October 29, 2018
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Retinal malpractice issues involve ROP, injections and wrong events

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George A. Williams

CHICAGO — Even though malpractice lawsuits for retinopathy of prematurity are rare, they are expensive, according to AAO President-elect George A. Williams, MD.

Williams, who is chair of the board of Ophthalmic Mutual Insurance Company, delivered pearls on the 30-year OMIC experience at Retina Subspecialty Day preceding the American Academy of Ophthalmology annual meeting.

“Let’s talk about getting sued,” he said.

From 1987 to 2016, OMIC managed about 5,000 claims, and only 30 of those have involved ROP, he said. However, four of the top 10 payments made over the years were for ROP cases.

Malpractice suits for ROP cases generally involve physician competence, “the failure to keep up with the latest developments in a rapidly changing field,” he said, as well as systems-based issues of patient tracking and follow-up.

OMIC now requires their insured physicians who work in this field to complete ROP education and their offices to implement tracking and coordination systems, beginning when the child is still in the hospital.

“Unfortunately, following discharge, one cannot rely on the parents,” he said. “So the office must have a robust appointment tracking system, and you must know how to call collective child services. In our practice, if a child doesn’t show, there is one phone call to the parents and the next one is to the police.”

Lawsuits involving intravitreal injections represent a relatively low frequency of claims in the OMIC experience, numbering 51.

While “virtually all” the drugs used in intravitreal injections have been involved in suits, there is no tendency of any one drug to have a greater liability risk, he said.

“A particularly troublesome problem for us is so-called wrong events in retina,” Williams said. “We’ve had cases of wrong gas concentrations, wrong drug, wrong eye and wrong dose.”

Because wrong events should never happen, the consequences for both the patient and the physician can be severe, he said.

OMIC makes available resources on its website to all members of the AAO, even if not insured by the company, Williams said. – by Patricia Nale, ELS

Reference:

Retinal malpractice issues: the 30-year OMIC experience. Presented at: AAO Subspecialty Day; Oct. 26-27, 2018; Chicago.

Disclosure: Williams reports he is a part-time employee of OMIC and serves as chair of the board of OMIC; he and his group practice are insured by OMIC.