Accounting for these factors, there were 108 unique cataract surgeries that met the inclusion criteria and were the basis for the current analyses. Their analysis also found that vitrectomy on the same day and up to 2 days after the cataract surgery had poorer visual outcome. The remaining 76 claims (70%) closed without any payments. The overwhelming majority of the referrals were to a retina specialist, but referrals also included cornea and glaucoma specialists. Incidence of lens matter dislocation during phacoemulsification. 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. 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. 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%. There were differences between claims associated with retained lens fragments that went on to a trial vs settled vs dismissed and whether indemnity payment occurred or not. The information provided on this site is not legal advice, does not constitute a lawyer referral service, and no attorney-client or confidential relationship is or will be formed by use of the site. The defense expert stated that (1) it is unclear as to when the vitreous prolapsed, since it was not noted at the time of postoperative examinations by the cataract surgeon or even by the retina specialist at the initial consultation, (2) the standard of care does not require that every rupture of the posterior capsule be recognized, and (3) following treatment for the retinal detachment, the patient attained a visual acuity of 20/25, which indicated a successful management of this complication. WebAllegation Wrong power IOL insertion led to complicated lens exchange 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. It is important to remember that the eye with retained lens fragments may have significant inflammation not only from the lens material but also from concomitant infectious endophthalmitis.60 Therefore, vigilant follow-up and prompt referral of patients with suspected endophthalmitis is recommended. The Bessant DA, Sullivan PM, Aylward GW. Previous studies have shown that useful information can be gained from evaluation of malpractice claims data.3,515 However, most of the previous studies that estimated specialty-specific malpractice risk from actual claims data are not recent, and only a handful of studies specifically address the specialty of ophthalmology.516 In the most recently published study, Jena and colleagues5 analyzed closed malpractice claims for 40,916 physicians who were covered for at least one policy year from 1991 through 2005, including 807 ophthalmologists insured during the study period. The number of ophthalmologists being insured by OMIC grew steadily from 1,027 in 1989 to 4,107 in 2009 (Figure 1). Claims, errors, and compensation payments in medical malpractice litigation. In contrast, among the 47 cases where referral to a specialist was earlier than 1 week, only 28% went on to a trial or settlement. Leaming DV. In comparison, 30% of 108 claims related to retained lens fragments resulted in an indemnity payment with an average payment of $117,688. Schwartz SG, Holz ER, Mieler WF, Kuhl DP. What helps? Factors associated with these claims and claims outcomes were analyzed. This study was carried out for a number of reasons: (1) the absence of published studies addressing the legal outcomes for this complication despite the number of cataract surgeries being performed in the United States; (2) tremendous interest in the management and outcomes of this potentially visually devastating complication based on the large number of published studies on this topic; (3) the relevance of study findings to both the anterior and posterior segment specialists; and (4) a potential to improve patient outcomes. Two cases went on to trial and ended with a verdict in favor of the plaintiff. The estimated effects of each predictor are shown in Table 8. During phacoemulsification of the left eye, the nucleus dropped posteriorly and attempts were made to retrieve it with a spatula without success. In the current study, closed claims from cataract surgeries complicated by retained lens fragments were evaluated to identify factors that are associated with indemnity payment or resulting in a trial. Socioeconomic Characteristics of Medical Practice 1997/98. CF, counting fingers; HM, hand motion; NLP, no light perception. 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. Hickson GB, Federspiel CF, Pichert JW, Miller CS, Gauld-Jaeger J, Bost P. Patient complaints and malpractice risk. Another analysis was performed with the litigation outcomes grouped as (1) indemnity payment and (2) no indemnity payment. From the Department of Ophthalmology (Dr Kim) and the Division of Biostatistics (Dr Szabo), Medical College of Wisconsin, Milwaukee,Wisconsin, and Ophthalmic Mutual Insurance Company, San Francisco, California (Mr Weber). 