Lawsuit...

[tommyboy]

I have not been on the boards for a very long time ... I was struggling for a very long time after I got out of the hospital for the second time (attempted suicide). Anyway one year post Lasik I was diagnosed with a corneal neuropathic disease as well as severe dry eye by several doctors in Boston.

I am now 17 months post Lasik and have done considerable research on corneal neuralgia, which is what I have - and from what I read on the net, published by one of my Doctors (Dr. Pedram Hamrah) this type of issue can easily be confirmed with a very simple test called a confocal exam - AND it is treatable with the best chance of full recovery in the first three months. I did not seek treatment until one full year as I had no idea I had this issue.

Doctor's ARE aware of this, in fact - my surgeon had one reported case of this - so he KNEW. The FDA is also aware of this, from the research I did.

I initially had no intention of suing my doctor because I did not think he did anything wrong ... it was just how my body reacted. But ... now I am thinking that I was not properly screened and that I most likely had dry eye prior to the surgery and they NEW that but did not tell me that. So I think they should prove with pre surgical documentation that I did not have any evidence of dry eye. Secondly, I would like to sue them for negligence related to post surgical care. I saw several doctors from the office that performed my surgery, including the surgeon himself and I complained countless times that I was in severe pain and that something was wrong and they just wrote it off as "common LASIK induced dry eye" and my eyes would be fine and return to baseline. The doctors also had the nerve to ask me, when I was ready, if I was interested in having a follow up procedure done to get me to 20/20 ... I thought they were joking.

The confocal exam is a very basic and simple exam that takes 10 minutes to perform. They should have performed a confocal exam or sent me to a lab that had one. If they would have done that, they would have known that I had little to no nerve regrowth and where there was some regrowth it was irregular. AND I could have started a treatment plan (Serum) much earlier - at 3 months. At 3 months this type of condition is TREATABLE. I would have even paid for the confocal exam! My doctor was AWARE of Serum drops, yet neglected to talk to me about that type of treatment plan. So I feel the surgeon and the doctors I met with post surgery are accountable for what has happened to me and they did not act in the best interest of their patient - ME.

Has anyone on this forum had any success in suing or is this a waste of my time?

I am thinking of going through with it anyway... what else can I do? 17 months out and I still can't read, can't watch TV, can barely use the computer and I am still in pain EVERY day even though I am on daily prescription pain meds as well as Serum tears 8 times a day! My short term disability ends next week and I have to go back to work, which I do not think is going to go very well since I am the Business Intelligence leader for a bank.... where I use the computer 8 hours a day or more. At 17 months, I am finally pissed at someone ... and I believe they should pay for what they did to me and my family.

Any feedback would be welcome.

Cheers,
Tom

[Colin P]

Hiya Tom.
Over here in England, the little guy usually has no-chance against a bigger/richer foe. Legal fees etc eventually force the little guy to back out, for fear of losing everything he owns, even the shirt of his back. And if your legal system is anything like ours over here? be prepared that it may take years, and will infuriate and stress you to breaking point, at the amount of bull-sh*t you have to wade through which is all geared up so that an individual decides against ever embarking on such an venture.
Over here we now have many 'no-win-no-fee' solicitors who will only touch a nailed-on case where they have to do very little and know damn well they will win. We have to ensure we read the samll print, as they don't do it for nothing-lol, the longer it drags on? the more they make, and you end up potless at the end of it despite winning your claim.. Good eh!.. An average solicitor over here will charge £100 per hour, and the same for writing a letter, which dont happen over night of course. The legal system rivals banks, politicians and estate agents for biggest crooks you could find... Good-luck Tom...

ps, real glad you're in a better place than you have been with your health, onwards and upwards!...

[littlemermaid]

Atul Gawande's book 'Better: A Surgeon's Notes on Performance' has been good reading for me. We are also dealing with a chronic condition set up by oral meds - still thinking and talking to docs about the incidence of side effects, with a view to ensuring monitoring and treatment in the future for the eyes.

There is an interesting new angle on this in UK and US - performance indicators for clinics and surgeons. Incidents and adverse results are to be reported.

Another interesting new angle is compulsory revalidation of docs, to ensure they are updating and practising at current standards.

So there might be other options to pursue instead/as well to feel your job is done, if not now, long term. It's been most useful to see this as an ongoing project while we get on with working on a good everyday life for the family. I use the anger to motivate change in the 'industry' with like-minded patient groups and docs who want to improve things.

With a patient group (like this), we share the burden and access current research and thinking. Eg our patient group on intracranial hypertension (unrelated to dry eye surface but with similar monitoring and treatment issues) is supporting and motivating a national research programme to establish a protocol and raise awareness among docs - up till now there has been c75% preventable vision loss from misdiagnosis and lack of monitoring. Patient experience tracking and assembling data has been the most useful research tool (your bank/business skills?).

