Retinopathy of prematurity represents one of the most commonly claimed for cases in the world of medical negligence. Being an affliction, which tends to have a profoundly negative impact on the lives of those it affects, there have been countless cases for medical malpractice or negligence surrounding the affliction in the past. More often than not, the onset of ROP is completely avoidable when the correct preventative measures are taken following premature births; which puts the onus on medical professionals to ensure that the proper care is taken to avoid it; and where those steps have been overlooked, there is often a clear case of negligence that allows the victims to make a claim.
But what exactly is ROP, how does it occur, how responsible are medical practitioners when it does, and what can you do if your family has fallen victim to it?
The first thing you will want to do it get assistance from a practitioner and expert in retinopathy of prematurity law, to assess whether or not you have a viable case to make.
What is Retinopathy of Prematurity?
Let’s start by defining the exact nature of ROP. It occurs in premature children, particularly when adequate care is not taken during incubation to ensure that optimal oxygen levels are present in the baby’s blood during this crucial stage.
In many instances, retinopathy of prematurity can lead to permanent blindness if it is not properly treated, which can have a number of obviously negative impacts on the child’s life and future. Beyond that, ROP puts an immense amount of emotional and financial strain on the parents of afflicted children; substantially lowering their quality of life.
How does it occur?
ROP occurs in prematurity and causes abnormal dilations in the blood vessels in the eye. As these blood vessels expand, they may start to bleed which causes scarring on the retina, which is the part of the eye that gives it its primary function; vision.
This scarring becomes the base of the problem for the sufferer. As they shrink, they begin to put pressure on the retina, which, in severe cases, may lead the retina to detach from the eye socket; resulting in blindness.
During a normal, full-term pregnancy, blood vessels grow from the centre of the baby’s retina, which generally takes place about 16 weeks into pregnancy. By about 8 months into pregnancy, these blood vessels should start branching out towards the edges of the retina, resulting in healthy eyes.
When babies are born prematurely, however, the growth of blood vessels across the retina is interrupted, resulting in the formation of abnormal blood vessels. These are the ones that risk expanding, scarring the retina and raising the risk of detachment, and therefore blindness.
Can it be avoided?
While ROP results from premature births, modern medicine is amply equipped to treat the disorder when it happens. It is also important to remember that cases differ in severity, with some being self-correcting.
In the case of whether or not it can be avoided, since this affliction only occurs under specific circumstances in premature births, it is essential that healthcare professionals consistently monitor children in incubation, particularly with regards to the oxygen content in their chamber and in their veins.
Irregular supplies of oxygen heighten the risk that blood vessels on the retina expand irregularly. Which means that with the right amount of vigilance, ROP can indeed be avoided, or at the very least, controlled following a premature birth.
Can it be treated?
In many cases, ROP is treatable, and the type of treatment appropriate for the disorder depends on its severity.
For most types, retinopathy of prematurity can be treated using either laser eye surgery or through administering injections. Laser surgery is the most common form of treatment.
Treatment through injections represents a fairly new approach to treatment that helps blood vessels to grow normally to reduce the risk of retinal detachment from scarring; there is, however, ongoing research into its long-term side-effects when administered on premature infants.
More complicated procedures, however, require more specialised treatments to be effective. This is particularly the case where retinal detachment has already occurred.
The first is scleral buckling, whereby a flexible silicon band is placed around the white of the eye, pushing it back into place so that it is closer to the outer wall of the eye.
The most complex approach to treatment is a vitrectomy, which involves replacing the clear gel at the centre of the eye, which is called the vitreous.
During this procedure, vitreous is replaced with a saline solution to remove scar tissue on the retina, which, over time, stops the retina from being pulled away from the back of the eye.
Expectations on Healthcare Professionals
This leaves a few steps where negligence can cause the affliction to worsen, particularly where incubation and following treatment are concerned.
The issue obviously beings at the paediatrician where both monitoring and diagnosis is concerned, as well as how effectively they have referred the baby to a capable ophthalmologist (eye doctor).
Expectations placed on hospitals
There are a number of expectations placed on hospitals or paediatricians following a premature birth, and they are directly related to avoiding afflictions such as ROP.
Following incubation, the medical practitioner needs to maintain consistent monitoring of the baby’s condition, as well as maintaining the correct levels of oxygen in the baby’s blood. Where negligence or any other complication causes the affliction to arise, there is a heightened risk of it occurring; which in most cases should be completely avoidable.
Where it is not avoidable, the paediatrician needs to refer the baby to a competent ophthalmologist so that it can receive a proper diagnosis and treatment.
