Cataract surgery with no cataracts? (Case #317)

• Medical Probability: 4 / 10
• Medical Error Summary: The mention of "nuclear sclerosis" in the chart means that cataracts were present. Even if the physician does not explicitly write the word "cataract', the presence of nuclear sclerosis is the same th...
• Causation Probability: 3 / 10
• Causation Summary: Complications after cataract surgery are rare but they do occur, The summary above makes no mention of any medical error in surgery. The error it suggests may have taken place was the decision to proc...
• Expert Summary: As a retinal surgeon, I manage many of the severe complications of cataract surgery. If this patient is alleging complications after surgery, there is a good chance I have managed similar complication...
• Similar Summary: I frequently encounter complications after cataract surgery, but I do not frequently perform cataract surgery or make the decision to take cataracts out.

Loss of vision post corneal transplant (from donor) and Endophthalmitis, bacterial infection. (Case #382)

• Medical Probability: 5 / 10
• Medical Error Summary: Based on the first operative report, there seemed to be an uncomplicated procedure. The surgeon noted that the wound in the eye was watertight, which makes infection much less likely. The only open qu...
• Causation Probability: 6 / 10
• Causation Summary:
• Expert Summary: I am a board-certified ophthalmologist and vitreoretinal surgeon. I specialize in treating disorders of the retina and vitreous, including endophthalmitis.
• Similar Summary: I treat cases of endophthalmitis frequently in my practice, around once a month.

Delayed Diagnosis of Retinal Detachment/Tear (Case #427)

• Medical Probability: 4 / 10
• Medical Error Summary: The patient may or may not have had a retinal detachment at the time of his first exam. Typically, patients with retinal detachment report that a portion of their vision is missing, but there is no re...
• Causation Probability: 4 / 10
• Causation Summary: Unless there was a retinal tear or retinal detachment that went undetected at the time of the initial exam, then there is no causation. There is not enough evidence in the description above to meet th...
• Expert Summary: I am a surgical retina specialist and treat retinal detachment every week in the clinic and operating room.
• Similar Summary: Delayed presentation of retinal detachment is common, even after initially presenting to a doctor with symptoms of a posterior vitreous detachment. I see cases like this one several times a year.

Cataract procedure, IOL placed with known cortical material not fully removed. (Case #460)

• Medical Probability: 3 / 10
• Medical Error Summary: The central question is whether failure to completely remove the cataract was outside the standard of care, and I do not think it was. The surgeon encountered a miotic pupil intraoperatively, which pr...
• Causation Probability: 3 / 10
• Causation Summary: It is true that complications from the first surgery were the cause of future complications in this patient's case, but the complications from the first surgery were not the result of negligence or an...
• Expert Summary: As a retinal surgeon, I routinely treat cases of complications from cataract surgery, including residual lens material in the eye after a complicated cataract surgery. In reality, the risk profile of ...
• Similar Summary: On a weekly basis at more than one hospital.

First-time bilateral Eylea HD (high-dose aflibercept) intravitreal injections. (Case #537)

• Medical Probability: 3 / 10
• Medical Error Summary: It is unlikely that a lapse in the standard of care resulted in this patient’s poor outcome. Endophthalmitis after an intravitreal injection is a rare occurrence, but it is also a known and predicta...
• Causation Probability: 3 / 10
• Causation Summary: There is no doubt that the eye became infected as a result of the injection. But the question is whether a medical error caused the infection. The medical record would have to demonstrate a lapse in p...
• Expert Summary: I am a board certified and fellowship-trained vitreoretinal surgeon and retina specialist. I perform thousands of intravitreal injections every year and dozens every week.
• Similar Summary: Sadly, with enough injections, infection predictably occurs. The quoted rates are between one in 3000 and one in 5000. Any doctor or practice that performs enough of these procedures will inevitably e...

Macular Hole caused by YAG Laser Capsulotomy (Case #571)

• Medical Probability: 3 / 10
• Medical Error Summary: The amount of energy and shots fired in the YAG procedure was very normal. It’s true that an error from YAG laser can cause macular damage, but it would manifest immediately after the procedure (not...
• Causation Probability: 3 / 10
• Causation Summary: Same rationale: normal power settings on the laser and a presentation that is not consistent with damage from YAG.
• Expert Summary: The expert is a board-certified vitreoretinal surgeon at Colorado Retina Associates in the Denver metro area. He trained at the University of Colorado (undergraduate, medical school, and residency) an...
• Similar Summary: Macular holes - all the time. Issues from YAG laser - commonly but usually the issue is floaters.