Epi Final
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Questions and Answers

What was the highest proportion of eye injury visits to the ER for 10-24 year-olds?

  • Sports products (correct)
  • Household items
  • Cutting and construction tools
  • Chemicals

    • Which household product was NOT mentioned as a common cause of eye injuries?

  • Cooking foods that can splatter hot grease or oil
  • Bleach (correct)
  • Oven cleaners
  • Disinfectants

    • What can be absorbed quickly into the blood vessels close to the eye's surface, causing severe damage or blindness?

  • Bleach
  • Disinfectants
  • Oven cleaners
  • Pesticides (correct)

    • Who are the patients at greatest risk of eye injury according to the text?

    <p>Patients with developing eye disease and weakened eyes from previous surgery</p> Signup and view all the answers

    What is crucial for optometrists to assess when prescribing glasses?

    <p>How patients intend to use their spectacles</p> Signup and view all the answers

    Which age group had the highest proportion of eye injury visits to the ER due to household items?

    <p>5-9 years</p> Signup and view all the answers

    What is the optometrist's role in eye injury prevention according to the text?

    <p>Assessing risk, advising, and educating patients</p> Signup and view all the answers

    What is crucial for optometrists to assess in every case history?

    <p>Patients' visual demands at work, home, and elsewhere</p> Signup and view all the answers

    What are the legal responsibilities in eye injury prevention for optometrists according to the text?

    <p>Establishing a doctor-patient relationship and adhering to reasonable standards of care</p> Signup and view all the answers

    What was among the top activities causing sports-related eye injuries for both children and adults in 2019?

    <p>Basketball</p> Signup and view all the answers

    What can cause trauma from sharp objects according to the text?

    <p>Champagne corks</p> Signup and view all the answers

    In Case Scenario 1, what Rx material would you order for John, a healthy 26-year old accountant with an Rx of OD +2.50sph OS +3.50sph?

    <p>1.67 high index lens</p> Signup and view all the answers

    In Case Scenario 2, what Rx material would you order for John, a healthy 26-year old accountant with hobbies including computer gaming and cooking, and an Rx of OD +2.50sph OS +3.50sph?

    <p>Polycarbonate</p> Signup and view all the answers

    In Case Scenario 3, what Rx material would you order for John, a healthy 26-year old accountant with hobbies including computer gaming, cooking, and fishing, and an Rx of OD +2.50sph OS +3.50sph?

    <p>CR-39</p> Signup and view all the answers

    In Case Scenario 4, what Rx material would you order for John, a healthy 26-year old accountant with hobbies including computer gaming, cooking, fishing, and yardwork, and an Rx of OD +2.50sph OS +3.50sph?

    <p>Polycarbonate</p> Signup and view all the answers

    What is the typical timeframe for trials to occur after a complaint is filed in medical malpractice litigation?

    <p>3-5 years</p> Signup and view all the answers

    What percentage of medical malpractice claims had documentation issues, with a majority being insufficient or lacking information?

    <p>20%</p> Signup and view all the answers

    What is the main player in the event of a medical malpractice claim being filed?

    <p>Insurance company</p> Signup and view all the answers

    What is the typical timeframe for a patient to sue in the event of a lawsuit?

    <p>2-3 years from the injury</p> Signup and view all the answers

    What does a settlement in a medical malpractice case admit?

    <p>It does not admit malpractice, guilt, or risk of excess financial responsibility</p> Signup and view all the answers

    What is the advice given regarding the demeanor of doctors to reduce the likelihood of being sued?

    <p>Be nice and maintain a professional demeanor</p> Signup and view all the answers

    What is the percentage of medical malpractice claims with insufficient or lacking information?

    <p>70%</p> Signup and view all the answers

    What is the typical timeframe for the insurance company to process a filed claim?

    <p>6 months to 1 year</p> Signup and view all the answers

    What are the important points to document in patient files according to the text?