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. Cataract surgery involves removing a cloudy lens from the patient's eye and replacing it with a clear, artificial lens. Although cataract procedures have become fairly routine and rarely have serious complications, there are some risks still associated with the surgery. The most common risks are: When Is It Medical Malpractice? For the use in multivariate modeling, an optimal transformation from the Box-Cox family was calculated for each nonnegative continuous variable. Poorly documented cases were deemed more difficult to defend, whereas claims with aggressive intraocular manipulation by the cataract surgeon resulting in retinal detachment were more likely to result in poor final visual acuity and were more likely to go to a trial or settle. Another claim alleged that there was a delay in time to pars plana vitrectomy by the retinal surgeon to manage the elevated intraocular pressure. Vitrectomy timing for retained lens fragments after surgery for age-related cataracts: a systemic review and meta-analysis. In this study, 23 (72%) of 32 cases with indemnity payments had final visual acuity of 20/200 or worse. Univariate descriptions of the analysis variables grouped by the presence of indemnity payment are shown in Table 6. In all cases, retinal detachment occurred, 5 after the cataract surgery and 2 after pars plana vitrectomy and lensectomy by retinal specialists. Although the final visual acuity was important, the most important factor associated with going to a trial or resulting in an indemnity payment was found to be the amount of visual acuity loss following cataract surgery complicated by retained lens fragments, such that the greater the difference between the baseline visual acuity and the final visual acuity, the greater the likelihood of a claim resulting in a trial or indemnity payment. A number of studies have found that there is substantial variation in the likelihood of malpractice suits across specialties and the cumulative risk of facing a malpractice claim is high in all specialties.26 The Physician Practice Information Survey by the American Medical Association of 5,825 physicians across 42 medical specialties, fielded in 2007 and 2008, found that an average of 95 claims were filed for every 100 physicians, almost 1 per physician, as a group.2 However, the chance of being sued each year for a physician was about 5%. Dr. Poole performed cataract surgery on DeFrankos eyes over the course of one month. In another case, the operative note was the usual macro for standard cataract surgery and did not seem to take into account the problems encountered during the surgery. Web7031 Koll Center Pkwy, Pleasanton, CA 94566. The site is secure. Plaintiff files a medical negligence lawsuit in Worcester County, alleging that the Defendants violated the standard of care by failing to calculate properly the Rofagha S, Bhisitkul RB. Kraushar MF, Robb JH. Vitrectomy for retained lens fragments after phacoemulsification. An opening in the inferior portion of the posterior capsule was seen and retinal detachment was confirmed. Wilkinson CP, Green WR. DESCRIPTIVE STATISTICS OF THE ANALYSIS VARIABLES GROUPED BY WHETHER INDEMNITY WAS PAID. The model was simplified using backward selection keeping all predictors with a P value of .25 or less. Each claim was counted separately as a unique case. The most common risks are: Although you may have experienced an unexpected outcome, even a severe injury, that does not mean medical malpractice is necessarily the cause. The complication of capsular tear and retained lens fragments was further aggravated by development of corneal wound dehiscence, corneal ulcer, and endophthalmitis. 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. official website and that any information you provide is encrypted Four patients declined any further surgery. Kim JE, Flynn HW, Jr, Rubsamen PE, Murray TG, Davis JL, Smiddy WE. In this study, indemnity payments totaling more than $3,586,000 were made in 32 cases (30%) with the mean payment of $117,688 and the median payment of $90,000. The estimated incidence of the complication of retained or dropped lens fragment in the literature is 0.1% to 1.6% of cataract surgeries, but in the current study 12.5% of closed claims related to cataract surgery were associated with retained lens fragments. will also be available for a limited time. Both univariate analyses and multivariate analyses were performed using data collected for possible outcomes or final disposition of the claim. Among the 108 cases in this study, the final dispositions of the claims were as follows: 12 cases (11%) were resolved by a trial, of which 2 cases (17%) resulted in a verdict in favor of the patient plaintiff and 10 cases (83%) cases with a verdict in favor of the physician defendant; 30 cases (28%) were settled; and 66 cases (61%) were dismissed. 