Glaucoma caused by steroid use

[littlebiddle]

What is the name of your state (only U.S. law)? Indiana

My daughter was born prematurely in 1997. From 1998 to 2008 she was under the care of a pediatric pulmonologist.

During the time she was under his care, she was prescribed inhaled and oral steroids for lung issues. I always wanted to know the side effects of medications or things to watch for. I remember clearly he mentioned she might be shorter than she might have otherwise been. (Could be - she is 17 and is 4'10" but that could also be genetics.)

Within the past two years, she developed glaucoma. Due to her premature birth, her eyesight was already compromised. Within the past two hears she has had surgery in both eyes for the sudden onset of open angle glaucoma.

Obviously, this has compromised her quality of life. She has transitioned from Carmel HS to The Indiana School for the Blind and Visually Impaired. The rest of her life will be affected by this disease.

Given that we did not discuss this side effect of steroid use, do you think the doctor has any liability? The outlook for her future is significantly different than before she developed glaucoma.

 

[quincy]

What is the name of your state (only U.S. law)? Indiana

My daughter was born prematurely in 1997. From 1998 to 2008 she was under the care of a pediatric pulmonologist.

During the time she was under his care, she was prescribed inhaled and oral steroids for lung issues. I always wanted to know the side effects of medications or things to watch for. I remember clearly he mentioned she might be shorter than she might have otherwise been. (Could be - she is 17 and is 4'10" but that could also be genetics.)

Within the past two years, she developed glaucoma. Due to her premature birth, her eyesight was already compromised. Within the past two hears she has had surgery in both eyes for the sudden onset of open angle glaucoma.

Obviously, this has compromised her quality of life. She has transitioned from Carmel HS to The Indiana School for the Blind and Visually Impaired. The rest of her life will be affected by this disease.

Given that we did not discuss this side effect of steroid use, do you think the doctor has any liability? The outlook for her future is significantly different than before she developed glaucoma.

How premature was your daughter? What was her birth weight?

Was she diagnosed with retrolental fibroplasia?

Was she diagnosed with bronchopulmonary dysplasia? Respiratory distress syndrome?

 

[littlebiddle]

How premature was your daughter? What was her birth weight?

28 weeks / 560 grams

Was she diagnosed with retrolental fibroplasia?

no - retinopathy of prematurity

Was she diagnosed with bronchopulmonary dysplasia? Respiratory distress syndrome?

BCP - yes RDS (same as BPD) yes

 

[quincy]

BCP - yes RDS (same as BPD) yes

Retinopathy of prematurity is the same as retrolental fibroplasia. It is one of the more common of the eye problems experienced by premature infants, especially among those who are born weighing less than 3 pounds. Retrolental fibroplasia can lead to angle-closure glaucoma.

Corticosteroids are used by some doctors to treat respiratory problems in premature infants (RDS and BPD are different). The use of steroids reduces the amount of time that an infant requires oxygen treatment (with oxygen treatment leading to its own problems). Some of the known side effects of steroid use are the stunting of growth, high blood pressure, and glucose problems.

Neonatalogists and pediatricians (and all doctors) must weigh the pros and cons of all treatments available. The doctors must decide if the benefits of one treatment outweigh the risks - and there will always be risks. When balancing the use of steroids in premature infants, the lungs will be on one side of the scale.

Although I do not see a connection between your daughter's glaucoma and the steroid use, instead seeing the glaucoma as a result of her early birth and the ROP, I am not a doctor. I am, however, the parent of a child who was born 13 weeks early, so I understand your concerns and your need for answers.

I think you need to go over with either your current pediatrician or with another neonatologist/pediatrician in your area your daughter's complete medical history, to get answers. A doctor can give you a better understanding of what can and cannot be the cause of the glaucoma, after a review of your daughter's treatments over the years.

I would have this discussion with a medical professional (or two) before making an appointment with an attorney. Based on what you have provided in the way of information, I do not see that you have a medical malpractice claim to pursue.

I wish your daughter the best.

 

[ecmst12]

Even IF the steroid use did contribute to the glaucoma (which may not be the case), don't you think it was more important for her to be able to breathe?

 

[littlebiddle]

Even IF the steroid use did contribute to the glaucoma (which may not be the case), don't you think it was more important for her to be able to breathe?

I will be straight up with you. That is a rude and demeaning question. It's no different than saying, "Do you wish she would have died?"

I should be able to ask questions about her blindness and feel sad about her blindness and wonder about the legalities of her going blind without having someone trying to shut me down by asking a question that is, in every conceivable way, a rhetorical question.

This is a legal forum. I asked a legal question. I was treated with dignity by the answer I received.

Here's hoping you never have a child or a family member with a chronic illness. Believe it or not, I've already answered the question you pose a million times. But thanks for the sincere interest you show.

