We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!
Presentation is loading. Please wait.
Published byLillian Rankin
Modified over 3 years ago
Ophthalmology Malpractice Suits – Navigating Eye Injury Issues and Claims Involving LASIK, Cataracts, ROP, and Other Procedures Webinar Presentation Tuesday, April 23, 2013 © Todd J. Krouner, April 12, 2013 1
INTRODUCTION 1.LASIK SURGERY MALPRACTICE CASES ARE ATTRACTIVE FOR PLAINTIFFS A. GENERALLY, DOCTORS WIN 80% OF MEDICAL MALPRACTICE CASES. B. GENERALLY, MY SUCCESS WITH LASIK CASES, EXCEEDS 80%. 2 © Todd J. Krouner, April 12, 2013
C. WHY THE DIFFERENCE 1.IT IS ELECTIVE 2. THERE IS NO UNDERLYING DISEASE 3. SURGEONS TURN CORNEAS INTO COMMODITIES, INVITING CONVEYOR BELT ANALOGIES THAT DESTROY JURIES PREDISPOSITION IN FAVOR OF DOCTORS. $250/EYE! 3 © Todd J. Krouner, April 12, 2013
D. SIGHT IS THE MOST IMPORTANT OF OUR FIVE SENSES 80% of what we learn comes in through our eyes. Jurors can be made to appreciate how diminished vision adversely impacts all aspects of daily life activity - - even though plaintiffs may appear well and are not physically deformed. 4 © Todd J. Krouner, April 12, 2013
II. LASIK Surgery Negligence A. TYPES OF CASES 1.CONTRAINDICATIONS - - ECTASIA Corneal ectasia is one of the most devastating complications after LASIK. Post-LASIK ectasia is considered in patients who developed increasing myopia, with or without increasing astigmatism, loss of uncorrected visual acuity, often loss of best-corrected visual acuity, with keratometric steepening, with or without central and paracentral corneal thinning, and topographic evidence of asymmetric inferior corneal steepening after LASIK procedure. Ectatic changes can occur as early as 1 week 2 or can be delayed up to several years after LASIK. 5 © Todd J. Krouner, April 12, 2013
ECTASIA IS PRESUMPTIVE EVIDENCE OF MEDICAL MALPRACTICE 95% OF THE TIME POST-LASIK ECTASIA IS CAUSED BY A SURGEON MISSING WARNING SIGNS IN PRE- OPERATIVE TOPOGRAPHIES. See J. Bradley Randleman, MD, Buddy Russell, FCLSA, Michael A. Ward, MMSc, FAAO, Keith P. Thompson, MD, R. Doyle Stulting, MD, PhD, Risk Factors and Prognosis for Corneal Ectasia After LASIK, Ophthalmology, 2003; 110:267-275; Randleman JB, Woodward M, Lynn MJ, Stulting RD, Risk Assessment for Ectasia after Corneal Refractive Surgery, Ophthalmology 2008; 115: 37-50. 6 © Todd J. Krouner, April 12, 2013
2. FLAP COMPLICATIONS 3. DATA ENTRY ERRORS 4. MAINTENANCE ERRORS 5. PRODUCT ERRORS ALCON LADAR 6000 BAUSCH & LOMB ZYOPTIX 317 BUT SEE Riegel v. Medtronic, Inc., 552 U.S. 312 (2008). 7 © Todd J. Krouner, April 12, 2013
