1. Rule Of Law
1.1. Breach of Duty
1.1.1. By way of a panel of experts, proving the standard of care administered by the co -defendants to the plaintiff was insufficient.
1.2. Injury
1.2.1. The " but if " question
1.2.1.1. But if not for the actions taken by the co-defendants, would the injury still have occurred?
1.2.1.2. Was the results of the negligent conduct foreseeable?
1.3. Standard of Care
1.3.1. Given the same situation, any other prudent and certified care provider, would have provide the same exact care as the co-defendants did.
1.3.1.1. The care provided to the plaintiff, by the co-defendants was in accordance with the standards set forth by the universal ophthalmologist community.
1.4. Causation
1.4.1. loss of vision was the result of the diagnosed and untreated glaucoma.
1.5. Duty of care
1.5.1. The dr patient relationship was firmly established,
1.5.1.1. There was a clear consideration and agreement between the plaintiff and co-defendants that the plaintiff would receive care for here eyes, from the co defendants.
1.5.1.1.1. The plaintiff and co defendant were engaged in their Dr patient relationship for over 8 years ( 1959 - 1968)
2. Analysis / Aapplication
2.1. According to the Plaintiff
2.1.1. Given the initial appointment resulted in the persction of contact lenses.
2.1.1.1. The continuous issues were not addressed any further than addressing them as resulting from contact lense issues.
2.1.1.1.1. The co-defendeants did not offer secondary or alter her care plan by adding tests for glacoma or other eye problems / conditons.
2.2. According to the defendant
2.2.1. The standard of care requered for tratement for a patient under the age of 40 was successfully followed.
2.2.1.1. The likelyhood of a patient under the age of 40 possing glocoma was so rare, that it was not reured when lcareing for the plaintif.
2.3. According to the court
2.3.1. The standard of care was adhered to,
2.3.1.1. However, with the consistent symptoms expressed by the plaintiff, it would have been wise of the co-defendants to have provided the inexpensive, quick and painless test to the plaintiff. ( In my opinion, they provided pour customhouse over all).
2.3.1.1.1. "There are precautions so imperative, even their universal distreard will not excute their omission." (T.J Hooper, 60 F.2d 737)
2.3.1.2. Even though the providers did not go up and beyond their standards of care, their lack of resolute to improve or resolve the plaintiffs pain any further than to state the issues are caused by their initial care plan of contact lenses. There was no medical requirement for them to provide additional testing at that time.
3. Conclusion
3.1. The verdict was overturned
3.1.1. The ruling was in favor of Helling.
3.2. The judgment for the co-defendants was reversed by the supreme court.
3.2.1. According to the standard of care, in which a reasonable prudent provider would have done given this same situation.
3.2.1.1. The argument included the option the co defendants could have provided a referral early on in their treatment plan.
3.2.2. The co defendants were found to have not provided the plaintiff the standard level of care.
3.2.2.1. Over the course of their 9 year Doctor patient relationship, the the glaucoma test even though the standards of practice did not demand it. Should have been attempted sooner than it wasa
4. Importance
4.1. Legacy standard of care
4.1.1. Providers can no longer rely solely on what the former or minimal level of acceptable action are as they pertain to patient care..
4.2. Diagnosis processes and practices must work equally hard to prove what the condition isn't, as they do to prove what it is.
4.2.1. Process of limitation requires potentially additional tests, which may in the end be quite necessary.
4.3. Physicians in all areas of care, are required to remain informed and current on their specialties expectations and standards of care.
5. Change to business processes
5.1. Elevated degree of accountability in review of standard precipitates with in the ophthalmology area of care.
6. Facts
6.1. Parties
6.1.1. Plaintiff
6.1.1.1. Barbara Heling
6.1.1.1.1. 32 year old female
6.1.1.2. There is a level of negligence I place on the plaintiff. Employees receive a 90 probationary period. Likewise the provider is the patients employee, if in 90 days there are no results, it is acceptable (nay I say) necessary to seek a second opinion.
6.1.2. Co-Defendant's
6.1.2.1. Dr Thomas Carey (Ophthalmologists)
6.1.2.1.1. Dr Robert Laughlin (Ophthalmologists)
6.2. What happened
6.2.1. 1959, 23 year old plaintiff attended eye appointment at co-defendant's ophthalmology practice.
6.2.1.1. Plaintiff presented Defendant's with myopia/ nearsightedness.
6.2.1.1.1. Defendant treatment plan for the plaintiff, was contact lens prescription.
6.2.1.2. At the onset of the appointment in 1959, the Dr Patient relationship was established.
6.2.1.2.1. The co-defendants along with the consent of the plaintiff, agreed to provide her with their ability to care for her optical related issues.
6.2.2. Between 1959 and 1968 the plaintiff had 9 additional visits to the Co defendant's practice.
6.2.2.1. The plaintiff's issues persisted though the 9 years under the care of the co-defendants.
6.2.2.1.1. The plaintiff symptoms were attributed to issues associated with contact lenses.
6.2.2.1.2. At the time, the standard of care for a woman under the age of 40, did not consist of testing for glaucoma.
6.2.2.1.3. October of 1968, the plaintiff was diagnosed as having glaucoma.
6.3. Procedural History
6.3.1. Expert testimony
6.3.1.1. Individual exporters in the field of ophthalmology, confirmed that the probability of glaucoma in patients under the age of 40 is rare.
6.3.1.1.1. The probability of the plaintiff possessing glaucoma is so insignificant that the testing needed to verify she is negative at her age is not considered standard of care practice.
6.3.1.2. Testified affirming that the standard of care for a patient the same as as the plaintiff would not require a glaucoma test.
6.3.1.2.1. However, expert testimony did note that the test should in fact have been administered eventually,given there is sufficient evidence presented indicating the test would be benefit both patient and provider.
6.3.1.3. Jury
6.3.1.3.1. Found the co defendants ations did infact adhear to the standards of care.
7. Issue before the court
7.1. Standard of care
7.1.1. Did the co-defendants provide the plaintiff with the appropriate level of care, which would satisfy the standard of care for their specialty, in caring for the plaintiff
7.1.1.1. Given the plaintiff was below the suggested age for glaucoma testing,
7.1.1.1.1. They did not test her for glaucoma.
7.2. Negligence
7.2.1. Were the co-defendants negligent in their choice to not test the plaintiff for glaucoma?
7.2.1.1. The plaintiff was 32 years of age.
7.2.1.1.1. The recommended age for glaucoma testing was 40.
7.3. Duty of care
7.3.1. Did the co-defendants satisfy their duty of care, by following the accepted age requirement associated with glaucoma testing?
7.3.1.1. At that time, there was no requirement stating the Co defendants needed to test the patient for glaucoma.
8. Impact
8.1. Hilbun Vs Hall (Miss 1985)
8.1.1. Patient died from cardio-respiratory failure after a GI procedure.
8.1.1.1. Family sued surgeon defendant.
8.1.1.1.1. Inadequate post surgery care.
8.2. Groth Vs Harris ( Wash, 1983)
8.2.1. Plaintiff complaining of eye issues
8.2.1.1. Obtained treatment from defendant
8.2.1.1.1. Various attempts to heal the issues, failed.
9. Influence
9.1. The testing of glaucoma, is now required in every eye visit, regardless of age, gender or reason for appointment.
9.1.1. The focus on continuing education and certification standards is elevated. Providers must maintain current industry standard levels, practices and improvements.