Abstract
Purpose
To review ophthalmic trauma malpractice claims in the Ophthalmic Mutual Insurance Company (OMIC) database to determine the frequency and causes of litigation.
Methods
A retrospective case series analysis of ophthalmic trauma claims from 2009 to 2019 was completed. Cases were selected only if the injury was secondary to trauma (e.g., fall, gunshot wound, paintball injury, etc.); iatrogenic traumatic surgical injuries were excluded.
Results
31 closed cases associated with 40 total claims related to ophthalmic trauma out of 2565 claims (1.56%) in the OMIC database were analysed. 13 of the 31 cases (41.9%) were decided for the plaintiff. In decisions for the plaintiff, the median settlement amount was $330,000 (range $125,000–$1,000,000). The most frequent initial diagnoses were corneal abrasion (n = 10), hyphema (n = 5) and open-globe injury (n = 5), and the most common final diagnoses were endophthalmitis (n = 8), intraocular foreign body (n = 7) and retinal detachment (n = 7). The most common causes of malpractice litigation were a delay in referral or follow-up (n = 11) and failure to get appropriate imaging (n = 8). In the 13 cases decided for the plaintiff, experts concluded nine did not meet standard of care.
Conclusions
Ophthalmic trauma malpractice claims are very uncommon in the United States, however, the payout is higher than non-trauma settlements, and approximately 40% of cases were decided for the plaintiff. Care could be improved with a careful history and complete ophthalmic examination (with dilated fundoscopy), imaging in appropriate patients, meticulous documentation, and early sub-specialist referral when the diagnosis or management plan was unclear.
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G.A.J. conceived the work. A.M.M. acquired the data. All authors played an important role in interpreting the results, drafting and revising the manuscript, approving the final version, and agree to be accountable for all aspects of the work.
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Dr. Pelton is a Board member of Ophthalmic Mutual Insurance Company (OMIC). Dr. Rapuano is a Committee member of OMIC. Dr. Menke is an employee of OMIC. The other authors do not have any conflicts of interests.
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Justin, G.A., Woreta, F.A., Colyer, M.H. et al. Ophthalmic Trauma Malpractice in the Ophthalmic Mutual Insurance Company Database. Eye 37, 109–119 (2023). https://doi.org/10.1038/s41433-021-01893-4
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DOI: https://doi.org/10.1038/s41433-021-01893-4