Refractive Surgery Malpractice 1. Schiffer v. Speaker – Ectasia - $7.25 M Verdict 2. J.C. - Ectasia where prior doctor said patient was not a good candidate 3. R.P. - Failure to calibrate laser resulting in severe central islands 4. R.G. - PRK on central frank keratoconus (see case study by Dr. Randleman) 5. Martinez v. Neatrour - Ectasia 6. S.D. - DEA cocaine use (ectasia) 7. A. P. - Ectasia/alteration of records/loss of insurance coverage 8. Devadas v. Niksarli - Ectasia/alteration of records/$5.6 M verdict 9. R.D. - Ectasia 10. J.R. - Defective medical device recall of Alcon Ladar vision 6000 central islands 11. D.K. - Defective medical device recall of Alcon Ladar vision 6000 central islands 12. S.P. - Defective medical device recall of Alcon Ladar vision 6000 central islands 13. M.S. -Hyperopic ectasia after 11 refractive procedures 14. L.S. - Hyperopic ectasia following four surgeries 15. J.D. - Steroid induced glaucoma following LASIK 16. E.K. - Ectasia - $950,000 for housewife with no loss of earned income 17. D.D. – Ectasia - $1M 8 © Todd J. Krouner, April 12, 2013
B. STATUTES OF LIMITATIONS 1. NEW YORK – CONTINUOUS TREATMENT 2. NEW JERSEY – DISCOVERY 3. FLORIDA – STATUTE OF REPOSE 9 © Todd J. Krouner, April 12, 2013
ECTASIA IS A TIME BOMB WITH A LONG FUSE LITERATURE REPORTS 6 YEAR DELAY IN DETONATION ONE DOCTOR REPORTED A 13-YEAR DELAY IN ONSET WHERE DOES THAT LEAVE PATIENTS IN TERMS OF A CLAIM? IS THE CLAIM BARRED BEFORE AN INJURY EVEN MANIFESTS ITSELF? 10 © Todd J. Krouner, April 12, 2013
C. STANDARD OF CARE 1.WHITE PAPER See Perry S. Binder, MS, MD; Richard L. Lindstrom, MD; R. Doyle Stulting, MD, PhD; Eric Donnenfeld, MD; Helen Wu, MD; Peter McDonnell, MD; Yaron Rabinowitz, MD; Keratoconus and Corneal Ectasia After LASIK, Journal of Refractive Surgery, 2005, 21:749-752. NO STANDARDS? WILD WILD WEST OF LASIK 11 © Todd J. Krouner, April 12, 2013 DRAFT 4/12/2013
A. INTRAOPERATIVE PACHYMETRY B. MICROKERATOME 2. BUT SEE, T.J. HOOPER © Todd J. Krouner, April 12, 2013 12
D. CASE EVALUATION 1.LIABILITY EXPERT REVIEW – PRE-SUIT GOOD LUCK FINDING AN EXPERT CASE STRENGTH 1-10 A. ECTASIA - - 9.5 B. WRONG NUMBERS - - 12 C. DRY EYE - - 1 D. INFORMED CONSENT - - 2 13 © Todd J. Krouner, April 12, 2013
2. DAMAGES (a) ECONOMIC LOSS (b) PAIN AND SUFFERING, INCLUDING LOSS OF LIFES ENJOYMENT (c) MEDICAL EXPENSES CORNEAL TRANSPLANTS © Todd J. Krouner, April 12, 2013 14
E. MEDICAL RECORDS A.WITHHELD B.BLACK AND WHITE INSTEAD OF COLOR C.ALTERED (LOSS OF INSURANCE COVERAGE) D.FORGED/FABRICATED E.DESTROYED F.ELECTRONIC 15 © Todd J. Krouner, April 12, 2013
F. VISUAL FUNCTION FORMULA 1.VF = VA + VQ FUNCTION = ACUITY PLUS QUALITY 16 © Todd J. Krouner, April 12, 2013
2. ELEMENTS OF VISUAL QUALITY 17 © Todd J. Krouner, April 12, 2013 LIGHT SENSITIVITY DIFFICULTY NIGHT DRIVING DOUBLE VISION FLUCTUATION IN VISION GLARE HALOS STARBURST DRYNESS PAIN FOREIGN BODY SEE GEORGE WARING, M.D., et al., Laser in situ Keratomileusis for Spherical Hyperopia and Hyperopic Astigmatism Using the NIDEK EC-5000 Excimer Laser, JOURNAL OF REFRACTIVE SURGERY, 2008; 24:123-136.