    <p>Diagnosis, treatment options, treatment plan, risks and benefits, prognosis, patient response, follow-up measures, and phone calls with patients and other doctors</p> Signup and view all the answers

    What is the cost of prevailing in court according to the text?

    <p>Extensive time and effort, including reviewing files, preparation for depositions, and time away from work and family</p> Signup and view all the answers

    What is the advice given regarding communication in the context of medical malpractice litigation?

    <p>Communicate clearly</p> Signup and view all the answers

    What is the advice given in terms of seeking legal advice in medical malpractice cases?

    <p>Seek legal advice when unsure</p> Signup and view all the answers

    What is medical malpractice defined as?

    <p>Any act or omission by a physician during treatment of a patient that deviates from accepted norms of practice in the medical community and causes an injury to the patient</p> Signup and view all the answers

    What is the primary reason for optometrists to be aware of the standard of care in optometry?

    <p>To avoid common mistakes and prevent malpractice lawsuit</p> Signup and view all the answers

    According to Chris Mazzolini from Medical Economics Journal, what percentage of physicians will face a malpractice suit at some point in their career?

    <p>50%</p> Signup and view all the answers

    What is recommended for examining contact lens patients to minimize malpractice risks?

    <p>Inspect and ensure all contact lens parameters are correct before fitting</p> Signup and view all the answers

    What must prescribers do to confirm that a patient received their prescription, according to the AOA (June 2020)?

    <p>Maintain proof that they satisfied the confirmation of prescription release requirement for at least three years</p> Signup and view all the answers

    What is recommended to avoid malpractice claims according to the text?

    <p>Follow co-management protocols</p> Signup and view all the answers

    What is crucial to document, according to the text, to serve as evidence of work and defense?

    <p>Every procedure performed</p> Signup and view all the answers

    What is the advice given to optometrists to reduce the likelihood of being sued?

    <p>Don’t be afraid to refer to your patient</p> Signup and view all the answers

    What is the legal requirement regarding the confirmation of prescription release, according to the AOA (June 2020)?

    <p>Maintain proof that they satisfied the confirmation of prescription release requirement for at least three years</p> Signup and view all the answers

    What is important for optometrists to do when examining contact lens patients to minimize malpractice risks?

    <p>Schedule follow-up visits at regular intervals and document no-show</p> Signup and view all the answers

    What must optometrists discuss with patients before starting any treatment?

    <p>The nature of the procedure, its risks and benefits, and alternatives</p> Signup and view all the answers

    What can optometrists be liable for if informed consent is not obtained?

    <p>Negligence and assault and battery</p> Signup and view all the answers

    What is the responsibility of optometrists in co-management relations with ophthalmologists?

    <p>They have joint and several liability in case of patient injury</p> Signup and view all the answers

    What are common causes of malpractice claims in optometry?

    <p>Failure to diagnose conditions</p> Signup and view all the answers

    What was the impact of the case Helling v. Carey on the standard of care in optometry?

    <p>Significant impact</p> Signup and view all the answers

    What can optometrists be held liable for in case of patient injury?

    <p>Negligence or intentional wrongful conduct of employees</p> Signup and view all the answers

    What is required before initiating any procedure according to the professional community rule?

    <p>Written informed consent</p> Signup and view all the answers

    What may lead to liability under negligence if not adequately performed?

    <p>Failure to explain risks and benefits</p> Signup and view all the answers

    What is involved in co-management relations between optometrists and ophthalmologists?

    <p>Joint and several liability</p> Signup and view all the answers

    What is the responsibility of optometrists in case of delayed referrals resulting in eye loss?

    <p>Full responsibility</p> Signup and view all the answers

    What are examples of malpractice cases in optometry?

    <p>Failure to diagnose uveitis leading to blindness</p> Signup and view all the answers

    What did the case Helling v. Carey involve?

    <p>Failure to diagnose glaucoma</p> Signup and view all the answers

    What did the appellate level federal court establish as a new standard for routine eye exams?

    <p>Performing dilated fundus examination using binocular indirect ophthalmoscopy</p> Signup and view all the answers

    What did the doctor advise for the teenager with reduced vision during the initial visit?