In UK even Trading Standards is looking at refractive surgery business. There is new regulation so far for eg cosmetic procedures. I notice they are monitoring adverse outcomes inside the industry because refractive surgeons report them in conferences and talk about follow-up (OSNSupersite/Healio).

There is doc pressure not to be open and talk about adverse results but detailed medical records with other providers who supplied copies and a Diary have been important.

Just as an example again, 3y down the line we just got from neuros 'there's nothing reported in the ongoing observations from eye clinic about vision obscurations and head pain, I don't think she had the condition in the first place'. And I notice the episode is missing from the hospital and GP records. That is the sort of misrepresentation to guard against too, particularly where there is no legal access to medical records. So vision problems, as Robster says, need to be meticulously recorded and backed up.

Love from London to you and the family, Tom.

[Scout]

Tom,

I am so sorry that you are going through this.

I would recommend that you get referred from people you know and trust to an attorney who specializes in medical malpractice in your area. Most attorneys have a low fee introductory consultation. An attorney in your area can give you a much better idea if your case has merit legally. Everyone who posts here (and all who have suffered post-LASIK complications) probably believe that you have a good case. But only an attorney can tell you if you have a good legal case. And that varies from state to state.

Here in California, your case would most likely not be accepted by most medical malpractice attorneys. We have a law here in California that was sold as a way to stop "frivolous lawsuits." Due to this law, there is now a cap on damages for medical malpractice claims of $250,000. This pretty much makes most cases unprofitable for attorneys here, so there are very few cases that are currently being filed.

The attorney you see can tell you about your state's laws and whether he/she thinks it is a case that can be won in a court of law.

I wish you the best.

Scout

[LaDiva]

Really sorry you are having such a hard time tommyboy. I hope that whatever you decide is the right choice for you. Whenever I think about suing someone, I always remember that lawyers will drag everyone through the mud, and that the process is costly and emotionally draining. I think you have every reason to sue, and hope that if you chose to do this you feel emotionally and physically up to the battle. Best wishes to you.

[robster]

Thought about going down the legal route myself. Main problem is that unfortunately once you sign that consent form you also sign away alot of your legal rights. Since all LASIK consent forms mention dry eye it is extremely difficult to successfully sue once you have dry eye even if your LASIK clinic told you that you had next to no chance of getting it. If you do decide to sue you will probably have a better chance of success basing your case on your visual problems rather than the dry eye. Just my opinion after seeing a few solicitors over here following my LASIK surgery.

[bunnyrabbit123]

Tommy,
You have every right to be angry. Do you or your family know an attorney you could consult about this? I do think you're entitled to be compensated for what your going thru but my limited experience is that lawyers (like some doctors) often promise things they can't deliver and a lawsuit can be extremely stressful, even when you are the wronged party.

[Cristi]

Hi Tommy
I'm sorry for the pain you are going through. We all have it in various degrees.... thanks God I'm not very bad but still have a serious case of LASIK induced dry eye.
I do not know what advice to give you in terms of lawsuit as I am from an eastern european country (laws are surely different here) and I decided that it is not worth for me trying to try such an attempt (post lasik life is miserable enough even without a law process)
I'd like to know if you would be so kind to help some more information about the confocal microscopy. You said that you did this test and it only took 10 minutes and that it proved that your nerves were regenerated in small numbers and that it was a irregular regeneration.
I too had a confocal microscopy last week I'm 14 months post lasik. I had to go to Norway to have it done along with other dry eye tests.
I found it being uncomfortable and it took like you said around 10 minutes.
I was told that it was almost impossible to test the entire cornea because it would have taken an entire day and doctor took only a sample at around 50 microns depth. He showed me the images and could see 3 nerves in that small sample I believe he said there were regenerated in the stroma and that in the stroma immediately after lasik there is no nerve left due to the ablation and the cut and that it was a good news that we say those tiny 3 little nerves....this on the positive side but on the other hand I was told that it couldn't tell if the nerves were normal or it was some abnormal regeneration.... How could you tell? What have you been told? I will soon hopefully receive the results in english and some pictures so maybe we can share and post here some images with our nerve regeneration or whatever it is I was also told that I had scars like after an infection in the worse eye. It looked like the milky way...some white shades on black...
Hope you the best I totally understand your anger and hope that justice will be done for you.
Cristina

[Rebecca Petris]

(((Tommyboy)))

Just glad to see you here. I have been thinking about you a lot and hoping you were OK.

I'll try & come back & reply about legal in a coupla days. Off the cuff, I would say that if it were me I'd go into it only on the full understanding that it would involve blazing some new trails and I would not attempt it unless one of the most experienced LASIK lawyers were on my team who understands the complexity of both the medical side and the equipment side enough to develop a really meaningful strategy.

[tommyboy]

Thanks for all the replies, ideas and feedback. Rebecca, I know you called me a couple months ago ... sorry I did not return your call.