Expectations placed on ophthalmologists
On the part of the ophthalmologist, there are a number of expectations that need to be met; if they are not, the affliction may worsen, and the practitioner may be guilty of negligence as a result.
These expectations include a responsibility to inform parents of a need for regular eye examinations, and they of course, they have to perform these examinations to the best of their ability.
ROP is most effectively treated when it is diagnosed in its earliest stages, which puts the onus on the practitioner to diagnose it as early on as possible.
Once a diagnosis has been finalised, the ophthalmologist needs to treat the condition as quickly and as effectively as possible, to ensure that any chance of irreversible damage is avoided.
Where facilities, paediatricians or ophthalmologists fail to fulfil these expectations, there is generally a clear case of medical negligence involved, which may make claiming a viable option for parents.
Making a Case for Medical Negligence
In such cases where ROP has caused blindness, the resultant affects on the lifestyle of both the baby and its parents can be severely hampered. They will incur costs, will find future employment difficult to obtain, and will generally suffer an overall loss of quality of life.
Fortunately, claims can be made against the offending practitioners to ensure that victims of negligence can be properly looked after for years to come.
The expenses you can claim for
While you might be tempted to not opt to make a claim against the practitioner in such an event, you should remember that the financial and emotional consequences of facing such negligence can be completely life altering.
A need for specialised equipment
Permanent blindness as a result of ROP may lead to a future reliance on specific equipment that assists the victim with leading a life of some degree of quality. This type of equipment may include speech compressors, talking terminal computers and reading machines to name a few.
These devices do not come cheap and need to be replaced or serviced from time to time. This means that they can end up taking up a large portion of a family’s overall budget; putting significant financial strain on them for indeterminant amount of time.
A need for therapy
The psychological trauma caused by blindness resulting from ROP can be significant and long-lasting, and is most effectively navigated with repeat therapy. This kind of therapy is not cheap, and in some cases, may even be unaffordable for some families.
Treatments related to ROP likely represent one of the largest expenses associated with it. We mentioned a number of treatments above which are generally placed in the hands of the ophthalmologist; namely laser surgery, injections, scleral buckle therapy and vitrectomy surgery.
These treatments may include additional expenses, such as staying over in the hospital; which, without the correct medical coverage, are all but affordable.
A loss of future potential earnings
Thinking a little further on down the line, families that have been victims of ROP complications in premature babies also need to consider the viability of their child’s professional future.
As humans, we are remarkably reliant on our sense of sight in most of the things that we do; and without really doing it on purpose, most professional fields are structured around us having this important sense.
Blindness thusly makes it difficult for people to find gainful employment in just about any professional sphere, which can have a vastly negative impact on the prospects for the future of a baby blind from ROP.
This particular long-term consequence needs to be considered when deciding to make a claim for medical negligence.
Proving Negligence Cases
Where medical negligence resulting in blindness from ROP is evident, claims against the practitioner can only be made if it can be proven that reasonable care was not taken by the practitioner to avoid complications.
To do so, it needs to be shown that another, competent doctor who is placed in the same situation, with the same set of facts and complications, would be unlikely to make the same mistakes or misdiagnosis. What this is aiming to prove, is that under any reasonable situation, that the same mistakes would never have been made by a competent doctor.
If it can be shown that these mistakes should never have happened under such a circumstance, the victim has a case for medical negligence.
Here is what you would need to do in order to prove this:
Obtaining hospital records
One of the most important documents required to make a case, is a complete set of medical records obtained from the hospital or practitioner suspected of negligence. Obtaining such documentation should be easy enough through contacting the facility, however they don’t always hang on to those records for extended periods of time, so it is in your best interest to obtain them as early on as possible.
Assess the prospect of a successful claim
These records should then be assessed by a team of experts in retinopathy of prematurity law, who will determine whether or not you have a valid case to make.
These experts need to have a sound understanding of medical law, and may even require the attention of medical experts with the skills and qualifications to assess the situation according to how they would have preferred to handle it.
Have You Been the Victim of Medical Negligence? Contact Paul du Plessis Attorneys
Often, medical negligence claims cannot be represented in a clear-cut case, and in every situation where medical negligence arises, investigations and assessments should be conducted by legal professionals, if the case has any chance of success.
If you or a family member has been the victim of medical negligence arising from retinopathy of prematurity, we invite you to get into contact with a representative from Paul du Plessis Attorneys today. We operate on a no-win no-fee basis to ensure that if your case doesn’t qualify for compensation, that you do not lose out.
Visit our website for further information on our legal specialisations in medical negligence, birth injuries, personal injuries and the road accident fund.