    <p>Glasses wouldn't correct the condition</p> Signup and view all the answers

    What was the reason for the optometrist being sued for malpractice?

    <p>Failure to refer the teenager for further evaluation</p> Signup and view all the answers

    What type of testimony may ophthalmologists provide in optometric malpractice cases?

    <p>Causation and failure-to-refer cases</p> Signup and view all the answers

    What was the median optometrist malpractice payment reported nationally?

    <p>$57,500</p> Signup and view all the answers

    In what situation is it recommended to perform automated visual fields?

    <p>When visual acuity isn't correctable to 20/20 and fundus exam is normal</p> Signup and view all the answers

    What did the doctor find during the dilated fundus exam for the teenager with reduced vision?

    <p>Normal discs and macula</p> Signup and view all the answers

    What was the outcome of the malpractice case against the optometrist?

    <p>Found culpable and awarded $9.2 million</p> Signup and view all the answers

    What is the role of ophthalmologists in optometric malpractice cases?

    <p>Testify about causation and failure-to-refer cases</p> Signup and view all the answers

    What did the federal panel determine the doctor should've performed during the routine eye exam for Karen Keir?

    <p>Dilated fundus examination using binocular indirect ophthalmoscopy</p> Signup and view all the answers

    What was the recommendation regarding routine eye exams after the precedent-setting case involving Karen Keir?

    <p>Dilation on nearly every patient</p> Signup and view all the answers

    What did the teenager with reduced vision later get diagnosed with?

    <p>Large brain tumor</p> Signup and view all the answers

    What does negligence refer to in the context of optometry?

    <p>Failure to exercise the standard of care</p> Signup and view all the answers

    What does the term 'duty' refer to in the legal responsibilities of optometrists?

    <p>The obligation to provide care adhering to the standard of care</p> Signup and view all the answers

    What is the definition of criminal negligence in the context of optometry?

    <p>Conscious, voluntary, and reckless actions or inactions</p> Signup and view all the answers

    What is the primary factor contributing to medical errors in optometry?

    <p>Misdiagnosis and failure to refer</p> Signup and view all the answers

    What is the definition of 'damage' in medical negligence cases?

    <p>Economic and noneconomic harm leading to monetary remedy</p> Signup and view all the answers

    What defines the standard of care for optometrists?

    <p>State laws or regulations established in case law</p> Signup and view all the answers

    What does causation under negligence encompass?

    <p>Direct and indirect harm caused by optometrist's action or inaction</p> Signup and view all the answers

    What constitutes the competency of an optometrist?

    <p>Knowledge and ability</p> Signup and view all the answers

    What is the definition of 'assault' in the context of optometry?

    <p>Intentional placing of a patient in reasonable apprehension of imminent harmful or offensive touching without consent</p> Signup and view all the answers

    What is the legal responsibility of optometrists to ensure patient safety and avoid negligence?

    <p>Adhering to the standard of care, rechecking prescriptions, and ensuring patient safety</p> Signup and view all the answers

    What is the consequence of breach of the standard of care by an optometrist?

    <p>Failure to conform to the standard of care</p> Signup and view all the answers

    What is the definition of 'battery' in the context of optometry?

    <p>Harmful or offensive touching without permission</p> Signup and view all the answers

