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Home E-Weekly December 12, 2017

Lawsuit: Gentamicin Injection Blinds Man After Cataract Surgery

Published: December 11, 2017

ROUTE OF ADMINISTRATION A patient was blinded during cataract surgery when an ophthalmologist injected gentamicin meant to be administered intravenously or intramuscularly into his right eye.

A cataract surgeon's highly unusual practice of prophylaxis of endophthalmitis — injecting gentamicin into the patient's eye post-cataract surgery — blinded an 80-year-old man in his right eye, court records show.

A Florida civil court awarded $13 million in damages to Miguel Diaz, 80, who filed a medical malpractice lawsuit against ophthalmologist Jonathan Leon-Rosen, MD, claiming the surgeon injected a highly toxic, concentrated form of gentamicin into his eye after his surgery at the Coral Gables (Fla.) Surgery Center. More lawsuits are coming, says attorney Gary Alan Friedman, who represents Mr. Diaz and 13 other patients who claim gentamicin injections caused swelling, inflammation and edema of the cornea. In all, 19 of Dr. Leon-Rosen's patients have filed suits claiming they suffer from toxic anterior segment syndrome (TASS), visual loss and blindness.

Mr. Freidman details the lawsuit in this short video produced by the Miami Herald.

While more and more surgeons are using antibiotic injection over topical drops to prevent endophthalmitis, few administer subconjunctival injections of gentamicin, says ophthalmologist T. Hunter Newsom, MD, of Newsom Eye & Laser Center in Tampa, Fla., in large part because gentamicin's spectrum of coverage is not good against gram-positive bacteria, which is often found in endophthalmitis.

"And problems can arise if you inject the wrong dose or concentration of gentamicin," says Dr. Newsom.

According to the complaint, the gentamicin Dr. Leon-Rosen injected into Mr. Diaz's eye was "defective, unsafe and unfit for human consumption."

Mr. Diaz filed his suit against Leon Medical Centers in Miami, Fla., and Dr. Leon-Rosen (no relation), the ophthalmology practice group, South Florida Eye Associates, and the Coral Gables ASC. In an interesting twist to this case, Leon Medical Centers tried to avoid liability by claiming Dr. Leon-Rosen acted as an independent contractor. The jury, however, found him to be an apparent agent of the healthcare group and thus held it liable as well.

Leon Medical Centers plans to appeal the verdict. In a written statement released to the Miami Herald, the company says: "While we are pleased that the jury correctly concluded that there was no negligence on the part of Leon Medical Centers, we are disappointed that the effect of their decision is to hold Leon Medical Centers liable for the actions of an independently contracted ophthalmologist group. Furthermore, Leon Medical Centers is committed to facilitating its patients' access to its independent healthcare specialists and in doing so, it is in no way misleading its patients."

Dr. Leon-Rosen's attorney declined to comment. Mr. Diaz's attorney was unavailable for comment.

Joe Madsen

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