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Malpractice Litigation in Pediatric Ophthalmology
Stephanie B Engelhard1, Megan Collins2, Christopher Shah1
1Department of Ophthalmology, University of Virginia, Charlottesville.
Insights
Pediatric ophthalmology malpractice cases are more likely to favor the plaintiff and result in higher awards than adult cases. Conditions like retinopathy of prematurity and legal blindness are common in these litigations.
Area of Science:
- Ophthalmology
- Medical Law
- Pediatric Medicine
Background:
- Understanding malpractice litigation outcomes is crucial for ophthalmologists to improve patient care and prevent lawsuits.
- Pediatric malpractice cases present unique challenges and outcomes compared to adult cases.
Purpose of the Study:
- To analyze the causes and outcomes of ophthalmology medical malpractice litigation involving patients under 18 years old.
- To compare pediatric malpractice cases with those involving adult patients.
Main Methods:
- A comprehensive review of the WestLaw database was conducted for ophthalmology malpractice cases from 1930 to 2014.
- Cases involving plaintiffs younger than 18 years at the time of the event were identified and analyzed.
- Pediatric cases were compared to adult cases regarding verdicts and settlement amounts.
Main Results:
- Sixty-eight pediatric ophthalmology malpractice cases were included; 48.6% resulted in plaintiff verdicts, significantly higher than adult cases (28.8%).
- Mean jury awards in pediatric cases were substantially higher than in adult cases ($4,815,693 vs. $3,422,134 difference).
- Common causes included traumatic ocular injury, retinopathy of prematurity, and endophthalmitis, with retinopathy of prematurity cases yielding the highest payments.
Conclusions:
- Ophthalmology malpractice litigation involving pediatric patients is more frequently resolved in favor of the plaintiff and associated with higher monetary awards.
- Cases involving retinopathy of prematurity, legal blindness, and endophthalmitis were more likely to result in plaintiff-favorable outcomes.
- This analysis provides critical insights for pediatric ophthalmologists regarding high-risk scenarios and conditions that may lead to litigation.
Importance:
Understanding outcomes of pediatric malpractice litigation allows ophthalmologists to gain insight into how to best care for patients and prevent such litigation.
Objectives:
To report and analyze the causes and outcomes of ophthalmology medical malpractice litigation involving patients younger than 18 years.
Design, Setting, And Participants:
The WestLaw database was reviewed from April 1 to 30, 2015, for ophthalmology-related lawsuits, including settlements and trial verdicts, in the United States from January 1, 1930, to December 31, 2014. Search terms included ophthalmology or ophthalmologist and malpractice anywhere in the retrieved documents. Cases in which the plaintiffs were younger than 18 years at the time of the inciting event were included. Pediatric cases were compared with adult cases.
Main Outcomes And Measures:
Pediatric malpractice case outcomes and settlement amounts.
Results:
Sixty-eight ophthalmology malpractice cases involving plaintiffs younger than 18 years were included in the study. Thirty-five cases (51.5%) were resolved via jury trial. Of these 35 cases, verdicts in favor of the plaintiff were issued in 17 pediatric cases (48.6%), compared with 168 of 584 adult cases (28.8%) (difference, 33%; 95% CI, -24% to 64%; P = .01). The 17 cases that resulted in verdicts in favor of the pediatric plaintiff had a mean jury award of $4 815 693 (median, $883 281; range, $147 765-$42 061 690). Nine of the total 68 cases (13.2%) resulted in a settlement, with mean adjusted indemnities of $1 912 738 (median, $1 377 689; range, $92 070-$8 493 086). The remaining 24 cases (35.3%) involved appellate rulings, pretrial and posttrial relief rulings, and 1 bench verdict. Jury awards were higher in pediatric vs adult cases (difference, $3 422 134; 95% CI, -$3 422 134 to $8 731 916; P = .002), as were indemnity payments (difference, $1 186 757; 95% CI, -$69 074 to $3 342 588; P = .003). Cases involving legal blindness were more likely to result in verdicts in favor of the plaintiff (difference, 60.5%; 95% CI, -1% to 62%; P = .30). Common clinical scenarios in cases of litigation were traumatic ocular injury (15 [22.1%]), retinopathy of prematurity (12 [17.6%]), and endophthalmitis (6 [8.8%]).
Conclusions And Relevance:
Malpractice litigation involving pediatric patients was more likely to be resolved in favor of the plaintiff and was associated with higher monetary awards than was adult litigation. Cases involving retinopathy of prematurity resulted in the highest payments to plaintiffs, and cases involving legal blindness and/or endophthalmitis were more likely to be resolved in favor of the plaintiff. This information may give pediatric ophthalmologists insight into the situations and conditions that commonly lead to litigation.
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