Case details

Eye surgeries met standard of care, ophthalmologist claimed

SUMMARY

$0

Amount

Verdict-Defendant

Result type

Not present

Ruling
KEYWORDS
head, headaches, impairment, left eye, partial blindness, sensory, speech, trauma to the eye, vision
FACTS
On Aug. 26, 2013, plaintiff Karen Fields, 70, presented to Dr. Khaled Tawansy, an ophthalmologist, for cataract surgery, including the implantation of an intraocular lens. The surgery was thought to be uneventful, but the following day, Fields could not see out of her left eye. Ultimately, it was determined that there was a hole in the posterior wall of the capsular bag, where the lens had been placed, and that further surgery would be needed. Fields returned to surgery on Sept. 9, 2013, and Tawansy moved the dislocated lens, which had fallen to the back of the eye, into the sulcus in order to remedy the problem. Post-operatively, the lens was determined to be out of position and further workup determined that the capsular bag and supporting zonules had collapsed. As a result, Fields returned to surgery again on Oct. 14, 2013, and the same lens was sutured into the sulcus in order to achieve fixation. Unfortunately, the lens was sutured into an “off center” position and, eventually, Fields underwent additional surgery on April 2, 2014 at Los Angeles County+USC Medical Center, in Los Angeles, at which time a new lens was implanted by a different eye surgeon. However during the surgery, the lens inadvertently moved to the rear of the eye, which necessitated the new eye surgeon to stop the case and reschedule Fields for a further surgery one week later in order to retrieve the lens. On April 9, 2014, a subspecialist in vitreoretinal surgery operated and placed the new three-piece lens into the sulcus with appropriate suture fixation. Repetitive eye surgery can cause trauma to the eye, including to the surface of the cornea, and Fields underwent a partial corneal transplant at USC on Sept. 2, 2014. Since then, Fields has re-acquired functional vision in the left eye, although her vision is not normal. Fields sued Tawansy and his medical office, Golden State Eye Center. Fields alleged that Tawansy failed to properly perform the surgeries and that Tawansy’s failure constituted medical malpractice. Fields also alleged that Golden State Eye Center was liable for Tawansy’s actions. Plaintiff’s counsel argued that the surgical technique used during the first surgery, in which the posterior wall was damaged, permitting the lens to fall out of place and move to the back of the eye, represented a substandard surgical technique and was below the standard of care. Counsel contended that Tawansy violated the standard of care by not seeing Fields until the day of surgery, leaving Fields’ preoperative workup to another ophthalmologist. Plaintiff’s counsel also argued that the surgical technique used by Tawansy during the second surgery, which was performed on Sept. 9, 2013, was below the standard of care due to Tawansy putting a single piece lens into the sulcus. Counsel contended that the second surgical technique directly violated the package insert issued by the manufacturer of the lens, which stated that a square-edged lens should never be put in the sulcus. Counsel also contended that a membrane peel performed during the Sept. 9, 2013 surgery was not indicated and simply represented additional unnecessary trauma to the eye. Plaintiff’s counsel further argued that the third surgery, which was performed on Oct. 9, 2013, was carried out in a fashion that was below the standard of care because the lens was not centered appropriately and should not have been put in the sulcus of the eye in the first place because the square-edged lens had a high propensity to damage the iris, a finding which was noted at USC in April 2014. Thus, plaintiff’s counsel argued that all of the surgeries performed at USC flowed from Tawansy’s substandard care of Fields, including the partial corneal transplant. Defense counsel argued that all three of Tawansy’s surgeries met the standard of care and that although Tawansy’s suturing of the lens into the sulcus during the third surgery was not optimal, it was within the standard of care to do so, as it allowed for functional vision. Counsel also argued that the three subsequent surgeries at USC were just unfortunate sequelae to the set of difficult circumstances following the surgeries performed by Tawansy., Fields claimed that she suffers from permanent pigment loss to the right eye, daily pain, and permanent blurred vision. She also claimed that she suffers from headaches and that she needs to wear glasses at all times to correct vision to a functional level. Fields claimed that as a result, she is unable to pursue her longtime hobby of sewing. She also claimed that she needs an electronic reader with large print in order to read and that she has difficulty seeing at night, causing her to be unable to drive at night because of her decreased vision function. Fields further claimed that she needs to wear sunglasses at all times when she is outdoors and that she may potentially need a second corneal transplant. Thus, Fields sought recovery of approximately $8,200 in special damages and an unspecified amount of general damages for her past and future pain and suffering. Defense counsel noted that there was no out-of-pocket loss associated with Fields’ care by virtue of her husband’s health coverage, which was enjoyed by the couple as a retirement benefit.
COURT
Superior Court of Kern County, Kern, CA

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