    Study Notes

    Eye Injury Prevention and Optometrist's Role

    • In 2014, over 193,000 adults and children were treated for home-related eye injuries in the US, with a third of injuries occurring in the kitchen, bedroom, bathroom, living room, or family room.
    • Highest proportion of eye injury visits to ER: Chemicals for ages 0-4 years, and > 65, household items in 5-9 year-olds, sports products in 10-24 year-olds, cutting and construction tools in 25-64 year-olds.
    • Sports-related eye injuries by age in 2019: Basketball, pools & water sports, non-powder guns, darts, arrows, slingshots, and bicycles were among the top activities causing injuries for both children and adults.
    • Common household products causing eye injuries include oven cleaners, glue, disinfectants, hair sprays, and cooking foods that can splatter hot grease or oil.
    • Other sources of injuries at home include lawn mowers, car repair, DIY activities, yard work, champagne corks, trauma from sharp objects, using hot objects around the face, and pesticides.
    • Pesticides can be absorbed quickly into the blood vessels close to the eye's surface, causing severe damage or blindness.
    • Patients at greatest risk of eye injury include children, one-eyed patients, amblyopes, and those with developing eye disease or weakened eyes from previous surgery or trauma.
    • The optometrist's role includes assessing risk, advising, and educating patients on potential eye injury risks and prescribing appropriate appliances to minimize risk.
    • It is crucial for optometrists to assess patients' visual demands at work, home, and elsewhere by asking about their activities and locations, as part of every case history.
    • Optometrists have a professional responsibility to assess risk, provide counseling, and advise patients on potential risks, particularly for those at higher risk such as amblyopes or post-LASIK patients.
    • Legal responsibilities in eye injury prevention include establishing a doctor-patient relationship, adhering to reasonable standards of care, ensuring the patient's injury is causally linked to the care provided, and addressing potential damages.
    • When prescribing glasses, understanding how patients intend to use their spectacles is crucial, especially considering factors like monocular vision, previous eye injuries, significant eye diseases, thin corneas, and risk of falls.

    Eye Injury Prevention and Optometrist's Role

    • In 2014, over 193,000 adults and children were treated for home-related eye injuries in the US, with a third of injuries occurring in the kitchen, bedroom, bathroom, living room, or family room.
    • Highest proportion of eye injury visits to ER: Chemicals for ages 0-4 years, and > 65, household items in 5-9 year-olds, sports products in 10-24 year-olds, cutting and construction tools in 25-64 year-olds.
    • Sports-related eye injuries by age in 2019: Basketball, pools & water sports, non-powder guns, darts, arrows, slingshots, and bicycles were among the top activities causing injuries for both children and adults.
    • Common household products causing eye injuries include oven cleaners, glue, disinfectants, hair sprays, and cooking foods that can splatter hot grease or oil.
    • Other sources of injuries at home include lawn mowers, car repair, DIY activities, yard work, champagne corks, trauma from sharp objects, using hot objects around the face, and pesticides.
    • Pesticides can be absorbed quickly into the blood vessels close to the eye's surface, causing severe damage or blindness.
    • Patients at greatest risk of eye injury include children, one-eyed patients, amblyopes, and those with developing eye disease or weakened eyes from previous surgery or trauma.
    • The optometrist's role includes assessing risk, advising, and educating patients on potential eye injury risks and prescribing appropriate appliances to minimize risk.
    • It is crucial for optometrists to assess patients' visual demands at work, home, and elsewhere by asking about their activities and locations, as part of every case history.
    • Optometrists have a professional responsibility to assess risk, provide counseling, and advise patients on potential risks, particularly for those at higher risk such as amblyopes or post-LASIK patients.
    • Legal responsibilities in eye injury prevention include establishing a doctor-patient relationship, adhering to reasonable standards of care, ensuring the patient's injury is causally linked to the care provided, and addressing potential damages.
    • When prescribing glasses, understanding how patients intend to use their spectacles is crucial, especially considering factors like monocular vision, previous eye injuries, significant eye diseases, thin corneas, and risk of falls.

