Medical malpractice experiences of vitreoretinal specialists: risk prevention strategies.

Abstract

To provide ophthalmologists treating patients with vitreoretinal diseases the means by which to improve patient care and risk management. The members of the Macula, Retina, and Vitreous Societies were mailed questionnaires regarding their malpractice litigation experience, and the responses were analyzed. Rhegmatogenous retinal detachment was the most common presenting diagnosis in these lawsuits. The most frequent modality of management was pars plana vitrectomy (40%). Negligent treatment (surgical or medical) (63%) was alleged more than negligent diagnosis (10%). Decreased vision after treatment (40%), failed surgery (13%), and no improvement in vision (10%) were the most common medical misadventures. Vitreoretinal specialists are at risk for malpractice litigation because a high percentage of the diseases they manage have significant potential for severe visual impairment or blindness and because most vitreoretinal surgery is more complex in nature than general ophthalmic surgery. Rhegmatogenous retinal detachment is the most common presenting diagnosis in most studies on ophthalmic malpractice litigation, and most of these patients are treated by vitreoretinal specialists. Many vitreoretinal patients present for treatment of trauma or failed treatment by another practitioner and may be more prone to litigation. As consultants, vitreoretinal specialists are at risk for being included in lawsuits primarily directed toward other physicians. These risks are a strong indication for a thorough discussion of informed consent and the development of a good physician-patient relationship.