Thread: Cataract operation gone wrong

My wife is currently still in Hospital after a Cataract operation went very wrong
Here is a brief history for your comments and help.

Right eye operation about 2 months was no problem almost instant clear vision. No pain and no problems whatsoever.
Went for the op on the second eye to be done about 3 weeks ago.
Problems with pain and blurred vision from the start.
went to A & E after 24 hours and was told not to worry "its normal" after a Cataract operation.
went back again after a few days and told don’t worry its normal but changed the drops she was on.
Went back again after a few days with just about the same reaction from NHS
Went back again Sunday 9th and by coincidence the senior registrar from the eye department was on duty and called out the emergency surgery team and took her straight in and did a operation.
Results
Don’t know (and still don’t) what caused the problem.
Lost the sight in her left eye
May loose the left eye completely.

We think there is a case for negligence during the first few visits.



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@ Jenschnifer you are experenced in this sort of thing???

It seems to me that there are two issues here:

The commonest procedure to remove cataracts is phacoemulsification. It has a very high success rate. However, all surgical procedures have some risks, and these must be explained before the patient's consent is obtained. It may be that the patient in this case is one of the few unfortunates to have suffered side effects or complications.

Secondly, the management of the post-operative condition raises some questions. Patients in A&E are usually seen by junior doctors in the first instance - if this was the case, did they ask more senior colleagues to review the patient before giving advice and discharging the patient? Did none of the doctors in A&E consult the on-call opthalmologist for advice during the first three attendances?

I worked in opthalmic theatres and have seen and assisted at very many phaco procedures. Standard advice to patients was that if they had any difficulties at all they should return to the eye ward at once, rather than go to A&E or their GP; it was on the same sheet as advice on driving and so on. Was the patient in this case not given any advice on what to do post-discharge?

Yes it was explained that there was minimum risk but not that she may loose complete sight or the eye completly.

The operation was carried out in the local Nuffield Trust but funded by NHS

Ecery time she went back to the A & E it was what the Nuffield advised (all 4 times)

"did they ask more senior colleagues to review the patient before giving advice and discharging the patient" no

She saw the on-call opthalmologist on all visits.

"Standard advice to patients was that if they had any difficulties at all they should return to the eye ward at once, rather than go to A&E or their GP" She was told by the Nuffield to go to A & E.

As of 15/12/07 she is in great pain and zonked out on Morphine.

we saw the micro biologist today for about 1 hour,
They dont know what is causing the problem

He recomended yesterday a anti biotic drip but the opthalmologist team rejected that. Next he recomended restriced ant biotics but by mouth. the opthalmologist team rejected that and have now gone for the IV option sugested yesterday.

It all sounds most unfortunate. The risks and side effects of surgery are supposed to be gone through in some detail during the consent process, and are printed on the consent form; the patient's signature indicates that this has been done and the risk accepted.

Where the surgery was carried out at other than a NHS hospital it makes sense for them to refer a patient to A&E since Nuffield hospitals don't have the resources to deal with such cases.

Since the patient was seen by an opthalmologist on each visit, it's hard to see what could have been done differently; medicine is not always straightforward and it's not always possible to diagnose immediately. It sounds as if it may be some sort of infection.

I'd suggest it's too soon to determine whether there was any negligence; until a firm diagnosis of the problem is made, at least.

It may be helpful to make an appointment to meet with the consultant in charge, through the PALS team at the NHS Trust, to discuss your concerns.

In the meantime, I wish your wife a speedy recovery.

"The lady dr who took my wife in on sunday (and was a senior registar in the opthalmologist dept) and performed the emergency surgery was sat on my wifes bed for an hour today in tears feeling it was her fault and said if she had been presented with my wife 1 week earlier she would have had her in then!!!"

My point is that she had seen a opthalmologist 3 times and been told no its OK.

IMHO the opthalmologist who saw her previous to sunday was not up to the job ???

I know they are all saying that they dont know what caused it but the opthalmologist should of seen something he did not understand and should of acted.

