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$1 million settlement for blindness in one eye

2004 Medical Malpractice Settlement Report

83-year old woman suffers acute vision loss.

The plaintiff is an 83 year old with a past medical history of chronic open angle glaucoma and cataracts. On 9/10/02, she woke up and could not see out of her left eye. (The plaintiff never regained any vision in her left eye, and the plaintiff was making no claim for any loss of vision in her left eye.) She went to see the defendant ophthalmologist who documented that the plaintiff had no pain, no fever, no weight loss, no masseter claudication, and no scalp tenderness. However, upon exam, he found that the plaintiff's optic nerve was swollen with hemorrhage. He questioned the diagnosis of non-arteritic optic neuropathy, and he ordered a CBC (complete blood count), ESR (erythrocyte sedimentation rate), and planned to see the plaintiff again in two weeks. There is no documentation present that he ordered a C-reactive protein (CRP), or that he instructed the plaintiff to return immediately for any visual difficulty with her right eye.

On 9/17/02, the plaintiff was admitted to Mercy Medical Center after presenting to the Emergency Department with acute vision loss in her right eye. Initial lab work revealed an elevated ESR of 66, and an elevated CRP of 1.86 (normal range 0.08-0.80). The treating physicians believed that the plaintiff's clinical history and evaluation were suspicious for temporal arteritis and started her on intravenous steroid therapy. On 9/18/02, a temporal artery biopsy was performed and subsequent pathologic analysis confirmed the diagnosis of temporal arteritis (giant cell arteritis).

The plaintiff alleged that the defendant ophthalmologist was negligent when he failed to order a CRP, and when he failed to inform the plaintiff to return immediately if she experienced any changes in her right eye. The plaintiff further alleged that if the CRP was elevated, the accepted standard of care required that the ophthalmologist immediately admit the plaintiff to the hospital for the initiation of intravenous steroid therapy, and to order a temporal artery biopsy to confirm or definitively rule out the diagnosis of temporal arteritis.

The defendant claimed that he complied in all respects with the applicable standard of care, and that nothing he did or failed to do caused the plaintiff's blindness. The defense further contended that steroids are not proven to be effective in treating temporal arteritis, and that to have any chance of being even somewhat effective, they must be given immediately after the onset of symptoms, an impossibility given that the symptoms were first associated with vision loss in the plaintiff's left eye. The defense was prepared to call two experts to testify that nothing could have been done to save the vision in the plaintiff's right eye.

The case settled within a year of filing for $1,000,000.


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