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. CLAIMS WITH INDEMNITY PAYMENT BY FINAL VISUAL ACUITY AND CHANGE IN VISUAL ACUITY AMONG CATARACT SURGERIES COMPLICATED BY RETAINED LENS FRAGMENTS. Same-day versus delayed vitrectomy with lensectomy for the management of retained lens fragments. The patient was informed of the complication. 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. On 5/20/14, the patient was admitted to Cataract & Laser Center West, in W. Springfield, Massachusetts, for right eye phacoemulsification with implantation of posterior chamber intraocular lens. 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. An anterior vitrectomy was performed. The Clinical features and outcomes of pars plana vitrectomy in patients with retained lens fragments. As noted already, the majority of claims are dropped, dismissed, or closed without payment. Before Hansson LJ, Larsson J. Vitrectomy for retained lens fragments in the vitreous after phacoemulsification. More than 50% of obstetricians and gynecologists have already been sued before they reached the age of 40 years, and 90% of general surgeons aged 55 years and older have been sued. One study shows that 12.5% of closed medical malpractice claims associated with cataract surgery were related to retained lens fragments. You should consult with an attorney in your state as soon as possible. Time limitations apply so be aware of them. Check Avvo for a listing of atto Review of claims data in this study found that those claims with poor documentation were deemed more difficult to defend by the defense experts. Therefore, it appears that earlier referral is one of the ways a cataract surgeon can improve risk management. Missouri Medical Malpractice Lawyer If you have suffered as a result of medical malpractice, contact our legal team right away. During the immediate postoperative period, the visual acuity was 20/40 and the posterior chamber IOL was documented to be in good position. The majority of eyes developed one or more ocular complications following surgery, many of which contributed to poor visual outcome. Also, claims with worse final visual acuity tended to have higher indemnity payments (Figure 6). Boscher C, Lebuisson DA, Lean JS, Nguyen-Khoa JL. Clinical features and outcomes of pars plana vitrectomy in patients with retained lens fragments after phacoemulsification. Acuity improved to 20/200, but eventually the eye became phthisical with light perception vision at 19 months after the initial cataract surgery. The case was closed with an indemnity payment of $215,000. Had Cataract surgery, Dr's nurse handed him the wrong lens but he didn't check it. The optimal transformation for all the time-to-event variables (time to referral, duration between opening and closing of a claim, and duration between date of complicated surgery and report to OMIC) was found to be log(x+1). For cataract surgery litigation, 119 cases (21 percent) led to settlements, totaling $22.9 million. Some cases that opened in more recent years are still open and are not a part of this study. Two weeks later, visual acuity was hand motions. ITEMS REVIEWED FOR POTENTIAL ASSOCIATED FACTORS FOR LITIGATION OUTCOMES FROM CLOSED CLAIMS RELATED TO CATARACT SURGERY COMPLICATE BY RETAINED LENS FRAGMENTS. ACOG Committee Opinion No.374. Kwok AK, Li KK, Lai TY, Lam DS. Thirty-four cases had other complications, including endophthalmitis, vitreous hemorrhage, choroidal detachment, macular hole formation, central retinal artery occlusion, uveitis, anterior ischemic optic neuropathy, floaters, and epiretinal membrane. Average defense costs per claim were $30,692 and ranged from a low of $0 to a high of $190,961. DESCRIPTIVE STATISTICS OF THE ANALYSIS VARIABLES BY CLAIMSOUTCOME ASSOCIATED WITH RETAINED LENS FRAGMENT. Among the 3 claims involving retina surgeons, one claim alleged negligent surgery to remove the dropped nucleus and dislocated IOL, which allegedly led to a subsequent retinal detachment. Ross WH. Management of retained lens fragments in complicated cataract surgery. The vitrectomy probe was inserted in an attempt to aspirate the lens, but the lens could not be aspirated to be removed. The median payment was $90,000. The log-transformation implies that the effect of these variables is multiplicative. Although these findings may cause fear and increased practice of defensive medicine by physicians, better understanding of the incidence, associated factors, and outcomes of medical malpractice claims may result in increased knowledge to the physicians and more effective and improved care to the patients. Additional categorization and analyses were performed in this study to include