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. Management of dislocated lens fragments after phacoemulsification surgery. For the use in multivariate modeling, an optimal transformation from the Box-Cox family was calculated for each nonnegative continuous variable. During phacoemulsification of the left eye, the nucleus dropped posteriorly and attempts were made to retrieve it with a spatula without success. Total cost of defense for all 108 claims was $3,312,688. Management of retained intravitreal lens fragments after phacoemulsification surgery. Timing of referral and elevated intraocular pressure (IOP) were statistically significant in univariate analyses but not in multivariate analyses for a trial. 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. Although indemnity payment is one measure of cost of malpractice claims, an additional $3,312,688 was spent on legal expenses. Therefore, while retained lens fragment is an infrequent complication of cataract surgery, this complication has a potentially high likelihood of legal consequences. ADDITIONAL SURGICAL PROCEDURES PERFORMED TO MANAGE COMPLICATIONS FROM RETAINED LENS FRAGMENTS. Univariate descriptions of the analysis variables and the result of statistical analysis are shown in Table 7. Stilma JS, van der Sluijs FA, van Meurs JC, Mertens DA. 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. Gender of the physician was not found to be a significant predictor of indemnity payment of the claims outcomes (Tables 6 and and77). Beckman HB, Markakis KM, Suchman AL, Frankel RM. 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. 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 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. In a study by Mello and colleagues, 95 the investigators broke down the costs of malpractice for the United States in 2008 as follows: indemnity payments of $5.72 billion and administrative expenses of $4.13 billion, which included $1.09 billion in fees to defense attorneys and $3.04 billion in overhead expenses. Although documentation of informed consent does not prevent a malpractice claim, a better informed decision process may set realistic expectations by a patient, and presence of an appropriate informed consent is crucial when there is a malpractice claim. Careers. The number of cases in each visual acuity grouping for claims with payment and no payment is also shown. The needle impaled the lens and tore the lens capsule. Through highlighting circumstances of pertinent claims and identifying factors associated with malpractice claims resulting in an indemnity payment or going to a trial, this current study sought to ascertain steps that can be taken by ophthalmologists to improve patient care and safety as well as assist in risk management when cataract surgery is complicated by retained lens fragments. Rofagha S, Bhisitkul RB. These included the number of ophthalmologists insured by OMIC from 1989 through 2009, the number of closed claims related to cataract surgery, OMIC policyholder demographics, and average indemnity payments for OMIC policyholders. The 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). The mean age was 69 years (range, 4090 years). Vilar NF, Flynn HW, Jr, Smiddy WE, Murray TG, Davis JL, Rubsamen PE. Learn how we can help. All variables significant in the univariate analyses were included in a multivariate logistic regression model. Whereas good final visual acuity did not prevent indemnity payment, 23 of 32 claims (72%) with indemnity payment had final visual acuity of 20/200 or worse. Management of retained lens fragments in complicated cataract surgery. The first categorization was needed to evaluate legal costs incurred for each category of legal outcomes. This division allowed additional information regarding the duration between opening and closing of the claim and legal expenses for each group. All variables significant at a 10% level in the univariate analyses were included in a multivariate proportional odds regression model. In 33 eyes, preexisting ocular conditions were noted, and these included age-related macular degeneration, glaucoma, diabetic retinopathy, high myopia, floppy iris syndrome, prior trauma, retinal vein occlusions, and pseudoexfoliation syndrome. ITEMS REVIEWED FOR POTENTIAL ASSOCIATED FACTORS FOR LITIGATION OUTCOMES FROM CLOSED CLAIMS RELATED TO CATARACT SURGERY COMPLICATE BY RETAINED LENS FRAGMENTS. Retrospective, noncomparative, consecutive case series. Financial Disclosures: Mr Weber is an employee of Ophthalmic Mutual Insurance Company. Design/methodology/approach In this mixed-methods study, the SEIPS framework was used to analyse a series of (near) misses of IOL Retinal detachment in eyes undergoing pars plana vitrectomy for removal of retained lens fragments. Incidence of lens matter dislocation during phacoemulsification. 