Malpractice Litigation in Ophthalmic Trauma

Abstract

Stephanie B Engelhard,1 Sherveen S Salek,2 Grant A Justin,3 Austin J Sim,4 Fasika A Woreta,5 Ashvini K Reddy6,7 1Department of Ophthalmology, New York-Presbyterian/Weill Cornell Medical College, New York, NY, USA; 2Department of Ophthalmology, Kaiser Permanente Washington, Silverdale, WA, USA; 3Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, USA; 4Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA; 5Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA; 6Athena Eye Institute, San Antonio, TX, USA; 7Department of Ophthalmology, University of Texas Health Science Center, San Antonio, TX, USACorrespondence: Ashvini K ReddyDepartment of Ophthalmology, University of Texas Health Science Center, 5282 Medical Drive #610, San Antonio, TX 78229, USATel [phone]Fax [phone]Email [email protected]: To report and analyze the causes and outcomes of malpractice litigation in ophthalmic trauma.Methods: The Westlaw® database was reviewed for ophthalmology litigation in the United States between 1930 and 2014. All ophthalmic trauma cases were included and compared to non-traumatic ophthalmology malpractice cases.Results: Forty-four ophthalmic trauma cases were included. Of these cases, 90.9% of ophthalmic trauma plaintiffs were male compared to 54.8% of plaintiffs in ophthalmology as a whole (P=< 0.001); 34.1% of cases involved minor plaintiffs compared to 6.4% in ophthalmology as a whole (P=< 0.001). Cases involving minors were more likely to be resolved in favor of the plaintiff than cases involving adult plaintiffs (53.3% vs 37.9%); however, this was not found to statistically significant (P=0.35). Overall, 54.5% of cases were resolved in favor of defendants; 40.9% of cases were resolved via jury trial with 50.0% resulting in payments to plaintiffs compared to the 29.6% rate of plaintiff verdicts in ophthalmology as a whole. Open globe injuries represented 61.4% of cases; 55.6% of these cases had intraocular foreign bodies and 37.0% developed endophthalmitis. Most cases (63.6%) alleged insufficient intervention. Of these cases, 31.8% of cases involved surgical or procedural claims, and 4.5% involved medical claims only.Conclusion: Males and minors were overrepresented among plaintiffs in ocular trauma litigation. Most cases involved open globe injuries, often complicated by retained intraocular foreign bodies and endophthalmitis. Analysis of malpractice litigation in ophthalmic trauma calls attention to commonly litigated scenarios to improve clinical practice and to inform risk management.Keywords: malpractice, litigation, risk, trauma, intraocular foreign body, open globe, orbital fracture, endophthalmitis

Keywords

• malpractice
• litigation
• risk
• trauma
• intraocular foreign body
• open globe
• orbital fracture
• endophthalmitis