June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Malpractice litigation in ocular oncology
Author Affiliations & Notes
  • Stephanie B Engelhard
    University of Virginia, Charlottesville, Virginia, United States
  • Christopher Shah
    University of Virginia, Charlottesville, Virginia, United States
  • Austin Sim
    University of Virginia, Charlottesville, Virginia, United States
  • Ashvini Reddy
    Wilmer Eye Institute , Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Stephanie Engelhard, None; Christopher Shah, None; Austin Sim, None; Ashvini Reddy, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5078. doi:
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      Stephanie B Engelhard, Christopher Shah, Austin Sim, Ashvini Reddy; Malpractice litigation in ocular oncology. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5078.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To report and analyze the causes and outcomes of ocular oncology malpractice litigation to inform clinical decision-making.

Methods : The WestLaw® database was retrospectively reviewed for all malpractice litigation including trial verdicts, settlements, and rulings related to ophthalmology in the United States from 1930-2014. Data including subspecialty focus of ocular oncology, patient demographic information, plaintiff legal allegation, clinical entity within ocular oncology, nature of injury, type of ruling, verdicts, indemnities and jury awards were collected and analyzed. All ocular oncology cases were included in this analysis. All monetary awards were corrected to 2015 United States dollars. Results were compared to the data from the analysis of all subspecialties.

Results : Sixteen ocular oncology malpractice cases were included in the study. The most common clinical scenarios leading to litigation were failure to diagnose and treat choroidal melanoma in 25% of cases and retinoblastoma in 18.8% of cases. Ten cases (62.5%) were resolved via jury trial. Defense verdicts were issued in 70% of ocular oncology cases, which was consistent with the rate across all ophthalmology subspecialties (70.4%). Three cases resulted in a mean jury award to the plaintiff of $511,244.48. Three cases resulted in settlements with mean indemnity of $828,928.14. Fourteen cases (87.5%) involved allegations of failure to diagnose cancers resulting in blindness in 10 (71.4%) and death or severely shortened life expectancy in the other 4 (28.6%). Two cases involved allegations of surgical errors leading to blindness.

Conclusions : Ocular oncology malpractice litigation is relatively rare and cases were generally decided in favor of the defendants; however, unlike other subspecialties in ophthalmology, every case in this analysis resulted in either blindness or premature death, highlighting both the importance of prompt diagnosis and treatment and the difficulty inherent in diagnosing cancers in and around the eye. Malpractice risk can be minimized by considering ocular cancers in patients with concerning symptoms and undertaking appropriate workup in a timely manner.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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