ABSTRACT
Nowadays despite attempts having made by the medical society, health and therapeutic personnel as well as advancements in the therapeutic technology, yet the rate of non-satisfaction and actions by patients continue to increase. The aim of this study was to investigate malpractice complaints against ophthalmologists referred to the state of legal medicine organization. This is a cross-sectional descriptive study on medical complaints cases against malpractice in the field of ophthalmology referred to the State of Legal Medicine Organization Medical Commission for consideration between 2003 and 2005. SPSS software was used for data analysis. Total medical negligence complaints considered in the medical commission during 3 years was 1581 cases, of them 147 [9.29%] cases were related to the field of ophthalmology. Out of total 147 cases set forth in the commission, in 31 cases it was established that a medical negligence has been occurred. Legally, the most common type of negligence was found to be of type of lack of expertise and in the next rank, carelessness. Among total cases considered in the present study, the majority was allotted to the actions brought against private sector health centers. Out of total approved cases as negligence in consideration, the rate of negligence allotted to the university centers was less than other therapeutic centers. The highest rate of filed complaints was related to the cataract surgery [92 cases], followed by LASIK procedure [21 cases]. Ophthalmologists are advised, while establishing a good communication and behavior with patients and their companions, to be careful that prior to committing any kind of procedure, to inform patients of probable and unpredictable complications of the treatment and also to have necessary medical consultations plus to apply pre- and post-operative cares. Furthermore, physicians shall be educated about legal issues
Subject(s)
Humans , Ophthalmology , Forensic Medicine , Cross-Sectional StudiesABSTRACT
To compare the success rate of adjunctive 5-fluorouracil [5-FU] and low molecular weight heparin [LMWH], and daunomycin in combination with triamcinolone during vitrectomy in eyes with retinal detachment [RD] and proliferative vitreoretinopathy [PVR]. In this prospective randomized clinical trial, 69 eyes from 69 patients with RD and PVR [grade B or C] randomized to 3 groups. Group 1: received 5-FU and LMWH [200 microgram/ml 5-FU and 5 IU/ml LMWH, Fragmin]; group 2: received daunomycin [0.5 mg] in 500 cc infusion fluid; and group 3: control group. In all patients, 0.1 cc intravitreal triamcinolone was used during vitrectomy. The patients visited on day 1, week 1, month 1, 3 and 6. Best corrected visual acuity [BCVA] and retinal status compared in the 3 groups. Complete data were available for 60 out of 69 patients. Thirty five patients [58.3%] were male and 25 patients [41.7%] were female. The patient age range was 19-84 years and the mean age was 49. The groups did not have significant difference in age, sex, duration of detachment, severity of PVR, preoperative visual acuity [V/A], lens status, type of tamponade and encircling band and buckle. Postoperative V/A and retina status also was the same in the 3 groups. Perioperative infusion of 5-FU, LMWH and daunomycin does not significantly increase the success rate of patients with RD and PVR comparing to control group. Although visual acuity improvement and retina reattachment rate in group 1 and 2 were better than control group, but statistical analysis failed to show significant difference between the 3 groups