3. POOR VISUAL QUALITY CAN ELIMINATE GOOD VISUAL ACUITY A. CONTRAST SENSITIVITYB. DEBILITATING GLARE © Todd J. Krouner, April 12, 2013 18
G. VISION SIMULATIONS 1.VISIONSIMULATIONS. COM 19© Todd J. Krouner, April 12, 2013
2. CUSTOM A. CONTROLB. WORSE EYE UNCORRECTED © Todd J. Krouner, April 12, 201320
A. CONTROLB. WORSE EYE UNCORRECTED © Todd J. Krouner, April 12, 2013 21
3. ABERROMETERS SCHIFFER E 22 © Todd J. Krouner, April 12, 2013
III. TRIAL OF THE LASIK CASE A. JURY SELECTION 1. JURY EXPERIENCE WITH LASIK 2. ELECTIVE SURGERY 23 © Todd J. Krouner, April 12, 2013
B. THE LASIK CONVEYOR BELT 1. LASIK CO$T 2. LASIK SHOOTERS 3. CO-MANAGED CARE. FOLLOW THE MONEY 4. SURGICAL SCHEDULE – 15 MIN/PATIENT 5. LUCY AT THE CHOCOLATE FACTORY MCDONALDS OF LASIK 6. DOCTORS DONT KNOW THEIR PATIENTS 24 © Todd J. Krouner, April 12, 2013
C.SHOW AND TELL 25 © Todd J. Krouner, April 12, 2013
D. INFORMED CONSENT 1. WAIVE THE CLAIM 2. PRECLUDE PLAINTIFF FROM BEING CROSS-EXAMINED BY LAUNDRY LIST OF SURGICAL RISKS © Todd J. Krouner, April 12, 2013 26
E. PAIN AND SUFFERING 1.PHYSICAL 2.EMOTIONAL – DEPRESSION 3.LOSS OF LIFES ENJOYMENT 4.PERSONALITY AFFECT 5.AESTHETIC LOSS 6.HAZARDS (a) MEDICAL – CORNEAL TRANSPLANT (b) ENVIRONMENTAL 27 © Todd J. Krouner, April 12, 2013
Alain Saad MD, Damien Gatinel MD, PhD, Anterior Segment and Refractive Surgery Department, Center for Expertise and Research in Optics for Clinicians (CEROC.
25 seconds left….. 24 seconds left….. 23 seconds left…..
10 year follow up of LASIK surgery for low to high levels of myopia Qasim Qasem FRCS, Caitriona Kirwan MRCOpth, Michael O’Keefe FRCS. Institutional Affiliations:
By Kelsey Matthews. History LASIK stands for laser in situ keratomileusis Developed in 1991 by a greek doctor Ioannis Pallikaris Purpose to correct.
Jeopardy Topic 1Topic Q 1Q 6Q 11Q 16Q 21 Q 2Q 7Q 12Q 17Q 22 Q 3Q 8Q 13Q 18Q 23 Q 4Q 9Q 14Q 19Q 24 Q 5Q 10Q 15Q 20Q 25 Final Jeopardy.
Poster produced by Faculty & Curriculum Support (FACS), Georgetown University School of Medicine LASIK Combined with Corneal Cross-linking in Eyes with.
LASIK Surgery Magnolia Gardens Eye Center. What is LASIK? Procedure uses excimer laser to reshape cornea Surgical procedure to correct myopia, hyperopia,
MYOPIA, ASTIGMATISM, HYPEROPIA… PERSONALIZED TREATMENT Bernard Mathys, MD Secretary-general of the Belgian Society of Cataract & Refractive Surgery.
TM What Every Patient Should Know About Advanced CustomVue Facts on the VISX Custom Laser Vision Procedure.
Laser Eye Surgery And other surgical vision correction.
We will resume in: 25 Minutes We will resume in: 24 Minutes.
Wavefront-Guided Laser Surgery. 2 How the eye works Light rays enter the eye through the clear cornea, pupil and lens. These light rays are focused directly.
WEEK 1 You have 10 seconds to name…
Slide 1 Advanced Piloting Cruise Plot. Advanced Piloting Cruise United States Power Squadrons ® Part I Question 1 Question 2 Question 3 Question 4 Question.
LADARVision4000 Vs VISX CustomVue LADARVision4000 Vs VISX CustomVue CustomCornea CustomCornea A Comparison of Wavefront Guided Refractive Surgery outcomes.
1 Comparison of bitoric with monotoric laser in situ keratomileusis for the correction of myopic astigmatism with the Nidek EC-5000 Laser. By Mohamed Abdul-Rahman.