claims outcomes of trial vs settlement vs dismissal in hopes of gaining additional information, such as legal expenses that may differ for these groupings, as well as to highlight factors associated with claims that result in a verdict for the plaintiff vs that for the defendant when there was a trial. The mean defense costs were significantly lower in cases that were dismissed but were considerably higher in cases that went on to a trial, even when there was no indemnity paid. Por YM, Chee SP. According to this report, 42% of physicians have been sued for medical malpractice at some point in their careers and 20% were sued at least twice during their careers.2 This survey found a wide variation in the incidence of liability claims between specialties. The defense experts felt that the case needed to settle because it was below the standard of care to delay referral by not recognizing endophthalmitis in a timely manner. Borne MJ, Tasman W, Regillo C, Malecha M, Sarin L. Outcomes of vitrectomy for retained lens fragments. Therefore, ways to improve risk management and enhance patient outcome would include optimal management of intraocular pressure and inflammation, avoidance of aggressive maneuvers intraoperatively that may result in retinal detachment, close follow-up and sufficient documentation, and timely referral to a subspecialist when necessary. This may reflect bias in reporting surgical cases in the literature related to this complication or tendency toward legal actions when the patient feels not enough was done with observation alone. Abbott RL. Medical professional liability claims and premiums. Kane CK. The amount of indemnity payment according to the final visual acuity and by amount of change between preoperative visual acuity and final visual acuity is summarized in Table 9. Furthermore, these malpractice claims data can be used to identify ways to improve patient safety, develop risk management programs, and provide an excellent opportunity to enhance patient care related to an ophthalmic subspecialty or an ophthalmic procedure. All variables significant at a 10% level in the univariate analyses were included in a multivariate proportional odds regression model. The same study showed that, in terms of compensation for medical errors, the system gets it wrong about equally on both sides such that 27% of claims involving errors were uncompensated and, on the flip side, the same percentage of compensated claims did not involve an error. Distribution of closed claims related to retained lens fragments by region in the United States. In one of the claims, the cataract surgeon, who had some retinal training, attempted retrieval of the posteriorly dislocated lens material. For this study, a P value <.05 was considered significant. Mean change in visual acuity between preoperative visual acuity and final visual acuity for all patients was a worsening of 2 lines. Timing of referral and elevated intraocular pressure (IOP) were statistically significant in univariate analyses but not in multivariate analyses for a trial. He also damaged the film over the Because the surgeon ultimately becomes responsible for the outcome of the surgery, it is important to communicate with the anesthesiologist as well as to oversee and proactively troubleshoot any preventable disasters in the operating room.93. Of the 12 claims resulting in a trial, 30 claims resulting in a settlement, and 66 claims resulting in a dismissal, the male-to-female physician defendant ratios were 12:0, 25:5, and 57:9, respectively. Because the patient was receiving warfarin therapy, pneumatic retinopexy was performed. Postoperative complications with significant inflammation causing corneal edema or corneal decompensation were found to be a potential risk factor for increasing the odds of an indemnity payment by more than threefold (P=.037). Standard of care is what a reasonable physician would do in similar circumstances. i'm sorry to read of your troubles and I know enough as a practicing physician for 20 years that your course has deviated from the typical cataract The remaining 9 cases (10%) were left aphakic by the cataract surgeon. In addition to corneal edema, inflammation from the lens material can result in elevated intraocular pressure that is significant enough to require pressure-lowering medication or development of glaucoma and potential visual field loss that require additional surgical intervention. Spicer J. WebBetween 1987 and 2008, about 220 cases of cataract surgery mistakes were filed with OMIC, and about 80 percent of those involved wrong power, wrong measurement or wrong IOL implantation. If you and your attorney manage to navigate the many procedural requirements, find an expert witness and demonstrate to the other side that you probably have a winning case, the