ABSTRACT
Resumen Objetivo: Realizar un análisis descriptivo de los incidentes en oftalmología reportados por médicos oftalmólogos de Argentina. Métodos: Se realizó un estudio basado en una encuesta desarrollada mediante un sistema electrónico, en agosto de 2021, dirigido a médicos oftalmólogos de Argentina. Se solicitó la descripción de incidentes oftalmológicos, clasificándolos en cuatro grupos, acorde a lo descrito por Organización Mundial de la Salud, en A: "Incidentes, casi-accidentes (no alcanzaron a los pacientes)"; B: "Incidentes (que alcanzaron al paciente, pero sin daño)"; C: "Incidentes prevenibles con daño" y D: "Incidentes no prevenibles con daño". El instructivo de la encuesta explicó la terminología y ofreció ejemplos de cada tipo de incidentes, que fueron evaluados mediante un proceso estadístico descriptivo. Resultados: Participaron 264 médicos oftalmólo gos quienes informaron 434 incidentes. A- Incidentes sin alcance al paciente: 125 casos (28.8%). B- Incidentes que alcanzaron al paciente sin daño: 117 casos. (27%). C- Incidentes prevenibles, con daño: 96 casos (22.1%). D- Incidentes no prevenibles con daño: 96 casos (22.1%). Los incidentes vinculados al uso de gotas fueron los más frecuentes en los 4 grupos (68, 75, 13 y 29 incidentes respectivamente). Conclusión: El 77.9% de los incidentes comunicados en este estudio se podrían haber evitado con adecuadas medidas de seguridad, siendo los más frecuentes los asociados a la utilización de gotas oftálmicas.
Abstract Objective: To perform a descriptive analysis of incidents in ophthalmology reported by ophthal mologists of Argentina. Methods: A questionnaire-based study was performed by an electronic survey during August 2021, including ophthalmologists of Argentina, requesting the description of ophthalmological incidents, which were classified in four groups, in accordance with World Health Organization Definition, as follow: A- "Inci dents, almost-accidents (patient no affected)"; B: "Incidents (patient affected without damage)"; C: "Preventable incidents, with damage", and D: "Not Preventable incidents, with damage". An instructive was supported in the survey explaining these definitions with examples of each kind of incidents. Data was processed for descriptive statistics. Results: The survey was performed by 264 ophthalmologists, reporting 434 incidents: A- Incidents, almost-accidents (patient not affected): 125 cases (28.8%). B- Incidents (patient affected without damage): 117 cases (27%). C- Preventable incidents, with damage: 96 cases (22.1%). D- "Not Preventable incidents, with damage: 96 cases (22.1%). In four groups the most frequent incidents were those associated with the use of ophthalmic drops (68, 75, 13, and 29 incidents respectively). Conclusion: Most of the incidents (77.9%) reported in this study could be avoided if appropriate safety measures were taken. Ophthalmic drops related incidents were the most frequent.
ABSTRACT
OBJECTIVE: To perform a descriptive analysis of incidents in ophthalmology reported by ophthalmologists of Argentina. METHODS: A questionnaire-based study was performed by an electronic survey during August 2021, including ophthalmologists of Argentina, requesting the description of ophthalmological incidents, which were classified in four groups, in accordance with World Health Organization Definition, as follow: A- "Incidents, almost-accidents (patient no affected)"; B: "Incidents (patient affected without damage)"; C: "Preventable incidents, with damage", and D: "Not Preventable incidents, with damage". An instructive was supported in the survey explaining these definitions with examples of each kind of incidents. Data was processed for descriptive statistics. RESULTS: The survey was performed by 264 ophthalmologists, reporting 434 incidents: A- Incidents, almost-accidents (patient not affected): 125 cases (28.8%). B- Incidents (patient affected without damage): 117 cases (27%). C- Preventable incidents, with damage: 96 cases (22.1%). D- Not Preventable incidents, with damage: 96 cases (22.1%). In four groups the most frequent incidents were those associated with the use of ophthalmic drops (68, 75, 13, and 29 incidents respectively). CONCLUSION: Most of the incidents (77.9%) reported in this study could be avoided if appropriate safety measures were taken. Ophthalmic drops related incidents were the most frequent.
OBJETIVO: Realizar un análisis descriptivo de los incidentes en oftalmología reportados por médicos oftalmólogos de Argentina. Métodos: Se realizó un estudio basado en una encuesta desarrollada mediante un sistema electrónico, en agosto de 2021, dirigido a médicos oftalmólogos de Argentina. Se solicitó la descripción de incidentes oftalmológicos, clasificándolos en cuatro grupos, acorde a lo descrito por Organización Mundial de la Salud, en A: "Incidentes, casi-accidentes (no alcanzaron a los pacientes)"; B: "Incidentes (que alcanzaron al paciente, pero sin daño)"; C: "Incidentes prevenibles con daño" y D: "Incidentes no prevenibles con daño". El instructivo de la encuesta explicó la terminología y ofreció ejemplos de cada tipo de incidentes, que fueron evaluados mediante un proceso estadístico descriptivo. RESULTADOS: Participaron 264 médicos oftalmólogos quienes informaron 434 incidentes. A- Incidentes sin alcance al paciente: 125 casos (28.8%). B- Incidentes que alcanzaron al paciente sin daño: 117 casos. (27%). C- Incidentes prevenibles, con daño: 96 casos (22.1%). D- Incidentes no prevenibles con daño: 96 casos (22.1%). Los incidentes vinculados al uso de gotas fueron los más frecuentes en los 4 grupos (68, 75, 13 y 29 incidentes respectivamente). Conclusión: El 77.9% de los incidentes comunicados en este estudio se podrían haber evitado con adecuadas medidas de seguridad, siendo los más frecuentes los asociados a la utilización de gotas oftálmicas.
Subject(s)
Ophthalmology , Humans , Argentina/epidemiology , Surveys and QuestionnairesABSTRACT
Introduction: Like all United States physicians, ophthalmologists may be implicated in lawsuits claiming fraudulent medical practice. In order to educate, raise awareness, and mitigate fraudulent practice, we reviewed a legal database and analyzed fraud claims in ophthalmology lawsuits. Methods: A retrospective legal literature review was performed on jury verdicts and settlements from the online legal database LexisNexis Academic from 1985 through 2020 that were filed by or against an ophthalmologist, involved a fraud claim, and included a final decision or settlement. Cases were evaluated for factors including demographics of plaintiffs and defendants, type of fraud claim, ophthalmologist party status (plaintiff or defendant), decision outcome, and amount awarded (when applicable). Results: Of the 27 cases analyzed, all ophthalmologist defendants involved were male and the most common sub-specialty for an ophthalmologist defendant was refractive surgery. The most common fraud type was a fraud claim involving a malpractice lawsuit (12 of 27), followed by contract fraud and billing fraud. While the ophthalmologists in malpractice-related fraud cases experienced more rulings in favor of the defendant on the fraud claims (8 of 12), ophthalmologists in billing fraud cases experienced fewer rulings in their favor (0 of 5). Discussion: Ophthalmology lawsuits involving fraud claims occurred in various settings, including malpractice lawsuits, contract cases, and Medicare and Medicaid billing. Defendants were all male and most commonly refractive surgeons.
