Philip Stanley, Johns Hopkins, the Navy, and Me

Posted on November 27, 2012. Filed under: Health, Medical | Tags: |

A Question of Medical Malpractiee

November 27, 2012

Fred Reed
By Fred Reed

This column may bore most readers. Bear with me. I offer it as a warning to the public.

On April 26, 2010, I went to see Dr. Philip Stanley, an eye surgeon at the Eye Clinic of Bethesda Naval Hospital of Bethesda, Maryland, for what he described as a routine removal of sutures following a corneal transplant at Johns Hopkins. In less than a half hour he ripped my eye wide open, inducing a massive choroidal hemorrhage and total detachment of the retina, leaving the eye blind. My attorney filed a malpractice suit under the Federal Tort Claims Act to Robert Thomas, of the Office of the Judge Advocate General in Norfolk, Va. The following are documents submitted under the FTCA. Stanley has since been at the Wilmer Eye Clinic of Johns Hopkins, which is aware of the malpractice suit. This sugests that despite good reputation–both Johns Hopkins and Bethesda Naval are thought to be of high quality–it is wise to research very, very carefully the physician who will attned you.

Robert Thomas of the Office of the Judge Advocate General’s office simply didn’t respond to the suit despite repeated requests.

Form 95 (2) Expert Witness (3) Email from Stanley

Medical Records

What Happened: Statement of Fred Reed

Dr. Stanley told me that the remaining visual problems in the eye were caused by astigmatism due to wrinkles in the cornea which were caused by the sutures that were used in the transplant. He suggested to me in an email on January 20, 2010 that I come in and see him between 29 March and 1 April “to take out sutures.”  At that point I understood that only a few sutures would be removed.  I made an appointment to see Dr. Stanley at April 26, 2010.

At around 9:00 AM I arrived at Dr. Stanley’s office at Bethesda Naval Hospital.  Dr. Stanley briefly examined me before a slit lamp and stated, “It’s been more than a year and the cornea is transparent and healthy, so we might as well take them all out.” He then said that “I want to make sure that removing the sutures will resolve the problem, since if it won’t help the vision there was no reason to do it.”  To this end he had a corpsman take me to another room, fit me with a hard contact lens, have me read an eye chart to check my vision.  It was explained that the lens covers the wrinkles in the cornea which fill with tears negating the astigmatism.  This was the only time a contact lens had been tried as a solution to the problem.  The results were excellent as the letters were sharply defined and clear. I easily read the 20/80 line and was reading the 20/60 line when an employee of the hospital interrupted stating, “Dr. Stanley is ready for you.”  I was then ushered back into Dr. Stanley’s office.

As I was sitting at the slit lamp Dr. Stanley produced a permission form for me to sign.  Since I could not read it, I specifically inquired what the risks in fact were because I had only the eye with the transplant that was capable of good vision. In response to this inquiry Dr. Stanley gave the unmistakable impression that he regarded this suture removal as very minor, jokingly stating that, “removing the sutures somewhat weakens the cornea and you should avoid being punched in the eye.” He said nothing whatever to suggest the possibility of losing the eye, which would have led me to reconsider the whole procedure. Had I known of the risks I would certainly have chosen any other solution, such as a contact lens, but Dr. Stanley did not tell me that a contact lens was an option.

Dr. Stanley then numbed the eye at the slit lamp and went around the periphery of the cornea, cutting the sutures. I knew that was being done because Dr. Stanley explained what he was going to do, and as he proceeded it was obvious that was what he was doing. He then tried to pull the sutures out, at one point stating that he wanted to use another instrument and going into another room to get it. He pulled harder and harder, which I could easily feel.  Dr. Stanley stated that the stitches were, “very tight,” “tight,” and, verbatim, “I’ve never seen this before.”  Soon he was pulling hard enough that I could feel the eye moving out of position, a fact Dr. Stanley commented on. I then felt a distinct pain in the back of the eye” From time to time heard, or felt, a tiny “pop” and the eye would settle back into position. I remember thinking, “This can’t be right. It feels like he is going to pull the front of the eye out.”

Dr. Stanley then said, “We may have a leak,” followed a few minutes later by an assertion that there was, “definitely a leak.”  I felt liquid running down my cheek and asked if it were tears or aqueous humor pouring from the eye.  Dr. Stanley responded “aqueous,” said that surgery would be needed to reseal the eye,  and left me, saying he had to get a gurney and make arrangements for assistance and an OR.

He left me sitting at the slit lamp with no bandage, contact lens to prevent loss of aqueous, clear shield, or other protective measure or bandage over the eye.  He did not tell me not to strain, squeeze, or touch the eye.  However at no point did I touch or squeeze the eye, having been through far too much eye surgery over the years to do such a thing.  In five or ten minutes a gurney was brought in. He placed me flat on my back on it.  I lay there for an extended period of time while Dr. Stanley tried to assemble the necessary personnel to undertake surgery to close the eye.  He did not place any sort of shield or bandage over the eye. In about a half hour or forty-five minutes Dr. Stanley put drops in the eye and suddenly I felt the most intense pain I had ever experienced. Someone said, “There’s blood coming from the eye.”  I had suffered a choroidal hemorrhage.  This hemorrhage has left the eye totally blind.

They were able to use general anesthesia since by chance I had been fasting in the expectation of having unrelated blood work done after the removal of the sutures.

I saw Dr. Stanley at Bethesda about a week later. He examined the eye, told me that I could go back to Mexico, and gave me antibiotic drops and a large supply of oxycontin, telling me to take two tablets every four hours. He gave me no instructions to seek follow-ups with an ophthalmologist in Mexico, and never communicated with me again, though he had my emaill address.

The loss of the eye was a terrible shock to me. I had expected to have normal or nearly normal vision in the eye and had planned to return to my work in journalism, having for example made tentative plans with Kara Hopkins, then the editor of The American Conservative, to go to Afghanistan for the magazine. Having been blinded, and thus unable to travel without my wife to help me, my reporting days were over. I became extremely depressed.  The effects of losing one’s vision are hard to describe. Loss of a leg would be a nuisance, but losing one’s sight is ghastly.

I began to drink more than I should, tried not to take my moods out on my wife, and tried to force myself to follow a normal routine. I had previously been diagnosed by the Veterans Administration as fifty percent disabled by PTSD resulting from service with the Marines in Viet Nam. The loss of the eye made the PTSD symptoms much worse.

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