Patterns of cataract surgery-related litigations in the United States from 2000-2020

Background: Awareness of the outcomes of cataract surgery-related malpractice litigation in the United States allows for ophthalmologists to better understand how to improve patient care and reduce litigation. Methods: United States malpractice trials involving cataract surgery were searched in the LexisNexis legal database. Monetary amounts were inflation-adjusted to 2020 dollars. Results: Over the past 20 years, 482 cataract surgery litigations from 37 states were identified. New York (27.5%), Florida (8.9%), and California (8.3%) had the most cases. However, District of Columbia (11.63), New York (6.86), and Rhode Island (3.80) had the most cases per 1,000,000 residents. 48.5% of verdicts were for the defendant, 11.8% were for the plaintiff, and 30.5% were settled. Leading reasons for litigation were retinal detachment and endophthalmitis. The average amounts demanded, offered, and awarded were $1,224,061, $241,314, and $1,350,600, respectively. When comparing 2000-2010 and 2011-2020, amounts demanded (p=0.039) in the second decade significantly increased but amounts awarded (p=0.118) did not. Conclusions: Almost half of reviewed cataract-related malpractice litigation resulted in a defendant verdict. Settlements or plaintiff verdicts were costly with amounts awarded averaging above $1 million. Over the past decade, while plaintiffs are requesting significantly more, there was no significant increase in awarded amounts.