Opinion ID: 509579
Heading Depth: 4
Heading Rank: 2

Heading: Failure to Perform an Indirect Dilated Examination

Text: 115 The district court also rejected plaintiffs' argument that Dr. Channing failed to comply with the standard of care because he did not perform a dilated examination with an indirect ophthalmoscope. The overwhelming medical testimony presented at the trial indicated that such an examination should have been part of Karen Keir's course of treatment. Dr. Mignone testified that a dilated examination would have been part of the initial work-up if a referral to ophthalmology had been made. J.A. 272. Dr. Wesley also testified that the standard of care required a dilated indirect ophthalmoscopy to be performed on the initial visit. J.A. 317-19. Dr. Estes stated that Karen should have had a dilated retinal examination during her first visit. J.A. 354. Even Dr. Abramson indicated that it would be appropriate to do an indirect ophthalmoscopy using dilating drops during the first visit of a child with a history similar to Karen's. J.A. 595. Finally, Dr. Hiatt testified that a dilated examination should have been performed and that, if the child would cooperate, an indirect ophthalmoscope should have been utilized. J.A. 623-24. 116 There is also considerable support for plaintiffs' contention that a dilated examination should have been performed on February 12, 1980. Dr. Wesley testified that, because Karen did not adapt to the patching procedure, a dilated indirect ophthalmoscopy should have been performed on that date. J.A. 328. Dr. Estes agreed with this assessment. J.A. 357. Dr. Feman stated that a dilated examination should be performed as a routine matter once a year. J.A. 450. Dr. Tirrill and Dr. Holweger concurred in this assessment. J.A. 471, 511. Because the last dilated examination was performed by Dr. Tirrill in February 1979, J.A. 464, the procedure should have been repeated in February 1980. 117 The foregoing discussion illustrates that there was indeed overwhelming evidence to support the conclusion that the standard of care required Karen Keir to be given a dilated indirect ophthalmoscopy during the time she was under Dr. Channing's care. The district court's contrary finding is clearly erroneous.