Here is what has been going on.
My Wife had cataract surgery late Nov 2007 on the left eye.
The right eye was done approx 6 weeks earlier and has been no problem.
4 times during the 2 weeks after the left eye was done, she went back to the A and E at Royal Devon and Exeter NHS as she was advised to do by the Private hospital (Nuffield) where the surgery was carried out but NHS funded.
She went there 4 times in this period complain of a lot of pain in the left eye and unable to see correctly.
She was told by the Dr in the eye room of the A and E that every thing was normal and it would settle down.
On the 4th visit to the A and E a different Dr was on duty and said that there was definitely some thing wrong and called in the emergency surgery team at 6 o’clock on a Sunday evening to investigate what was going on in the eye. She was immediately admitted to Otter ward in the RD and E.
Samples were taken during the surgery but the RD and E could not get anything to "grow" so there were sent off to London and Germany for further test.
my wife was now on a regime of eye drops and pain killer drugs and that was the way it stayed till about Friday.
We asked during the week if they had tested for fungal infection as suggested by my step daughter who sees a lot of eye problems at her work with animals.
we where assured that a fungus would of shown on the test that were done.
On the Friday my wife saw the PALS team at the hospital as we where not happy with things. I.E.
Drops that where supposed to be done hourly where often 3 hours late. Drugs where sometimes 2 hours late. Infection control was not enforced, A Dr took a blood sample without even wearing gloves.
within 1/2 hour of the visit to the PALS team there had been a Micro Biologist a Dr and Head of PALS team (who know one had even seen on a ward before). More samples where taken and low and behold a Fungal infection was found!!!!
We had a visit on the ward from the Micro Biologist on the Saturday who told us that he recommended to the medical team on the Friday AM that a drip should be started but the Medical team had rejected his idea. He then recommend a course of tablets but the medical team rejected that as well and on the Sunday started the drip he had recommended 36 hours earlier and almost immediately there was an improvement in my wife's condition.
She was then on the drip that had to be especially made up by the hospital every day for another week which took us up until Christmas eve, the Dr had said the course of drips would finish then (7 day course) and she would be able to go home then on some very special anti fungal tablets,(£300 each) 4 different drops, anti infatory tablet and pain killers as required.
The "carrier bag of Drugs" was given to us with the assurance that everything that was needed was in there.
When we got home on the PM of Christmas eve we found that the anti fungal drugs where missing and had to go back to the hospital and almost beg them to get them. They gave us 2 Tablets. she was supposed to have 2 a day.
The pain was so intense on Christmas day that my wife was re-admitted to the same ward for 24 hours where she was on double strength morphine, "again". She saw a eye Dr on Boxing day who gave her some drugs and said sorry that they had missed her drugs to take home on Christmas eve but they had called a Pharmist in on Christmas day to do it all up again and they now had every thing sorted and would be giving us some more drugs to take home, but put some drops in my wife's eye first that would take 25 min to react and he would see here again and then send her home. We took a seat in the day room and after about 5 minutes a staff nurse with a very bad attitude problem bought in the bag of drugs that we had seen in the Dr room and said "there are your drugs, you can go home now" I remaindered her that the Dr had put drops in and wanted to see my wife and asked her to page him, she said she was not aware of that and went off in a huff. I went looking for her after about 15 min's when no Dr had turned up and she said "Oh I was just about to page him" I stayed with her while she phoned him. He came straight away. examined my wife's eye again and off home we went.
Every thing was fine for about 2 weeks, little or no pain and the green pus in the eye was disappearing and my wife was thinking of driving again and going back to work.
Last week there has been a serious relapse. There has been appointments at the hospital where the changes have been commented on as bad and unusual. On a visit last week it was discovered that the retina had become detached from the back of the eye. (This was bad according to the Dr) My wife has been and still is as I write in extreme pain. and yesterday the Dr changed her pain killers tablets to Pharracetamol that you can buy over the counter, stopped the anti fungal E
My wife is now just about permanently "zonked out" on 2 pharacentamol and 2 tramadol every 6 hours.
One Dr that my wife saw on Monday last (we went there twice in one day because of the pain) put a contact lens in her eye to protect it as all the different drops she had been told to put in had caused the front of the eye to started to break down.
Summary:-
On the concession form there is a warning that the cataract surgery may not work.
Nothing about you may go blind in the eye or lose it altogether
They are now saying that they may have to remove the eye completely. All this from what the NHS see as a simple procedure which has a 1 in 3000 failure rate.
The Dr who carried out the surgery says that technically the surgery was %100 successful.
The fungal infection is called Aspergillie (may be mis spelt) and there is evidence that his has been found in the RD & E before.
We found out that this fungus was found on the first sample that was taken (on the Sunday evening emergency) but was discarded as a cause as it was thought to be a slide contaminate.
My wife has been off work sine early December.
We feel that we are not being given the full story and that the RD & E are trying to cover something up. The Dr concentred is playing his cards very close to his chest and you almost have to beat any information out of him, He is also very blasé and off hand about my wife's eye. He is, I think, the senior in the eye unit but other eye Dr we have seen at different times seem much more concerned and helpful.

The eye has now been removed

do you have it in writing that a fungus grew on the first plate and was discarded? If not get it and take it to a solicitor. This is medical negligence at its worst! laboratory staff should NEVER throw away plates, I worked in an infectious diseases unit for many years and I have never heard anything like it.

I wish your wife the very best in her recovery.