Laser Eye Surgery Technology LASIK. Anatomy of the eye.
My Alphabet Book 2 a b c d e f g h i j k l m n o p q r s t u v w x y z My name is Autumn and I work hard at school.
Refractive Surgery Seminar: An Introduction to Laser Vision Correction Emily Birkholz, MD John Hoines, MD Ophthalmology Associates of Mankato.
INTRAOPERATIVE FLAP COMPLICATIONS IN LASIK SURGERY PERFORMED BY OPHTHALMOLOGY RESIDENTS IN TRAINING Arturo Gómez-Bastar MD Arturo Ramirez-MirandaMD Lorena.
Bausch & Lomb 217A Excimer Laser Overview Why It Is Unmatched !
Faik Orucov*, MD, Sinan Goker*,MD, Abraham Solomon**, MD, Joseph Frucht- Pery**, MD Comparison of Tecnolas and Allegretto laser in situ keratomileusis.
Application of Quantitative Method for Prospectively Identifying Risk for Ectasia After LASIK in Normal, Suspect, and Ectatic Eyes Mujtaba A. Qazi, MD.
Wavefront-guided Ablation Retreatment in Myopic Eyes Engy M Mohamed MD, Orkun Muftuoglu MD, R.Wayne Bowman MD, V. Vinod Mootha MD, H. Dwight Cavanagh MD,PhD,
LASIK Surgery Camellia Gardens Eye Center. What is LASIK? Procedure uses computer controlled laser to reshape cornea Surgical procedure to correct –Myopia.
Januar 2005 S M T O T F L
Advanced Surface Ablation Insert name/ Practice name/ Logo here if desired.
Title Subtitle 1. A. B. C. C. * D. Click to try again! INCORRECT.
ABC Technology Project Mrs. Kiddle. ABCs of Technology Word 1 Word 2 Word 3 Word 4 Word 5 Word 6 Word 7 Word 8 Word 9 Word 19 Word 20 Word 21 Word 22.
1 Chapter 1 The Study of Body Function Image PowerPoint Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
A New Technique for Precise, Predictable SBK Surgery Using the B&L Zyoptix XP Microkeratome David R. Shapiro, MD Shapiro Laser Eye Center Ventura, California.
GG Consulting, LLC I-SUITE. Source: TEA SHARS Frequently asked questions 2.
LASIK Surgery Student Name. What Is LASIK? Surgical procedure to correct myopia, hyperopia, and astigmatism. LASIK is acronym for laser assisted in situ.
PSSA Preparation. Question 1(no calculator) D Question 2 (no calculator)
RAY TRACING & WAVEFRONT ANALYSIS USING THE TRACEY SYSTEM Donald R. Sanders, M.D., Ph.D. Center For Clinical Research.
LASIK: How It’s Done Vincent J. Marino, D.O. FAOCO Medical Director, LASIKPlus Cincinnati & Dayton, OH 7840 Montgomery Rd. Cincinnati, OH Centerville.
Year 6 mental test 5 second questions Multiplication and Division Tables knowledge.
DIVIDING INTEGERS 1. IF THE SIGNS ARE THE SAME THE ANSWER IS POSITIVE 2. IF THE SIGNS ARE DIFFERENT THE ANSWER IS NEGATIVE.
Cataract Extraction with Pseudoaccommodating Intraocular Lens in Patients with Previous Radial Keratotomy Ross Bloomberg, MD Niraj Shah, BS William Martin,
Chapter 5 Test Review Sections 5-1 through 5-4. Simplify each expression. 1)2) 3)4) 5) 6)
WYNNEDALE MEDICAL CENTER Laser Eye Surgery Unit Find out if Laser Surgery is right for you.
LASIK Aravind Eye Hospital, Tirunelveli. - Technological explosion in field of refractive surgery refractive surgery - 25 years later, 20 different refractive.
Lasik Eye Surgery. What is a Lasik Eye Surgery? How a Lasik Eye Surgery works? Why this procedure is performed? What are the risks? What is required before.
Richmond House, Liverpool (1) 26 th January 2004.
Intacs Insert name/ Practice name/ Logo here if desired.
© 2017 SlidePlayer.com Inc. All rights reserved.