Abstract
Objective
To assess the characteristics of malpractice lawsuits against Canadian ophthalmologists
and the predisposing factors leading to claims.
Design
Retrospective case series.
Methods
A systematic search of the 2 largest Canadian online legal databases, LexisNexis Canada
and Westlaw Canada, was performed to collect cases against ophthalmologists in Canadian
courts from 1977 to 2021.
Results
This study comprised 68 legal cases, including 52 lawsuits, 14 cases appealed once,
and 2 cases appealed twice. Most cases concerned surgical procedures (46.2%), followed
by misdiagnoses or lack thereof (32.7%) and nonsurgical procedures (21.2%). Half the
cases (n = 26) were immediately dismissed by the judge in favour of the ophthalmologist,
though among the remaining half that proceeded to trial the majority (88.5%) were
won by the patients. All appeals by patients were dismissed by the judge. The median
monetary value of damages awarded was $308,202.
Conclusions
This study is the first to report on ophthalmology-involved medical litigation cases
in Canada. Most cases were ruled in favour of the ophthalmologist, but most of those
that were not immediately dismissed by the judge were ruled in favour of the plaintiff.
Notably, a plurality of these cases argued for a lack of informed consent, and every
case in which a lack was successfully pleaded was ruled in favour of the plaintiff,
highlighting the importance of appropriate informed consent. The findings of this
study give Canadian ophthalmologists insight into areas of practice that commonly
lead to litigation and can aid in improving clinical practice and risk management.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Canadian Journal of OphthalmologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Rates and characteristics of paid malpractice claims among U.S. physicians by specialty, 1992–2014.JAMA Intern Med. 2017; 177: 710-718
- Malpractice risk according to physician specialty.N Engl J Med. 2011; 365: 629-636
- Ophthalmic malpractice lawsuits with large monetary awards.Arch Ophthalmol. 1996; 114: 333-337
- Donaldson MS Corrigan JM Kohn LT To err is human: building a safer health system. National Academies Press, Washington (DC)2000
- Evaluating the medical malpractice system and options for reform.J Econ Perspect. 2011; 25: 93-110
- Medical errors, malpractice, and defensive medicine: an ill-fated triad.Diagnosis (Berl). 2017; 4: 133-139
- Defensive medicine among high-risk specialist physicians in a volatile malpractice environment.JAMA. 2005; 293: 2609-2617
- National costs of the medical liability system.Health Aff (Millwood). 2010; 29: 1569-1577
- Malpractice litigation in pediatric ophthalmology.JAMA Ophthalmol. 2016; 134: 1230-1235
- Malpractice litigation in glaucoma.Ophthalmol Glaucoma. 2021; 4: 405-410
- Medical malpractice in uveitis: a review of clinical entities and outcomes.Ocul Immunol Inflamm. 2018; 26: 242-248
- Seven hundred medicolegal cases in ophthalmology.Ophthalmology. 1990; 97: 1379-1384
- Clinical negligence in ophthalmology: fifteen years of national health service litigation authority data.Ophthalmology. 2013; 120: 859-864
- A decade of clinical negligence in ophthalmology.BMC Ophthalmol. 2007; 7: 20
- Review of ophthalmology medical professional liability claims in the United States from 2006 through 2015.Ophthalmology. 2018; 125: 631-641
- Increasing incidence of cataract surgery: population-based study.J Cataract Refract Surg. 2013; 39: 1383-1389
- Toward more effective risk prevention.Surv Ophthalmol. 2009; 54: 150-157
- Practical and philosophical considerations of the physician-patient relationship.Ann Ophthalmol. 1987; 19: 83-84
- Unsolicited patient complaints in ophthalmology: an empirical analysis from a large national database.Ophthalmology. 2016; 123: 234-241
- In the eyes of the law: malpractice litigation in oculoplastic surgery.Ophthalmic Plast Reconstr Surg. 2014; 30: 119-123
Article info
Publication history
Published online: March 14, 2023
Accepted:
February 23,
2023
Received in revised form:
February 6,
2023
Received:
July 13,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
