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Washington, D.C. – Ophthalmology – Floaters And Decreased Vision Following Cataract Surgery

On 8/12/2011, an ophthalmologist performed cataract surgery on a patient’s left eye, which resulted in serious complications immediately following the surgery.  During the procedure, a rent occurred in the capsule.  On the following day, the patient met with the ophthalmologist during a post-operative appointment, and the patient allegedly informed the ophthalmologist that he suffered pain and discomfort in the left eye.  The ophthalmologist allegedly told the patient that his eye “looked okay” as there were no floaters, cells, or flair in vitreous, and scheduled a follow-up appointment for the following week.

At the follow-up appointment, the patient complained of floaters and decreased vision in the left eye and the ophthalmologist referred the patient to a retina specialist, who determined that there was a tear of the capsule in the left eye and that there was still some cortex within the eye.  The retina specialist performed corrective surgery and the patient received treatment and medical care from the retina specialist thereafter.  After the corrective surgery, the patient allegedly continued to suffer pain and decreased vision in the left eye.

At the time of the procedure performed by the ophthalmologist, the patient’s pre-surgical best corrected vision was allegedly 20/40-20/100; after the cataract surgery performed by the ophthalmologist and subsequent retina surgery performed by the retina surgeon, the patient’s vision was reduced to 20/70-20/100.  The patient was sent back to the ophthalmologist for glasses but was upset when the ophthalmologist recommended “temporary readers” until his vision became stable.  The patient never returned for a follow-up examination.

The Board obtained the patient’s medical records so that those records could be reviewed by an independent peer reviewer.  The peer reviewer concluded that the “overall patient management did not meet the standard of care.”  Specifically, the peer reviewer found that the ophthalmologist failed to provide a comprehensive evaluation of the patient prior to cataract surgery.  The patient’s medical records did not reflect a complete eye examination with visual acuity, refraction for best correct vision, pupil evaluation, slit lamp evaluation for rubeosis iridis, or posterior segment evaluation.  In view of the patient’s pre-surgical vision of 20/100, the peer reviewer noted the ophthalmologist’s inadequate discussion of the surgery, the reasons for the surgery, possible complications, and alternative management.

For this allegation and others, the Board judged the ophthalmologist’s conduct to be below the minimum standard of competence given his significant complications post-cataract surgery in several cases, his consistent use of-of the incorrect intraocular lens type when a posterior capsule tear occurred, and his inadequate record documentation.

For this allegation and others, the Board ordered the ophthalmologist not to perform any procedures, make any appropriate and/or necessary referrals for his patients, and undergo an assessment and audit of his practice every 3 months until this requirement is terminated by the Board.

State: Washington D.C.

Date: February 2017

Specialty: Ophthalmology

Symptom: Vision Problems

Diagnosis: Post-operative/Operative Complication, Ocular Disease

Medical Error: Procedural error, Failure to examine or evaluate patient properly, Failure of communication with patient or patient relations, Lack of proper documentation

Significant Outcome: Permanent Loss Of Functional Status Or Organ

Case Rating: 2

Link to Original Case File: Download PDF

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