Abstract
Purpose:
Retinal conditions tend to be emergent such as ruptured globes, acute retinal detachments, endophthalmitis, intraocular foreign bodies, and vascular occlusions, many of which may result in severe permanent vision loss. Also, vitreoretinal surgeries and procedures may not result in significant improvement in vision or may be mostly performed to prevent further vision loss. Previous studies have shown that poor visual outcomes and resulting patient dissatisfaction are among the risk factors for medical malpractice claims. We reviewed malpractice claims associated with diseases and surgeries related to retina and compared the medicolegal outcomes to other ophthalmic conditions and procedures.
Methods:
Retrospective consecutive case series. Closed claims data from an ophthalmic insurance company for a 10-year period between 2003 and 2012 were reviewed. Claims filed were separated into retina related versus other ophthalmic specialties and the medicolegal outcomes were analyzed.
Results:
During the 10-year period, there were 2,246 closed claims and 349 (15.5%) were related to retinal conditions and procedures. 20 (5.7%) of the 349 retinal claims were resolved by a trial, 43 (12.3%) were settled, and 286 (82%) were dismissed. The defendant prevailed in 95% of trials. Indemnity payments totaling more than $12,106,000 were made in 44 (12.6%) of the claims made against retina specialists (median payment, $150,000). Legal expenses for the 349 cases totaled more than $7,337,000 (mean: $21,024). When claims outcome, median payment, and mean legal expenses of the non-retina related claims and retina related claims were compared, there was no significant difference.
Conclusions:
Even though the retinal conditions tend to be more acute and emergent and may result in severe and permanent vision loss with a disappointing visual outcome for the patient and the physician, the proportion of medical malpractice claims related to retinal conditions and surgeries is not great when compared to non-retinal conditions. The majority of medical malpractice claims made against the retina specialists or those related to retinal conditions are .dismissed. Even when progressed to a trial, there is a high likelihood of the case resulting in a verdict in favor of the ophthalmologist. Therefore, emergent, severe, and chronic nature of retinal conditions does not increase adverse medicolegal outcomes for the retina specialists.
Keywords: 688 retina •
462 clinical (human) or epidemiologic studies: outcomes/complications •
466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials