Abstract
Purpose :
To report the diagnoses, causes, and outcomes of medical malpractice lawsuits in neuro-ophthalmology to inform clinical decision-making and guide risk management.
Methods :
Retrospective review of malpractice verdicts, rulings, settlements related to ophthalmology in the United States WestLaw® database from 1930-2014. Data including subspecialty focus of neuro-ophthalmology, patient age, patient gender, legal allegation, nature of injury, verdicts, indemnities, and (when applicable) financial award were collected and analyzed. To enable meaningful comparison, monetary awards were adjusted to 2015 United States dollars.
Results :
A total of1086 malpractice cases against ophthalmologists were identified, and 53 (4.9%) of these had subspecialty focus in neuro-ophthalmology. Overall, 37.7% of outcomes favored the defendant. The most common diagnoses leading to litigation were failure to diagnose an optic nerve or other CNS tumor (27%), complications related to strabismus surgery (24%), failure or delay in diagnosing GCA (18%), and failure to diagnose a CVA (14%). A total of 10 suits (19%) resulted in settlement, with mean adjusted indemnities of $559,414 (median, $726,812.66; range, $83,312.90 - 1,453,184.32). 14 cases (26%) resulted in plaintiff verdict, with mean adjusted indemnities of $2,733,518 (median, $7,371,927; range, $110,761.73 – 14,733,366.48). Outcomes favoring the plaintiff were more common in neuro-ophthalmology than in any other specialty, and monetary awards for malpractice in neuro-ophthalmology were higher than awards for all other ophthalmology subspecialties except for retina.
Conclusions :
Neuro-ophthalmology represents a small percentage of the litigation in ophthalmology, but is more likely to be associated with outcomes favoring the plaintiff than any other subspecialty.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.