Posted by Gary Burger on September 18, 2019
Here’s a scary story with Halloween coming up. Our client Roy goes to Wal-Mart on May 20, 2016, for new eyeglasses, He sees Dr. Kenton McWilliams and complains his left eye is painful and tearing,
McWilliams treats Plaintiff with steroid eye drops without doing a diagnostic culture. Roy’s condition gets worse – blurry vision, watering, severe pain and pressure, and light sensitivity.
A few weeks later, Roy sought treatment from another doctor who performed appropriate diagnostic testing and determined that Plaintiff had a staphylococcus infection for which antibiotics were necessary and steroid drops were harmful.
His eye had become really red:
After his treatment, Roy was left with greatly diminished vision in his left eye and sensitivity to light.
We filed suit and did depositions in the case.
We tried to show that Dr. McWilliams breached the standard of care by failing to properly diagnose Mr. Payne, by prescribing Neo Poly Dex, and failing to rule out contraindicated diagnoses (including, but not limited to, fungal infections). If you put steroids in a fungal infection its like putting gas on a fire.
What started out as a likely corneal abrasion and eye infection spiraled into a large corneal ulcer with permanent scarring and vision loss.
My Deposition of McWilliams went well – he did not even have a diagnosis when he prescribed the medication. Here are some excerpts:
Q: And then what did you diagnose him with?
A: Well, I wasn’t sure what it was. So it looked like a recurrent corneal erosion. And I have a question mark.
Q: So then what did you decide to do?
A: I don’t – I think I explained to him there’s something going on, but I’m not sure what it is. I don’t know if I explained the term recurrent corneal erosions because typically I don’t explain that under those terms.
It does not take an expert to understand that in order to properly treat a condition, you have to know what the condition is. McWilliams didn’t.
And the standard of care when prescribing Neo Poly Dex drops requires that an optometrist rule out contraindicated diagnoses, otherwise further damage to the eye, such as corneal ulcers and scarring, can occur.
Q: So it is the standard of care to rule those corneal, fungal and viral out before you prescribe it; is that correct?
A: Generally speaking, yes.
Q: And you did not rule those out prior to making the prescription that you did, fair?
A: I would say that’s fair in any case, but yes.
Q: Isn’t a – aren’t you supposed to check for a fungus infection before you prescribe that medication?
A: Or at least rule it out.
Q: Did you rule it out?
A: I couldn’t really rule out anything at that point.
Dr. McWilliams had to admit that:
A. Typically if you suspect fungal you wouldn’t prescribe it. If you suspect corneal viral, especially herpes, you wouldn’t want to prescribe it.
Roy kindly did a video with me:
Dr. McWilliams also breached the standard of care by failing to schedule a follow up appointment with Mr. Payne to monitor his condition.
Q: Is it important to, if you’re giving someone an antibiotic with a steroid, to do close monitoring of his condition thereafter?
A: I would agree.
Later I asked:
Q: So you did not tell him to come back in seven days. You told him to take the medication for seven days, correct?
McWilliams had to admit:
Q: What would you have done differently, knowing the history?
A: Knowing all the history and his visits to the second, third, and fourth doctors I probably would have referred his case right away.
Q: Meaning when he first came to you?
A: Had I known how bad it potentially could have been I would have referred him to a corneal specialist.
Q: So are you saying you would have referred him to a specialist, May 20, the day you saw him, had you known everything in hindsight, or are you saying that had he called you back you would have referred him?
Q: Did you have complaints about patients – from patients about the care they received?
A: I would say occasionally.
We settled the case for $200,000. There were notes in the medical records that Roy’s vision was not significantly diminished and he did take some time before he went and got additional medical care.