Doctor negligently performed eye surgery causing cornea damage: BC court

A doctor breached his obligation to adequately disclose the risks of a procedure similar to a cataract surgery, and a reasonable person in the patient’s circumstances would not have pushed through if aware of such risks, a BC court said.

The plaintiff patient wanted to correct his vision to decrease his dependence on glasses or contact lenses. In September 2016, the defendant doctor performed two refractive lens exchange surgeries on the patient’s eyes.

During the procedure for the left eye, the doctor discovered that he inserted a defective intraocular lens (IOL). He replaced it with another IOL. The patient sustained cornea damage and lost the vision in his left eye. He also developed ptosis, which disfigured his face and significantly obstructed his vision.

Around a year later, the patient underwent a corneal endothelial transplant, which restored his left eye’s vision. He also had two surgeries to repair his drooping left eyelid, caused by the ptosis. These two procedures were unsuccessful.

The patient sued the doctor. He alleged that the left eye surgery caused damage to his cornea and eyelid. He asked for non-pecuniary damages, damages for past and future loss of income earning capacity, damages for cost of future care, aggravated damages, punitive damages, and health care costs under BC’s Health Care Costs Recovery Act, 2008.

The patient made the following claims:

• He did not give informed consent for the surgery because his doctor failed to adequately disclose the risks of corneal damage, permanent vision loss, ptosis, and the need for a corneal endothelial transplant
• The doctor negligently performed the surgery by failing to inspect the IOL before implanting it, by failing to recommend an appropriate IOL, by failing to use microsurgical instruments, and by failing to administer the proper anaesthetic

The doctor accepted that he replaced the first IOL, which complicated and prolonged the surgery. But he argued that he adequately informed the patient of the risks and did not breach the standard of care.

Doctor found liable

In Anderson v Chu, 2023 BCSC 280, BC’s Supreme Court awarded the patient non-pecuniary damages of $180,000 and health care costs of $7,765.83.

First, the court found the patient credible because he gave a straightforward, responsive testimony and made no embellishment or exaggerations. On the other hand, parts of the doctor’s testimony about his regular practices had credibility concerns, the court said.

Second, the court ruled that the doctor failed to adequately disclose to the patient certain risks associated with the surgery, including risks of the following: corneal damage or disfunction, the resulting need for a corneal endothelial transplant, permanent vision loss, and ptosis. Corneal damage or disfunction, permanent vision loss, and ptosis were material risks, the court added.

Third, the court held that a reasonable person in the patient’s circumstances would not have consented to the surgery if the doctor properly advised them about such risks.

Fourth, the court had no difficulties concluding that the surgery probably caused the patient’s cornea damage, ptosis, ongoing double vision, and impaired depth perception.

Lastly, the court determined that the doctor was negligent in performing the surgery. According to the court, he breached the applicable standard of care by failing to inspect the first IOL before loading it into the injector and by failing to administer the appropriate anaesthetic, which caused the patient excruciating pain.