Custer Benjamin L, Ballard Steven R, Carroll Robert B, Barnes Scott D, Justin Grant A
*School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD; †Department of Ophthalmology, Womack Army Medical Center, Fayetteville, NC; and ‡Department of Health Education and Training, Tripler Army Medical Center, Honolulu, HI.
Cornea. 2017 Oct;36(10):1243-1248. doi: 10.1097/ICO.0000000000001289.
To review data on malpractice claims related to refractive surgery to identify common allegations and injuries and financial outcomes.
The WestlawNext database was reviewed for all malpractice lawsuits/settlements related to refractive eye surgery. Data evaluated included patient demographics, type of operation performed, plaintiff allegation, nature of injury, and litigation outcomes.
A total of 167 cases met the inclusion criteria, of which 108 cases (64.7%) were found to be favorable and 59 cases (35.3%) unfavorable to the defendant. A total of 141 cases were tried by a jury with 108 cases (76.4%) favorable and 33 cases (23.6%) unfavorable to the defendant. Laser in situ keratomileusis was performed in 127 cases (76%). The most common allegations were negligence in treatment or surgery in 127 cases (76%) and lack of informed consent in 83 cases (49.7%). For all cases, the need for future surgery (P = 0.0001) and surgery resulting in keratoconus (P = 0.05) were more likely to favor the plaintiff. In jury verdict decisions, cases in which failure to diagnose a preoperative condition was alleged favored the defendant (P = 0.03), whereas machine malfunction (P = 0.05) favored the plaintiff. After adjustment for inflation, the overall mean award was $1,287,872. Jury verdicts and settlements led to mean awards of $1,604,801 and $826,883, respectively.
Malpractice litigation in refractive surgery tends to favor the defendant. However, large awards and settlements were given in cases that were favorable to the plaintiff. The need for future surgery and surgery leading to keratoconus increased the chance of an unfavorable outcome.
回顾与屈光手术相关的医疗事故索赔数据，以确定常见的指控、损伤及财务结果。
在WestlawNext数据库中检索所有与屈光性眼科手术相关的医疗事故诉讼/和解案件。评估的数据包括患者人口统计学信息、所进行的手术类型、原告指控、损伤性质及诉讼结果。
共有167例案件符合纳入标准，其中108例（64.7%）对被告有利，59例（35.3%）对被告不利。共有141例案件由陪审团审理，其中108例（76.4%）对被告有利，33例（23.6%）对被告不利。127例（76%）实施了准分子原位角膜磨镶术。最常见的指控是127例（76%）治疗或手术疏忽及83例（49.7%）缺乏知情同意。对于所有案件，未来需要手术（P = 0.0001）及手术导致圆锥角膜（P = 0.05）的情况更有利于原告。在陪审团裁决中，指控术前病情未被诊断的案件有利于被告（P = 0.03），而机器故障（P = 0.05）有利于原告。经通胀调整后，总体平均赔偿额为1,287,872美元。陪审团裁决和和解的平均赔偿额分别为1,604,801美元和826,883美元。
屈光手术中的医疗事故诉讼往往有利于被告。然而，在有利于原告的案件中给予了高额赔偿和和解。未来需要手术及手术导致圆锥角膜增加了不利结果的可能性。