 

[littlebiddle]

I will be straight up with you. That is a rude and demeaning question. It's no different than saying, "Do you wish she would have died?"

I should be able to ask questions about her blindness and feel sad about her blindness and wonder about the legalities of her going blind without having someone trying to shut me down by asking a question that is, in every conceivable way, a rhetorical question.

This is a legal forum. I asked a legal question. I was treated with dignity by the answer I received.

Here's hoping you never have a child or a family member with a chronic illness. Believe it or not, I've already answered the question you pose a million times. But thanks for the sincere interest you show.

And Quincy - if you google open angle glaucoma and steroids, there are peer reviewed medical references that document a correlation. I wrote back to you last night but it didn't get posted for some reason. The first reference I can find is 1997. The pulmonologist that treated her was familiar with the link between cataracts and steroids, but not glaucoma and steroids.

The medical community is tiny when you are in the middle of it. My question arose only because her future needs now are very different than they were when blindness wasn't in the picture. I have to prepare for when I'm not here and those preparations change when you add a major disability. The SOL issue in Indiana is a handicap in many ways because things don't happen right away. Thanks for your suggestions. It's hard to get local doctors to candidly discuss what another doctor did or didn't do. Getting to know the best caregivers in the medical community is somewhat of a Faustian gift.

Indiana's laws trouble me because even if there was a clear and convincing link, it would be difficult to receive damages because of the time constraints. Many things that happen do not show up within two years in a neat and tidy fashion. The medical events that occur that significantly change the course of their lives often appear after the SOL. It's unfortunate, because as a parent, I am left to figure out how to make sure she is taken care of financially, even after I am dead. And I never get to take a deep breath again because I'm always slightly holding it.

I appreciate your thoughts. And I hope your child is one of those little fighters who beats the odds.

 

[Proserpina]

And Quincy - if you google open angle glaucoma and steroids, there are peer reviewed medical references that document a correlation. I wrote back to you last night but it didn't get posted for some reason. The first reference I can find is 1997. The pulmonologist that treated her was familiar with the link between cataracts and steroids, but not glaucoma and steroids.

The medical community is tiny when you are in the middle of it. My question arose only because her future needs now are very different than they were when blindness wasn't in the picture. I have to prepare for when I'm not here and those preparations change when you add a major disability. The SOL issue in Indiana is a handicap in many ways because things don't happen right away. Thanks for your suggestions. It's hard to get local doctors to candidly discuss what another doctor did or didn't do. Getting to know the best caregivers in the medical community is somewhat of a Faustian gift.

Indiana's laws trouble me because even if there was a clear and convincing link, it would be difficult to receive damages because of the time constraints. Many things that happen do not show up within two years in a neat and tidy fashion. The medical events that occur that significantly change the course of their lives often appear after the SOL. It's unfortunate, because as a parent, I am left to figure out how to make sure she is taken care of financially, even after I am dead. And I never get to take a deep breath again because I'm always slightly holding it.

I appreciate your thoughts. And I hope your child is one of those little fighters who beats the odds.

Perhaps unusually, Indiana doesn't toll the SOL as it applies to minors.

(Well, it does, but only marginally and it wouldn't help you anyway).

This is a helpful comparison in case it helps someone else:

http://www.ncsl.org/research/financial-services-and-commerce/medical-liability-malpractice-statutes-of-limitation.aspx

 

[ecmst12]

I think you misunderstand my point. My point is that (as quincy mentioned) all drugs have risks, benefits, and side effects. You and your doctor need to weigh the risks and benefits when deciding on a course of treatment. Your doctor determined that the risk of her not being able to breathe was greater than the risk that the treatment offered. Since you accepted the treatment, you agreed with his or her assessment. It's unfortunate that she's now having additional problems with her vision, but even if the steroids contributed to that (which again, they may not have), it's still better that she's still here and alive, right? So why would you be looking to punish the doctor that saved her life? That's what I don't understand. I see that you're trying to think of ways to provide for her future, which I can understand, but you don't seem to get what accusing her doctor of malpractice really means.

Also, correllation does not equal causation. Your daughter's case has multiple confounding factors and the glaucoma may have been in her future regardless of anything else. Like I said, I do understand that you are thinking about her future support, but I don't think a lawsuit payout is going to help you here.

FYI, the SOL for minors in your state BEGINS to run on their 18th birthday, so that is not a factor.

 

[ecmst12]

My source http://www.statuteoflimitations.net/minors.html No idea if it is reliable.

 

[Ladyback1]

And Quincy - if you google open angle glaucoma and steroids, there are peer reviewed medical references that document a correlation. I wrote back to you last night but it didn't get posted for some reason. The first reference I can find is 1997. The pulmonologist that treated her was familiar with the link between cataracts and steroids, but not glaucoma and steroids.

