The current issue of the ASA Newsletter has an analysis from the Anesthesia Closed Claims Project database on the problem with eye injuries in anesthesia. The authors of the study focused on the years 1990-2012 in which there were 184 anesthesia claims during eye surgery.
The most common event during eye surgery that led to a malpractice lawsuit was needle injury to the globe in association with a regional block, which occurred in 29% of the claims. Fortunately, the claims rate for needle trauma have been decreasing due to the more widespread use of topical anesthesia, dropping from 37% in the 1990s to 19% in the last decade. Death during eye surgery was the second largest complaint, comprising 27% of claims. Other injuries, including difficult intubation, myocardial infarct, and poor ventilation, have held steady.
Eye surgery claims were more likely to lead to malpractice payments to plaintiffs, 68% compared to 54% for all other surgical anesthesia claims. The average payout was $205,000.
The most common eye injury when regional block is excluded was optic nerve injury which occurred in 38% of claims. Most of these injuries were related to spinal surgery. When it does occur, the effects are devastating, and it reflects in the claims payouts. It has risen from $129,400 twenty years ago to $429,000 recently. Due to this explosive rise in eye injury claims, the ASA issued a Practice Advisory for Perioperative Visual Loss Associated with Spine Surgery in 2006.
By contrast corneal abrasions have decreased in occurrence to only 18% of eye injury claims. Half of the claims resulted in payments to the plaintiff. The median payment was $12,000.
Go to the ASA Newsletter website for a lot more statistical information on this dreaded anesthesia complication.
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