Botched Steroid Injection on Periorbital Hemangioma

Filed under Surgical Errors, Other Cases

The Mimeron Case

An infantile hemangioma, or “strawberry mark,” is a very common type of birthmark made of blood vessels. Most hemangiomas are not visible at birth. They may at first only appear as a small bruise, scratch or a tiny red bump. Unlike other types of birthmarks, hemangiomas grow and change greatly during the first months of life. They may occur anywhere on the skin surface but are most common on the scalp, face and neck. All skin hemangiomas are seen by 6 months of age.

In this case, Jason Mimeron was born with a left periorbital hemangioma (a hemangioma near his left eye). This hemangioma was monitored by Jason’s pediatrician throughout the first year of his life. Eventually, when the pediatrician noticed that the hemangioma continued to grow, he became concerned that it could eventually impact Jason’s vision. The pediatrician eventually referred Jason and his family to a tertiary hospital that specializes in pediatric care.

At that hospital, Jason was examined by the Defendant, a pediatric ophthalmologist. The treatment options for Jason included laser treatment, surgical removal, steroid therapy (oral, topical, or injection into the birthmark itself), or a tumor shrinking drug. The Defendant recommended steroid therapy. Following the Defendant’s advice, Jason, then one year old, underwent a periorbital steroid injection performed by the Defendant.

Immediately following the injection, Jason was diagnosed with glaucoma in the left eye. It was later determined by another pediatric ophthalmologist that Jason sustained an infarction of the left optic nerve caused by the steroid injection. It was also determined that Jason suffered from an iris atrophy of the left eye that was also caused by the steroid injection. As a result, Jason was rendered completely blind in his left eye, with a small pupil, and reduced color in his left iris. He will eventually require plastic/cosmetic surgery for his now deformed eye and the surrounding area. Tragically, there is no surgical treatment to cure the blindness in his left eye.

When Jason’s family came to our office looking for answers to what happened, we first requested the medical records and had them reviewed by an expert pediatric ophthalmologist. The expert was astounded. As is turned out, the volume of steroidal agents that the Defendant injected - which caused the injuries - was inconsistent with any known protocol.

As we further investigated this case, we discovered that the Defendant was an admitted abuser of Percocet and opioids dating back to 1994. We further found that the Defendant attended an intensive outpatient treatment program with an addictionologist, was being monitored by the Physicians’ Health Program, a program of The Foundation of the Pennsylvania Medical Society, admitted to having a “daily” opiate usage relapse the same year he operated on Jason, was confronted by a hospital department chairman over his drug use, had been diagnosed with recurrent opioid dependence, and had a treatment plan that included outpatient pharmacotherapy, weekly psychotherapy, and an ongoing recovery program for physicians with a history of drug dependence.

We also discovered that the Defendant had multiple lawsuits against him – based on similar circumstances – and that he left Pennsylvania to begin practicing at a hospital in Ohio that also specializes in pediatric care (where he continues to treat children, perform surgeries, perform steroid injection, etc. – his medical license was merely put on “probation”).

On behalf of Jason, we brought suit against the Defendant and the hospital (his employer). The case was filed 4 years after the surgery when Jason was 5 years old. We were permitted to file suit more than 2 years after the negligence because Pennsylvania law permits victims who were “minors” to file suit up until their 20th birthday.

The Defendants’ lawyer first took the position that the volume of steroids used was based on proper and accepted protocol; however, when required to produce any such accepted protocol or literature that would support the amount that was used, the Defendants could not do so. The Defendants’ lawyer then took the position that the Defendant’s drug use would be inadmissible at trial if we could not specifically prove that the Defendant was on drugs the day he treated Jason.

Shortly thereafter, the case settled for a seven-figure sum. The settlement proceeds were placed into a Special Needs Trust - to be used exclusively for Jason - that our firm helped establish with a local bank.

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Publisher: Harry S. Cohen and Associates, P.C.