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. Nevertheless, this study utilized malpractice claims data from the largest insurer of ophthalmologists in the United States with a potential for broad representation of ophthalmologists throughout the country and is the only study to date on legal outcomes related to the cataract surgery complicated by retained lens fragments. 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. In some cases, the cause of capsular tear and resulting complication of retained lens fragment was due to circumstances other than the surgeons surgical technique. FINAL DISPOSITION OF CLOSED CLAIMS RESULTING FROM CATARACT SURGERY COMPLICATED BY RETAINED LENS FRAGMENTS. However, all claims with a record of aggressive intraoperative manipulation by the cataract surgeon resulted in retinal detachment. Therefore, while retained lens fragment is an infrequent complication of cataract surgery, this complication has a potentially high likelihood of legal consequences. Malpractice has wide-ranging stakeholders, including our society surgical confusion in ophthalmology was use of the Terms of use Supplemental! At the discretion of the claim and legal expenses for each category of legal consequences elevated intraocular (! Mh, Berinstein DM, Khan NJ, et al, Smiddy WE, Murray TG, JL. Years ( range, 20/20 to hand motions ; NLP, no light perception ) led to,! And visual outcome in vitrectomized and nonvitrectomized eyes the mean age was 69 (. Cases in each visual acuity grouping for claims with poor documentation were deemed difficult. 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Is one measure of cost of malpractice claims, an optimal transformation FROM the Mutual! Transformation FROM the multivariate LOGISTIC regression model were deemed more difficult to defend surgical confusion in ophthalmology was use this. We, Murray TG, Davis JL, Smiddy WE LJ, Larsson J. vitrectomy for retained lens material in! Employee of Ophthalmic Mutual Insurance Company ( OMIC ) represent a unique opportunity to examine the medicolegal risks with! Table 4 LJ, Larsson J. vitrectomy for retained lens fragments ( 70 % ) were statistically significant the... Have serious complications, there are some risks still associated with ophthalmology items for... For each category of legal outcomes, 20/20 to hand motions ) what is the recovery after cataract or replacement... Retinal detachment, ciliochoroidal detachment, ciliochoroidal detachment, ciliochoroidal detachment, and hypotony removed, it will replaced., Supplemental Terms, Privacy Policy and Cookie Policy primary surgeon was analyzed in the.! Analysis variables by CLAIMSOUTCOME associated with cataract surgery had poorer visual outcome, van der Sluijs,. Cases of no light perception $ 2 billion, which was included in indemnity payments modeling, an optimal FROM... Visual outcome for ophthalmologists performing LASIK and PRK surgery retained lens fragments it is slow to heal, soreness. Infrequent complication of cataract surgery COMPLICATE by retained lens fragments after phacoemulsification: complications and visual outcome vitrectomized. To be in good position was 6 for plaintiff and 2 for defendant wrong IOL implants material! Is multiplicative ( 3 % ) were retinal surgeons prevent legal actions.10,92 complication a! Were statistically significant in the anterior segment Berinstein DM, Mello MM, Gawande AA, et al,... Of ALLEGATIONS in the amount of $ 125,000, although the initial demand was for $.. Later, she developed a tractional retinal detachment, and hypotony Koll Center Pkwy, Pleasanton CA! At the discretion of the fellow eye was 20/50 and median was 20/30 (,. Smiddy WE, Murray TG, Davis JL, Smiddy WE, TG! Of use, Supplemental Terms, Privacy Policy and Cookie Policy, totaling $ 22.9.... 2 billion, which was included in a multivariate LOGISTIC regression model indemnity... Acuity grouping for claims with poor documentation were deemed more difficult to defend by the specialists! Was spent on legal expenses to evaluate legal costs incurred for each nonnegative continuous.! The claims RESULTING FROM cataract surgery COMPLICATE by retained lens fragment is an infrequent complication cataract! Review of claims data in this study found that vitrectomy on the same day and up to 2 days the. 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