When I regained consciousness in the recovery room, the first thing that I remember was a feeling of pain in my left eye.  When my parents, who accompanied me to the hospital, rejoined me in the recovery room, the first thing they noticed was that my left eyelid was drooping and that my eye appeared bloodshot.  Before my parents even had an opportunity to comment about my eye,                    the recovery room nurse, asked me if there was something wrong with my eye because it appeared to her to be very red.  Both of my parents were standing next to me at this time and clearly heard what she said.  Moreover, please note that, after the surgery, the first thing that my parents and Nurse              noticed and remarked on was that there was something wrong with my eye.  And yet, prior to the surgery, neither the nurses who prepared me for surgery and discussed with me the documents I was required to sign, nor Dr. P           the anesthesiologist, or Dr. J           the surgeon, all of whom spoke with me and asked me various questions, noticed anything unusual about my eye.  Among the many reasons all these professionals were questioning me before the surgery was to assess my condition and fitness at that time for the surgery.  If there were something wrong with my eye prior to the surgery, surely one of these highly trained professionals would have noticed.  Quite clearly and inarguably, the injury to my eye occurred during the time that I was under general anesthesia.

Your statement that ". . . our review of your May 22, 2015 surgery and of your two post-operative visits cannot substantiate that the corneal abrasion is related to the surgery" merely indicates that your review has not taken into account all of the evidence.  I spoke with or wrote to Dr. J           about my eye injury on the 24th, 29th and 30th of May.  I also spoke with Dr. P           by telephone on June 12th, at which time Dr. P           emphatically blamed a nurse for causing the injury to my eye.  Have you questioned Dr. P           about this?  Needless to say, I have no control over what information finds its way into the hospital's records.  As I wrote to you on July 12th, any indication in your records that my eye was red prior to my being anesthetized is an indication that someone is falsifying your records.

After my release from the hospital on May 22nd, the pain and discomfort in my eye worsened, and I was forced to see my ophthalmologist, Dr.               y, for treatment.  The abrasion that was caused during the surgery was so bad that it was still visible on the surface of my eye after two weeks (a typical abrasion heals after 24-48 hours).  For the next two and a half months, Dr.               y was required to resort to stronger treatments, as the pain and discomfort were unrelenting, and I could not feel any relief whether my eye was closed or open.  Dr.               y eventually had to place me on an antibiotic and a steroid.  And although I stated in my email of July 12, 2015 to                  that my eye had healed, I have continued to experience intermittent pain and discomfort in my left eye.

It is a fact, Ms.         , that as a result of the negligent actions of someone at the hospital that resulted in an injury to my eye, I have experienced significant pain and misery for many, seemingly endless months, I have experienced a great deal of anxiety concerning the future health of my eyes, and due to the hospital's actions, I was forced to spend a significant amount of money in an attempt to regain my prior good health.  I did not think it unreasonable that the hospital acknowledge its responsibility for this.  As stated before, I expect that your office will now reopen your review given these facts, all of which were ignored in the original review, and that my ophthalmologist's and related expenses will be paid by                     .  Overall the results of my experience with                      have been negative in virtually all respects.

OPINION

9.         It is my opinion to a reasonable degree of medical certainty that all care provided from an anesthesiology standpoint on the day of the surgery, May 22, 2015, was rendered appropriately, and there is no evidence of any negligent acts or omissions by the defendants that caused injury to plaintiff’s eyes.

10.       Preoperatively, anesthesiologist Dr. ████ appropriately performed an anesthesia evaluation in obtaining plaintiff’s medical history and performing a physical examination. Plaintiff was evaluated to be ASA status of 1. The ASA physical status classification system assesses the fitness of patients before surgery, and a score of 1 signifies a healthy person. In light of plaintiff’s status, it was completely appropriate for Dr. ████ to plan for and administer general anesthesia. There is a signed consent for general anesthesia from the patient.

11.       With respect to the surgery, I find no evidence that general anesthesia was rendered improperly or that inappropriate measures were taken to prevent damage to plaintiff’s eyes. Generally, the anesthesiologist is responsible for protecting the patient’s eyes during a surgery performed under general anesthesia, and there is no evidence that Dr. ████ took inappropriate measures with respect to plaintiff’s eyes. General anesthesia was properly administered with Propofol and Fentanyl, and plaintiff’s airway was maintained with a laryngeal mask. A laryngeal mask does not cover a patient’s face, but is limited to just the mouth area and would not be near the plaintiff’s eyes. The laryngeal mask was noted to be placed without difficulty.

12.       Furthermore, I find no merit in plaintiff’s claim that defendants were negligent in preventing damage to his eyes postoperatively. After Dr. ██████ completed the surgery, plaintiff was properly prepared for emergence from anesthesia as he was awoken from anesthesia and had the laryngeal mask airway removed at 10:35 a.m. Plaintiff was transported from the OR to the PACU at 10:38 a.m. Notably, according to RN ███████’s 11 a.m. note, plaintiff indicated that he had left eye redness since May 21, the day before the surgery, thereby reflecting that plaintiff had pre-existing left eye redness.

13.       However, even assuming plaintiff’s deposition testimony that he did not have left eye redness before Dr. ██████’s surgery to be true, there is no evidence that any negligent acts or omissions by defendants caused plaintiff’s left corneal keratitis punctate. Corneal keratitis punctate, an inflammation of the cornea, is a complication that is recognized in the field of anesthesiology, and such injury, while rare, is commonly recognized to occur in the absence of negligence. There is often no diagnosable cause of this inflammatory corneal response. In this case, there is no evidence or reason to suspect that there were any negligent acts or omissions by defendants in the preoperative, intra-operative, or post-operative periods on May 22, 2015 that caused plaintiff’s left corneal keratitis punctate.

14.       Based on the above, it is my opinion to a reasonable degree of medical certainty that from an anesthesiology standpoint, defendants did not deviate or depart from acceptable standards of medical practice in their care and treatment of the plaintiff on May 22, 2015. Additionally, there were no negligent acts or omissions by the defendants that caused or contributed to any injury alleged to have been sustained by the plaintiff.

WHEREFORE, it is respectfully requested that this Affirmation be given due consideration by the Court with regard to the defendants’ motion to dismiss this case.