Risk Management

Why are Dilating Drops in the News?

A medication used routinely by ophthalmol- ogists—dilating drops—was the subject of a recent ruling in the Massachusetts Supreme Court, which in turn occasioned an ASCRS Member Alert. The court opined that if a physician does not warn of the possible side effects of a medication or treatment, he can be held liable not only to his patient but to all those “forseeably put at risk for a failure to warn.”

While this case was triggered by a motor vehicle accident, OMIC has also dealt with mal- practice allegations involving falls after dilation. Indeed, we recently settled such a case, and were already editing articles on risks related to dilating drops for this issue of the Digest (see Closed Claim Study and Risk Management Hotline) when we were contacted by policyholders in response to the ASCRS Alert. It is important to reiterate OMIC’s long-standing recommendations on an ophthalmologist’s duty to warn patients about the effects of dilating drops.

We first suggested such a practice in 1992, when former OMIC committee member Richard A. Deutsche, MD, advised ophthalmologists to “Discuss Potential Side Effects of Eye Drops” in the AAO’s Argus, and we provided a sample consent document for dilating drops in 2002.

At the 2007 AAO Annual Meeting, the OMIC Forum on “Medication Safety and Liability” focused attention on two other high-risk medica- tions that play a role in ophthalmic liability: anticoagulants and steroids. Policyholders who were not able to attend the forum may order a complimentary copy of the CD by calling Linda Nakamura at (800) 562-6642, ext. 652. Insureds are also encouraged to consult “Hemorrhage Associated with Ophthalmic Procedures” and our sample consent form for triamcinolone acetonide (KenalogTM), both available at www.omic.com.