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Medicolegal claims for retinopathy of prematurity (ROP) have risen due to increased survival of premature infants and complex causes. This review guides ophthalmologists acting as expert witnesses in ROP cases.
Area of Science:
- Ophthalmology
- Neonatology
- Medical Law
Background:
- Retinopathy of prematurity (ROP) claims decreased after oxygen's role was identified but have since increased.
- Increased survival rates of extremely premature infants contribute to rising ROP cases.
- The multifactorial causes of ROP and oxygen's precise role remain incompletely understood.
Purpose of the Study:
- To review medicolegal claims related to retinopathy of prematurity.
- To guide ophthalmologists serving as expert witnesses in ROP litigation.
- To clarify the complexities surrounding ROP diagnosis and causation.
Main Methods:
- Analysis of 500 medicolegal claims concerning ROP.
- Review of the evolving understanding of ROP etiology.
- Examination of diagnostic challenges and misdiagnoses.
Main Results:
- No ophthalmologists were sued in the analyzed ROP cases.
- Ophthalmologists are frequently called upon as expert witnesses in ROP litigation.
- The risk-benefit analysis of supplemental oxygen in ROP is often complex.
Conclusions:
- Ophthalmologists play a crucial role as expert witnesses in ROP medicolegal cases.
- Understanding the nuances of ROP causation and diagnosis is vital for expert witnesses.
- Further research is needed to clarify the multifactorial aspects of ROP and oxygen's role.
Abstract:
The incidence of medicolegal claims based on retinopathy of prematurity (ROP) diminished in the 1960s after the role of oxygen was presumed to be understood. It has since increased again for a number of reasons. More very premature infants are being saved. The causes of ROP are multifactorial, not well understood, and the role of oxygen as a significant factor is not always clear. Moreover, the risk/benefit ratio of supplemental oxygen is not always easy to evaluate. The morphologic features of ROP are common to a number of disorders, which may be misdiagnosed as ROP. In the series of 500 medicolegal claims that I have studied, no ophthalmologists have been sued in cases concerning ROP. However, they are routinely called as expert witnesses and it is to guide them in that role that I am reviewing the subject.