The medical community is tiny when you are in the middle of it. My question arose only because her future needs now are very different than they were when blindness wasn't in the picture. I have to prepare for when I'm not here and those preparations change when you add a major disability. The SOL issue in Indiana is a handicap in many ways because things don't happen right away. Thanks for your suggestions. It's hard to get local doctors to candidly discuss what another doctor did or didn't do. Getting to know the best caregivers in the medical community is somewhat of a Faustian gift.

Indiana's laws trouble me because even if there was a clear and convincing link, it would be difficult to receive damages because of the time constraints. Many things that happen do not show up within two years in a neat and tidy fashion. The medical events that occur that significantly change the course of their lives often appear after the SOL. It's unfortunate, because as a parent, I am left to figure out how to make sure she is taken care of financially, even after I am dead. And I never get to take a deep breath again because I'm always slightly holding it.

I appreciate your thoughts. And I hope your child is one of those little fighters who beats the odds.

As far as her future and financial issues--PLEASE apply for SSDI for your daughter if you haven't already!

 

[littlebiddle]

As far as her future and financial issues--PLEASE apply for SSDI for your daughter if you haven't already!

Duly noted! Right now, at 17, she receives SSI, and will apply at 18 for the next step.

I went to school for years and was a professional. Well respected in my field. Depression - an insidious disease - has ruined my career and many aspects of life that others take for granted. Hell, I took it for granted until I lost it all. I have had poor advice along the way by mental health professionals. Totally different forum. But above it all, I just want to protect my daughter. She also has developmental delays and will not earn a diploma, but rather a certificate. These aren't legal issues, these are just life.

 

[Proserpina]

My source: http://www.in.gov/idoi/2614.htm

Specifically:

Statute of Limitations

No claim may be brought unless filed within two years from the date of the alleged malpractice except that a minor under the age of six has until his eight birthday to file. Some exceptions exist.

Filing of a proposed complaint tolls the applicable statute of limitations to and including a period of 90 days following receipt of the opinion of the medical review panel by the claimant.

But hang tight. Let's see if we can clarify the exceptions.

 

[Proserpina]

Ah, snap. No luck there unfortunately.

Tolling of the Statute of Limitations

In addition to late discovery, it may be possible to avoid the harsh result of a statute of limitation by arguing that the statute has been "tolled". When it is said that a statute is "tolled", it means that something has stopped the statute from running for a period of time. Typical reasons for tolling a statute of limitations include minority (the victim of the injury was a minor at the time the injury occurred), mental incompetence (the victim of the injury was not mentally competent at the time the injury occurred), and the defendant's bankruptcy (the "automatic stay" in bankruptcy ordinarily tolls the statute of limitations until such time as the bankruptcy is resolved or the stay is lifted).

Under Indiana law, with the exception of product liability actions and medical malpractice cases, the statute of limitations begins to run on the minor's 18th birthday. For malpractice cases involving minors below the age of six, a claim may be filed up to the child's eighth birthday.

(emphasis mine)

However - I did also find this:

The Indiana Supreme Court recently resolved a conflict among lower court decisions as to the validity of the two-year statute. It held that the statute is constitutional on its face, but that it cannot be constitutionally applied in cases where the long latency period of a medical condition prevents the injured party from discovering the malpractice within two years. ****** v. Richey, 711 N.E.2d 1273, 1279 (Ind. 1999) (failure to diagnose breast cancer). When this exception applies, plaintiff may file within two years from the discovery of the malpractice and resulting injury, or from learning facts that, with reasonable diligence, should have led to such discovery. Van Dusen v. Stotts, No. 03S00-9711-CV-631, 1999 WL 463489 (Ind. July 8, 1999). See also Ledbetter v. Hunter, 652 N.E.2d 543 (Ind. Ct. App. 1995) (questioning the constitutionality of the statute as it applies to minors). -

Given the apparent wishy-washy interpretation, it's worth running it by a local medmal attorney anyway. It won't cost you anything and at least you'll know; just don't pin your hopes on it.

 

[littlebiddle]

Ah, snap. No luck there unfortunately.



(emphasis mine)

However - I did also find this:



Given the apparent wishy-washy interpretation, it's worth running it by a local medmal attorney anyway. It won't cost you anything and at least you'll know; just don't pin your hopes on it.

And truly ... I don't want to ruin a doctor's career. I mean, neonatology - and all the disciplines that come after -- is/are all still relatively new areas of medicine. But it is no secret that having a NICU in your hospital definitely adds a lucrative stream of cash to the bottom line. MOO. I believe I've heard hospital admins call it a cash cow. Moo. Grace is one of their calves.

I just want to take care of my daughter. If I could set up a trust with some seed money, that would be preferable to a lawsuit. That probably doesn't happen in the legal realm. But maybe it should. I'm not looking to get rich on the back of my daughter. I just want my daughter to be taken care of when I'm no longer able to be her advocate.