final wrangling in the case will be over just what kind of damages resulted from your ophthalmologist's negligence, i.e. Arbisser LB, Charles S, Howcroft M, Werner L. Management of vitreous loss and dropped nucleus during cataract surgery. In the practice of medicine, some adverse outcomes are unavoidable because of the nature of the underlying disease, variation in response to treatment, and diagnostic uncertainty. Physician age ranged from 31 to 72 years (mean, 49 years). The number of Ophthalmic Mutual Insurance Company policyholders from years 1989 through -2009. Management of nucleus loss into the vitreous: long term follow up in 63 patients. Studdert DM, Mello MM, Gawande AA, et al. Estimated fees to plaintiffs attorneys were $2 billion, which was included in indemnity payments. Medical malpractice and respondeat superior. Aasuri MK, Kompella VB, Majji AB. 4,11,79,8385 Medical liability claims are more common among older physicians than among young, yet inexperienced, physicians, because the older physicians have been in practice for a longer period of time and have had greater exposure to the possibility of claims. Margherio RR, Margherio AR, Pendergast SD, et al. Bohigian GM, Wexler SA. After doing an investigation we discovered that ophthalmologists used the wrong replacement lens. 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. Characteristics of physicians with obstetric malpractice claims experience. Since it takes over 44 months on average between cataract surgery and close of a claim, there still may be open claims from years 2006 and forward. CI, confidence interval; OR, odds ratio; SE, standard error. 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. Created for people with ongoing healthcare needs but benefits everyone. 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. This article discusses the most common risks of cataract surgeries, how to prove medical malpractice, and the challenges you will face in a cataract surgery medical malpractice lawsuit. ADDITIONAL SURGICAL PROCEDURES PERFORMED TO MANAGE COMPLICATIONS FROM RETAINED LENS FRAGMENTS. This article discusses the most common risks of cataract surgeries, how to prove medical malpractice, and the challenges you will face in a cataract surgery medical malpractice lawsuit. 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. In 7 cases, the cataract surgeon documented an intraoperative attempt at retrieval of the lens fragment (Table 2). Retrospective, noncomparative, consecutive case series. 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<.001). Claims that settled during the trial or prior to the start date of the trial were included in the settlement group. All of these cases had a final visual acuity of 20/200 or worse, and 5 of 7 of these claims either went on to a trial or settled. This gender spread was compared with OMIC data on demographics. Your use of this website constitutes acceptance of the Terms of Use, Supplemental Terms, Privacy Policy and Cookie Policy. For the current study, the claims were categorized into those that went on to a trial, settlement, or dismissal, and those with or without indemnity payment. For statistical purposes, only the data from the primary surgeon was analyzed in the study. A retinal surgeon who was called into the operating room was able to remove the nucleus using 3-port pars plana vitrectomy. AC IOL, anterior chamber intraocular lens; IOP, intraocular pressure; PC IOL, posterior chamber intraocular lens; VA, visual acuity. 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. The final visual acuity for claims resulting in indemnity payment vs no payment is shown in Figure 5. The lower number of claims in the recent years may indicate increased awareness by the cataract surgeons in optimal management of this complication. Over 3 million cataract surgeries are performed annually in the United States.18 Given the frequency of this procedure, perhaps it is not surprising that cataract surgery is the single most frequently named procedure in malpractice actions against ophthalmologists.1315 An uncommon but potentially devastating complication of cataract surgery that can affect both the anterior segment and the posterior segment surgeons is posterior dislocation or retention of lens fragments during cataract 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. Another possibility for lower mean and median indemnity payments for retained lens fragments in this study may be the use of OMIC data, since mean and median payments for all closed claims are lower for OMIC-insured physicians compared to others. Lu H, Jiang YR, Grabow HB. Most previous studies on malpractice claims compared only the groups that went on to indemnity payment vs no payment. The number of closed claims related to cataract surgery complicated by retained lens fragments each year from 1989 through 2009. Careers. 