Crisiti - to answer your questions on the confocal. I have had three exams done in Boston. The first exam yielded no nerve generation at all post lasik one year in one of my eyes and very little, with abnormal regrowth in the other. Honestly, it is hard to interpret the images, for me at least. But, I did take the pictures with me to my local corneal specialist in CT and he took a quick look at them and pointed at one of the pictures and showed me irregular nerves growing... and I did not tell him that was what Dr. Pedrham told me. He was able to decipher that himself via the images. I can tell you the printed copies of the confocal are definitely hard to read, compared to viewing them in the office on the computer. You can see much, much more on the images on the computer as they can move around the images as well as zoom in and out.

On my second visit - two months on the Serum - there was little regrowth, but was told that was expected and the little regrowth was promising. My eyes hurt more then, then they ever did before... my doctor told me as my nerves grow back I will most likely feel pain, more pain than I did before. And he was right, the pain was unbearable.

Then another two months went by and I noticed a considerable change, my eye pain decreased from a 7 to somewhere around a 3 or 4. My eyes still hurt and bother me, but much better then before.

So my third confocal at 4 months I was not surprised to hear that I had about 30% regrowth. He showed me the pictures on the screen and I saw a bunch of large nerves (look like roots of a plant or a tree) ... and I saw a ton of little branches everywhere.

He told me 30% was very good and we should expect to get to between 50% to 70% ... the downside of the news was that he told me that could take another month or another year - he has no way of telling.

I also told him that I currently do not watch TV, read, drive or use the computer and when I do my eyes hurt more and get blurry pretty fast. I told him what I did for a living (worked on the computer 8+ hours a day) and he said I should consider a career change. And he was not kidding.

I asked him if I could make a full recovery, and would my pain receed down from a 3/4 to a zero and he said he wanted to set expectations that this could be the best it gets ... or it could get better, but he could not make any promises.

My next exam is on March 29th.

I do not think sharing our images (printed version) will help much. But I would be happy to talk with you anytime, just PM me and I will give you my contact information.

Thanks again,
Tom

[Phillips55]

tom,
I had lasik 2 years ago and have had severe problems with dry eye and visual problems. It's been hard because the lasik doctor strung me along for a year without giving me any direction at all, save omega 3. I finally started doing my own research and sought out treatment. I too have considered litigation against my lasik surgeon. I mean his conduct was frankly appalling. Unfortunately I live in a state where it's next to impossible to sue a doctor for malpractice. Some states are better than others. I am very interested in serum drops and have read about Dr. Hamrah. Is true that you should have at least a 50% solution at 8x a day? Also, someone else I think mentioned this here, but I wonder if re lifting the flap and then applying serum would have any effect on the present abnormal growth and potential healthy nerve regeneration.

[Phillips55]

I also just found this on corneal nerve regeneration, which is interesting.
http://www.fatsoflife.com/fol-april-...edf-treatment/

[Guest]

Also, someone else I think mentioned this here, but I wonder if re lifting the flap and then applying serum would have any effect on the present abnormal growth and potential healthy nerve regeneration.

I imagine the downside to that is that you are disrupting whatever nerve re-growth that has already occurred... you'd be setting yourself right back to day 1 post-lasik, except that you are now trying to get the nerves to regrow for a second time.

Also, I doubt they would apply the serum under the flap due to risk of infection, and even if they were willing to do it, it would be one dose of serum, which is highly unlikely to be enough to do anything significant, then they'd squeegee the flap back down and you'd be back to where you are now, except WORSE (since as I mentioned, lifting the flap will severe any nerves that have already started to regrow back into the flap.)

[patientpatrick]

Hey Phillips55,

thank you for posting that article. I'm not sure what to believe though.

According to the article it states: "These nerves are damaged in certain types of surgery, such as LASIK, performed to reshape the cornea and sharpen vision. Usually, these nerves do not regenerate after injury."

Every other article I've read says that the nerves do regenerate, some say back to normal in 3-6 months, some say 5 years, some say they only grow back partially normally.

Also: "Experimental studies in animals with corneal nerve damage have shown that when DHA, a long-chain omega-3 fatty acid found mainly in seafood, and a growth factor called PEDF are applied to the eye after surgery, corneal nerves regenerate almost fully."

I'm assuming that this is applied directly to the eye as opposed to being ingested. If this was the case, I'm surprised that there aren't any fish oil based drops. There are castor oil, and corn oil... seems like fish oil plus the PEDF growth factor would make a powerful drop for all us Lasik sufferers. My question would be, would this have to be done immediately after surgery, or could this still have effective results for us over a year post-lasik.

Just some thoughts that i found interesting.

[Phillips55]

I wasn't actually thinking about putting serum under the flap but rather a 3-6 month regimen after the procedure. I think Tommy referred at some point that flap healing was signigant when serum was used within 3 months of surgury. I guess I was just thinking along the lines of like when a doctor has to re-break a bone so that it heals properly.