Patient’s Vision Loss Worsened by Delayed Treatment

    Vision LossThis case involves a patient who experienced progressive vision loss and was eventually diagnosed with a pituitary tumor. The patient underwent medical imaging and had films taken, however no abnormal findings were reported. The patient had gotten progressively worse since the imaging was preformed; and as a result she went back in 6-years later, at which time a mass was found. She was diagnosed with large pituitary macro-adenoma. She had a resection left inferior turbinate mass and had acute worsening of vision. Another radiologist looked at the film from the original imaging, where the mass was described as a size of pea, but by the time it was found it was the size of a small plum. The plaintiff alleges had she been diagnosed sooner, action could have been taken to prevent her progressing loss of vision.

    Question(s) For Expert Witness

    • 1. Do you routinely treat patients similar to the one described in the case? Please explain.
    • 2. Do you believe this patient may have had a better outcome if the care rendered had been different?
    • 3. Have you ever served as an expert witness on a case similar to the one described above? If so, please explain.

    Expert Witness Response E-006021

    I routinely see and treat patients with similar circumstances to those described in this case overview (ie: with a small mass not being appropriately identified on an imaging study). The patient most likely would have had a better outcome if the mass compressing the optic nerve or optic chiasmal had been identified earlier, and had been surgically resected sooner. I have served as an expert witness on a similar case, but it settled before going to court. As a neuro- ophthalmologist, patients who have vision problems resulting from compression of the optic nerve or chiasm by intracranial tumors such as pituitary tumors and meningiomas are referred to me on a regular basis. I would be happy to review this matter on behalf of the plaintiff.

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