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Patient Suffers Blindness from Undiluted Injection, Settles Lawsuit for $1 Million

Patients depend on their doctors to make the right choices, to administer the right medicine and to provide the highest level of medical care.

Patients deserve all of these things from their doctors, not just a partial list, or the best two out of three.

Unfortunately for this woman, her doctor made an error when injecting medicine into her eye and she is now completely blind in that eye, despite numerous procedures and attempts at correcting her vision.

The 39-year-old woman with 20/20 vision went to her ophthalmologist after two-weeks of progressive visual changes in her left eye.

She was diagnosed with toxoplasmosis or parasitic infection of the left eye, and her doctor prescribed oral antibiotics and antiparasitics. At first, the patient noted some improvement in her vision but suffered side effects from the antibiotics, including persistent gastrointestinal problems.

Several weeks later during a follow-up visit, the physician noted the patient’s vision had begun to deteriorate. The patient said she had stopped taking her medications due to the intolerable side effects.

Her physician brought up an alternative treatment option that involves an injection of the antibiotic directly into the eye. They discussed the benefits and risks of intraocular injections, and the patient consented to the procedure.

Preparing for the injection, a technician retrieved undiluted clindamycin from the pharmacy, and confirmed with a fellow that it was the correct medication. The technician then drew up the medication and gave it to the ophthalmologist, who injected it into the patient’s eye.

The patient suffered abrupt vision loss. Initially, the physician believed the vision loss was due to increased pressure during the infusion, and he ordered an angiogram, followed by intraocular washings with saline.

When the patient’s vision did not return, the ophthalmologist transferred her to a specialty hospital, where she underwent a pars plana vasectomy or PPV, which is the removal of all fluid from eyeball. During the PPV the ophthalmologist observed ischemia of the retina. The patient’s vision loss remained, and she was referred to a retinal specialist. She has undergone seven surgical procedures, but despite interventions she still has no meaningful vision in her left eye.

Upon further investigation, the ophthalmologist and his fellow concluded that the patient likely received an undiluted dose of the antibiotic.

There was some confusion amongst the technician, the fellow and the ophthalmologist about who was responsible for dilution. The ophthalmologist generally relied on the office staff and fellow to draw up and dilute the medication. When he injected the medication he thought it had already been diluted; however, based on the injury suffered, he is no longer sure.

The ophthalmologist disclosed the error to the patient, and accepted full responsibility. The office has implemented a new policy requiring that all medication dilution be witnessed and signed off on.

The patient sued the clinic and ophthalmologist for negligence in the preparation and administration of clindamycin, resulting in her permanent vision loss. The case was settled against the ophthalmologist for more than $1 million.

This patient had a strong medical malpractice case based on the following factors:

Serious overdose. She was accidentally injected with a dose of clindamycin that was 15 times stronger than what it was supposed to be. Her doctor believed the medication had already been diluted and was unaware that he was injecting a concentrated dose. Prepackaged dosing can help reduce the risk for such an error.

No confirmation. The doctor did not confirm the medication he was injecting had been appropriately diluted. Any provider who administers medications is also responsible for the five rights - they need to make sure they have the right patient, the right time, the right drug, the right dose and the right route. These five quick checks can help reduce medication errors.

No formal process for administering medications. Policies for diluting medications should require that a licensed provider perform the dilution and a second provider verify the accuracy before the medicine is given.

The physician took full responsibility. When negligence is clear and the defense experts and defendant himself cannot conclude that an action met the standard of care, a case does not have to be adversarial and drawn out. The defense team can shift to negotiating a settlement over monetary damages.

For more on dosing or pharmaceutical issues, see the library of articles by Daytona Beach nursing home injury attorney.

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