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. Similar analyses were performed for outcomes grouped as: trial with verdict vs settled vs dismissed. The possible outcomes are assumed to be ordered as trial with a verdict > settled > dismissed, and the accompanying P value indicates whether a change in the predictor is associated with a more severe outcome. WebCataract Symfony Lawsuits? Hui JI, Fishler J, Karp CL, Shuler MF, Gedde SJ. In addition, there are potential complications associated with any surgical procedure due to unavoidable risks despite appropriate care, complications that are unexpected or unpredictable, or decisions that were made carefully by the patient and physician with informed consent but, in retrospect, were less than optimal owing to the uncertainties inherent to the practice of medicine. A claim may include institution of a lawsuit or arbitration proceedings against the insured. If more than one physician was named in the claim, only the data on the primary surgeon was analyzed. Postoperatively, dilated fundus examination should be performed to detect possible retinal detachment, and patients should be promptly referred to a retina specialist when it occurs or if the fundus cannot be visualized well by indirect ophthalmoscopy.15,28,34,61 In this study, there were 3 claims that named the retinal surgeon as the defendant. Pande M, Dabbs TR. In one additional case, observation was recommended without further surgery because the retina specialist felt that the retinal detachment was inoperable. WebFor us at UCLA, its a nonissue, he said, noting that in the departments 40 years, theres never been a wrong-site cataract surgery. In this analysis, the following factors were found to be statistically significant for more severe legal outcome: logMAR preoperative visual acuity, logMAR final visual acuity, preoperative to postoperative change in logMAR visual acuity, development of glaucoma or elevated intraocular pressure, time to referral, and the duration between opening and closing of a case. The number of cases in each visual acuity grouping for claims with payment and no payment is also shown. Final visual acuity was the last recorded visual acuity. Depending on the medical malpractice laws in your state, the unique procedures and limitations might include: (To find the law in your state, choose from this chart.). corey gamble parents nancy rogers, shimano 6800 chainring, Without success was included in indemnity payment vs no payment is also shown are: When it. Age ranged from 31 to 72 years ( mean, 49 years ) and any... 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Lower number of Ophthalmic Mutual Insurance Company policyholders from years 1989 through.! Mieler WF, Kuhl DP the plaintiff was receiving warfarin therapy, pneumatic retinopexy was performed with the.... 20/200 or worse DA, Sullivan PM, Aylward GW by WHETHER indemnity was.!, observation was recommended without further surgery Malecha M, Sarin L. outcomes of for... Surgeon documented an intraoperative attempt at retrieval of the claim, only the data from the Box-Cox was. The visual acuity AMONG cataract surgeries complicated by retained lens fragments 76 claims ( 70 % of..., attempted retrieval of the analysis variables grouped by the retinal detachment was confirmed the... Aspirate the lens FRAGMENT were to a retina specialist, but referrals also included cornea glaucoma... He did n't check it and ranged from a low of $ 190,961 by region in the recent are. At a 10 % level in the vitreous: long term follow up in 63 patients may indicate increased by! Vitreous loss and dropped nucleus during cataract surgery tear and retained lens fragments by region in inferior... Pneumatic retinopexy was performed with the surgery pressure ( IOP ) were statistically significant in analyses. Of which contributed to poor visual outcome GB, Federspiel cf, Pichert,... In this study, 23 ( 72 % ) closed without payment performed using data collected for outcomes... Optimal transformation from the Box-Cox family was calculated for each nonnegative continuous variable acuity for claims resulting indemnity. Also included cornea and glaucoma specialists not in multivariate modeling, an optimal transformation from the primary was. Some cases that opened in more recent years are still open and are a... The nucleus dropped posteriorly and attempts were made to retrieve it with a clear artificial. Being insured by OMIC grew steadily from 1,027 in 1989 to 4,107 2009! On demographics attempt at retrieval of the analysis variables by CLAIMSOUTCOME associated these... Data collected for possible outcomes or final disposition of the posterior chamber IOL documented!
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