    Medical Malpractice Litigation and Documentation Best Practices

    • Proper documentation is crucial in litigation, as "if it is not written as part of the patient's record, it did not happen."
    • Trials usually occur 3-5 years after a complaint is filed, and with the statute of limitations, it could be 6-8 years after the patient’s injury.
    • Missing important facts in patient files can lead to challenges in accurately recalling conversations with the plaintiff and their responses under oath.
    • Important points to document include diagnosis, treatment options, treatment plan, risks and benefits, prognosis, patient response, follow-up measures, and phone calls with patients and other doctors.
    • 1 in 5 medical malpractice claims had documentation issues, with 70% of those being insufficient or lacking information.
    • If a claim is filed, the insurance company is the main player, and it is usually denied. The timeframe for this process is 6 months to 1 year.
    • In the event of a lawsuit, the timeframe for a patient to sue is approximately 2-3 years from the injury, varying by state.
    • In the case of a settlement, it does not admit malpractice, guilt, or risk of excess financial responsibility. The timeframe for trial is 3-5 years from the filing of the complaint.
    • There are examples of significant settlements in cases involving eye injuries, such as $16 million for a 14-year-old blinded in one eye and $8.5 million for a teacher who lost vision in one eye.
    • Key takeaways include understanding patients' needs, communicating clearly, seeking legal advice when unsure, and emphasizing eye safety, given the 2.5 million preventable eye injuries in the USA annually.
    • The cost of prevailing in court includes extensive time and effort, including reviewing files, preparation for depositions, and time away from work and family.
    • Nice doctors are sued less, and it is advised to be nice and maintain a professional demeanor.

    Impact of Malpractice Cases on Optometric Standards of Care

    • Precedent-setting case involving Karen Keir, age 4, established new standard for routine eye exams
    • Federal panel determined doctor should've performed dilated fundus examination using binocular indirect ophthalmoscopy
    • Appellate level federal court created new standard requiring dilation on nearly every patient
    • 13-year-old girl presented with blurred vision, history of amblyopia in the family
    • Doctor performed dilated fundus exam, found normal discs and macula, advised glasses wouldn't correct the condition
    • Teenager returned after a year with reduced vision, later diagnosed with a large brain tumor
    • Optometrist sued for malpractice, found culpable, and awarded $9.2 million
    • Teenager had normal vision on previous screenings and experts testified tumor could've been treated a year earlier
    • Recommendation to perform automated visual fields when VA isn't correctable to 20/20 and fundus exam is normal
    • Ophthalmologists may not provide standard of care opinion testimony against optometrists
    • Ophthalmologists may testify about causation and failure-to-refer cases in optometric malpractice cases
    • A total of 609 optometrist malpractice payments reported nationally, ranging from $50 to $2,050,000, with a median of $57,500

    Understanding Medical Malpractice and Legal Responsibilities of Optometrists

    • Misdiagnosis and failure to refer are common factors in malpractice cases.
    • Medical errors can be errors of omission (not taking necessary actions) or errors of commission (taking the wrong action).
    • Negligence is when an optometrist fails to exercise the standard of care, and duty refers to the obligation of an optometrist to provide care adhering to the standard of care.
    • Competency of an optometrist consists of knowledge and ability, and breach is the failure to conform to the standard of care.
    • Standard of care is usually defined by state laws or regulations established in case law.
    • Causation under negligence can be direct (optometrist's action directly harms the patient) or indirect (optometrist is liable for the foreseeable consequences of their action or inaction).
    • Damage in medical negligence cases can be economic (medical costs, lost wages) or noneconomic (pain, suffering, loss of consortium) and leads to monetary remedy for injured patients in civil courts.
    • Criminal negligence includes conscious, voluntary, and reckless actions or inactions, such as insurance fraud or HIPAA violations.
    • A sample case of negligence involves an optometrist prescribing glasses without rechecking the prescription, leading to a patient's injury.
    • Assault is the intentional placing of a patient in reasonable apprehension of imminent harmful or offensive touching without consent, and battery is a harmful or offensive touching without permission, which can lead to civil lawsuits.
    • Optometrists have legal responsibilities to adhere to the standard of care, recheck prescriptions, and ensure patient safety to avoid negligence and legal consequences.
    • Understanding the legal responsibilities and potential liabilities is crucial for optometrists to provide quality care and avoid malpractice.

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    Description

    Test your knowledge on eye injury prevention and the important role of optometrists in assessing and advising patients on potential risks. Learn about common causes of eye injuries at home, in sports, and in various activities, and understand the optometrist's legal and professional responsibilities in preventing eye injuries.

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