Date of Verdict:
Court and Case No.:
C.P. Allegheny No. 13-009115.
Michael A. Della Veccia.
Type of Action:
Timothy Conboy, Caroselli, Beachler, McTiernan & Conboy, Pittsburgh, Pa.
Ronald M. Puntil Jr., Marshall Dennehey Warner Coleman & Goggin, Pittsburgh, Pa., for The Waterfront Surgery Center; Miles A. Kirshner, Margolis Edelstein, Pittsburgh, Pa., for Ramakumar Gounder and Advanced Ophthalmology East LLC.
Dr. Brian Debroff, ophthalmology, Stratford, Conn.
Dr. Garry Condon, ophthalmology, Pittsburgh, Pa.; Dr. Robert Morrison, ophthalmology, Bethlehem, Pa.; Dr. Christopher Rapuano, ophthalmology, Philadelphia.
On April 30, 2012, plaintiff Patricia Frantz, an event specialist in her 70s, underwent a cataract phacoemulsification with insertion of an intraocular lens to her right eye, which was performed by ophthalmologist Dr. Ramakumar Gounder at The Waterfront Surgery Center in Homestead, Pa.
The procedure requires the surgeon to make a 2.75-millimeter incision in the patient’s cornea, and a phacoemulsification probe and ultrasonic vibration are administered to break up the accumulated cataract mineral, which is extracted through a saline-irrigation system.
The April 30, 2012, operative report said, “Midway during phacoemulsification, it is noted that the phacoemulsification machine started to have a chiming alarm sound, at which time the phacoemulsification setting was brought down to irrigation mode and removed. The cornea was then noted to turn white at the incision site. Phacoemulsification was then retuned and then the phacoemulsification probe was reinserted into the anterior chamber.”
Frantz was discharged the same day, and was told to take acetaminophen for pain.
On May 1, 2012, during a follow-up exam, Gounder noted that Frantz’s status was post-phacoemulsification with intraocular lens, and that she had corneal burns and corneal edema. According to Frantz’s pretrial memorandum, Gounder told Frantz that her vision would steadily improve but the prognosis was guarded, and he prescribed eye drops. On May 3 and May 10, 2012, Frantz returned to see the physician for having difficulty seeing and for seeing black spots in her right eye.
Frantz sued Gounder, his practice, Advanced Ophthalmology East LLC, and Waterfront Surgery Center on claims of medical malpractice. Waterfront Surgery Center was voluntarily dismissed prior to trial. Frantz claimed that she suffered a corneal burn to her right eye during the cataract surgery with Grounder, who improperly performed the procedure.
Frantz’s counsel argued that in order for the phacoemulsification machine to properly operate, there are a series of safety checks needed to avoid a mishap. Frantz’s counsel faulted Gounder for not performing the safety checks, since, as the surgeon, he was responsible to make sure his team had properly prepared the phacoemulsification machine prior to surgery.
Frantz’s expert in ophthalmology opined that if the phacoemulsification power was changed to infusion, as reported by Gounder, only after the phacoemulsification machine began to chime, there would be little time for a corneal burn of this severity to have occurred. The expert cited the operative report in which it stated, “phacoemulsification was then retuned and then the phacoemulsification probe was reinserted,” and maintained that it was likely the machine was improperly tuned at the beginning of the procedure. There have been documented cases of corneal burns as a result of improper tuning of the phacoemulsification, according to the expert.
The defense maintained that the unintended burn to Frantz’s cornea was a known and recognized potential complication of the procedure. According to the defense, when the warning chime sounded on the surgical machine, Gounder reacted immediately and appropriately. He was able to complete the operation and lessened the impact of the burn by fully sealing the wound with a single surgical stitch.
The defense’s expert in ophthalmology testified that Frantz’s injury was an unfortunate complication that suddenly occurred, even with the careful safeguards in place. The expert cited how Gounder was able to close the wound watertight with a single stitch, which remained intact for over a week postoperatively, which meant that even if the eye was damaged, it was managed well and at least not overly disfigured initially. The expert pointed to Frantz’s diabetic and dry-eyes condition, both of which can hamper wound-healing and can cause the problem to worsen if not constantly attended to. The expert concluded that Gounder did not deviate from the standard of care.
On May 29, 2012, Frantz sought a second opinion from an ophthalmologist, who noted that she had a corneal burn to her right eye during the cataract surgery with Grounder. Her right cornea was reportedly scarring and thinning. The physician noted peripheral opacity of the right cornea, mild edema and corneal scarring temporally with striae and high astigmatism. The ophthalmologist discontinued the eye drops and prescribed her tobramycin and dexamethasone.
On June 5, 2012, Frantz returned to the ophthalmologist, and her vision was no better, which prompted the doctor to stop the tobramycin and dexamethasone and restart her on the eye drops. On July 5, 2012, Frantz reported to the ophthalmologist that her vision had not improved and she was seeing shadows, which she communicated again during an Aug. 7, 2012, visit.
On Nov. 7, 2012, Frantz underwent an astigmatic keratotomy by the physician at an outpatient surgery center in Pittsburgh. A postoperative visit was done the next day, in which Frantz was given additional eye drops. On Dec. 13, 2012, during another visit, Frantz was complaining of what appeared to be a watery film over her right eye.
According to court papers, on Jan. 17, 2013, Frantz continued to complain of feeling like there was a film over her right eye. She continued using the prescribed eye drops and acetaminophen for pain. As of Jan. 30, 2013, her corrected visual acuity for her right eye was 20/80 for distance and 20/70 for near vision; her left eye was 20/25 for distance and 20/20 for near. During a visit to the outpatient surgery center on Feb. 28, 2013, Frantz continued to complain of impaired vision and a film in her right eye.
Frantz sought a third opinion on Oct. 3, 2013, during which time an ophthalmologist told her that she has a hole in her eye and the burned area was scarred. The physician further conveyed that if she continues to experience significant pain in her right eye, she is to go to an emergency room, because it may be that her retina is detaching and she would need immediate attention. No further treatment was rendered.
Since 2010, Frantz has worked as an event specialist, wherein she set up a stand at different stores to distribute food samples to customers. Prior to the surgery, she worked four to five days per week, approximately six hours a day, and earned $10.45 an hour. Since the corneal burn, Frantz reportedly has only been able to work two or three days per week, since she is not comfortable driving farther distances and therefore relies on her husband to drive her to work. She sought to recover $12,540 in past lost earnings.
Frantz claimed that her right eye is in constant pain and visually impaired. Although she is allowed to drive during evening hours, she is reportedly afraid to do so. She sought to recover unspecified amounts in noneconomic damages for past and future pain and suffering, and her husband sought to recover damages for his claim of loss of consortium.
After five days of trial, the jury found that Gounder was not negligent.
— This report first appeared in VerdictSearch, an ALM publication •