Engelhard Stephanie B, Salek Sherveen S, Justin Grant A, Sim Austin J, Woreta Fasika A, Reddy Ashvini K
Department of Ophthalmology, New York-Presbyterian/Weill Cornell Medical College, New York, NY, USA.
Department of Ophthalmology, Kaiser Permanente Washington, Silverdale, WA, USA.
Clin Ophthalmol. 2020 Jul 12;14:1979-1986. doi: 10.2147/OPTH.S260226. eCollection 2020.
To report and analyze the causes and outcomes of malpractice litigation in ophthalmic trauma.
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.
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.
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.
报告并分析眼科创伤医疗事故诉讼的原因及结果。
回顾Westlaw数据库中1930年至2014年间美国的眼科诉讼案件。纳入所有眼科创伤病例，并与非创伤性眼科医疗事故案件进行比较。
共纳入44例眼科创伤病例。在这些病例中，眼科创伤案件的原告90.9%为男性，而整个眼科领域原告的这一比例为54.8%（P<0.001）；34.1%的案件涉及未成年原告，而整个眼科领域这一比例为6.4%（P<0.001）。涉及未成年原告的案件比涉及成年原告的案件更有可能以原告胜诉告终（53.3%对37.9%）；然而，这在统计学上无显著差异（P=0.35）。总体而言，54.5%的案件以被告胜诉告终；40.9%的案件通过陪审团审判解决，其中50.0%的案件判决向原告支付赔偿，而整个眼科领域原告胜诉判决的比例为29.6%。开放性眼球损伤占病例的61.4%；其中55.6%的病例有眼内异物，37.0%的病例发生了眼内炎。大多数案件（63.6%）声称干预不足。在这些案件中，31.8%的案件涉及手术或操作索赔，4.5%的案件仅涉及医疗索赔。
在眼科创伤诉讼的原告中，男性和未成年人占比过高。大多数案件涉及开放性眼球损伤，常伴有眼内异物残留和眼内炎。对眼科创伤医疗事故诉讼的分析提醒人们关注常见的诉讼情形，以改进临床实践并为风险管理提供参考。
