June 02, 2002

Dominic Morgan v. Nevyas Eye Associates - Report on Standard of Care Deviation (2)

Terrence P. O'Brien, M.D. 
Associate Professor of Ophthalmology 
External Diseases and Cornea Director, Ocular Microbiology 
Director, Refractive Eye Surgery 
The Eye Surgery Center at Green Spring Station
10753 Falls Road, Suits 305 
Lutherville, MD 21093 
410-S83-2820/FAX 410-583-2842 
Email: tobrien@jhmi.edu

June 7, 2002

Steven A. Friedman, M.D., J.D.
850 West Chester Pike, 1st Floor 
Havertown, PA 19083

RE:    MORGAN, DOMINIC 
          JHH: 4-3200368

Dear Dr. Friedman:

I have had the opportunity to carefully review in detail all of the medical records related to Dominic Morgan's care, including the recent defense medical exam provided by Dr. Steven Orlin in Philadelphia, Pennsylvania, as well as the comprehensive ocular evaluation conducted by Dr. James Salz in Los Angeles, California.  In addition, I reviewed the MD-TV videotape "Infomercial Transcript" that Dr. Anita Nevyas-Wallace used to promote the "Nevyas Excimer Laser" without providing information to viewers regarding the investigational status of the Excimer laser with the FDA.

In review of Dr. Salz' extensive examination and conclusions, I am of the opinion in complete agreement with Dr. Salz to the best degree of medical probability that the care rendered by Dr. Anita Nevyas-Wallace on behalf of Dominic Morgan fell below standard for LASIK surgery at the time.  Indeed, I completely agree with Dr. Salz that Dr. Nevyas-Wallace failed to appropriately screen Mr. Morgan and exclude him as a viable candidate for LASIK surgery based on his extensive prior ophthalmologic history which would have predicted a less than optimal result, as he has ultimately experienced with the surgery performed by Dr.  Anita Nevyas-Wallace.

Dr. Friedman, your kind attention to this information and awareness of my opinion to the best degree of medical probability which is in complete agreement with Dr. Salz that Dr. Anita Nevyas-Wallace had substandard care related to the treatment provided with LASIK surgery on behalf of Dominic Morgan. If you have any questions regarding this deviation from the standard of care in patient selection and treatment, please do not hesitate to contact me directly at 410-847-3508.

Sincerely, 
Terrence P. O'Brien, M.D.
Director, Refractive Surgery

Declaration of Terrence P. O'Brien, M.D.

I, Terrence P.O'Brien, M.D. make this declaration subject to the penalties of 18 Pa.C.S.A. Sec. 4904 relating to unsworn falsification to public authorities:

  1. When I saw Dominic Morgan 4/20/00, it was after the 12/5/99 note by Dr. Harlan and the 2/14/00 ERG by Dr. Sunnas, but before the June 2000 noted by Dr. Guyten.  My evaluation was not yet completed.
     

  2. Dominic Morgan's history of significant ROP was a contraindication to LASIK, and I told Mr. Morgan that but I had not then determined if LASIK was the only factor contributing to his problems, and I thus indicated that situation by the phrase "unclear etiology."
     

  3. Dr. Guyton felt that, in theory, a lens problem could be part of Mr. Morgan's visual problem, and that to exclude that possibility it would be appropriate to wait two years to see if any lens problem progressed.  If there were no progression, then he felt the lens could not be a significant factor contributing to Mr. Morgan's visual problem.
     

  4. After two years passed without any progression of Mr. Morgan's minimal unclear sclerosis, it was quite clear that the lens opacity was minimal and not a significant contributor to Mr. Morgan's problems.  It became evident with medical certainty that the LASIK procedure was the principal factor responsible for Mr. Morgan's visual problems.
     

  5. I concur with Dr. Salz's analyses and opinions.  Dominic Morgan's history of ROP was a contraindication for the LASIK procedure.  He was never a suitable candidate, and the LASIK performed by Dr. Anita Nevyas-Wallace is responsible for his problems.
     

  6. I served as an expert against in the earlier Cheryl Fiorelli case, and the Dr. Stephen Orlin was Nevyas-Wallace's expert.  In that case Nevyas-Wallace performed LASIK when the preoperative best corrected visual acuity (BCVA) was below 20/40.

Terrence P. O'Brien, M.D.

Posted by Admin at June 2, 2002 06:33 PM