Karen Thiel just wanted to see well without wearing contact lenses.
Instead she became the victim of a botched procedure that seriously injured her cornea and resulted in persistent pain, a series of eye infections and permanent vision loss. Ten years after her surgery, the now-retired clerical worker says she still has trouble seeing, even when wearing glasses.
The same year, in 1999, Nicholas Pucek went through a similar ordeal. Too much of his cornea was cut away during a corrective procedure on his left eye, and a flap of the cornea dislocated. Pucek sought treatment for complications more than two dozen times over a six-week period and eventually received a cornea transplant.
Juries awarded both Thiel and Pucek hundreds of thousands of dollars after the two underwent Lasik surgery at the hands of Dr. Nicholas Caro. The Chicago ophthalmologist has been sued almost 50 times in Cook County since the early 1990s for medical malpractice, with 29 of the suits filed in the last decade.
The state's chief medical prosecutor investigated Pucek's case and recommended more than a year ago that Caro's medical license be "suspended, revoked, or otherwise disciplined." The formal complaint alleges that Caro mishandled Lasik surgeries and failed to properly manage treatment of post-operative complications.
Yet no disciplinary action has been taken and Caro continues to operate on people's eyes, highlighting ongoing concerns that the Illinois Department of Financial and Professional Regulation is not aggressive enough in pursuing bad doctors.
Daniel Bluthardt, director of the department's division of professional regulation, declined to comment on Caro's case but said disciplinary proceedings for physicians take time. "It's not unusual for a case, from start to finish, to take as long as two years" to resolve, he said.
The agency's complaint, filed in March 2008, was based on a report received a year earlier and was amended in July and October to include additional cases. A formal hearing has yet to be scheduled.
Reached by phone at St. George Corrective Vision Center on West Peterson Avenue where he is medical director, Caro blamed the allegations of malpractice on a litigious society.
"A lot of doctors get sued," he said. "I'm a high-volume surgeon and do a lot of surgeries, and they're cosmetic. You're going to get sued. Other doctors who do Lasik have the same problem."
Lasik is an elective surgical procedure in which a laser is used to change the shape of the cornea, the clear covering of the front of the eye. Lasik, which stands for laser-assisted in situ keratomileusis, is intended to reduce a person's dependence on glasses or contact lenses. The procedure is one of the most common cosmetic surgeries performed in the U.S.
Caro said he has performed about 25,000 eye procedures in 25 years
According to the Ophthalmic Mutual Insurance Company, which insures about 30 percent of U.S. ophthalmologists, about 75 percent of the specialists who practice at least 25 years have three or fewer lawsuits or malpractice claims in their career.
The Tribune checked the records of more than a dozen other Lasik doctors in the Chicago area and found none had been sued for malpractice more than 12 times; most had far fewer lawsuits.
"My license has never been disciplined, and I have never had any problems with the department [of professional regulation]," Caro said before cutting the phone interview short because, he said, he does not talk to reporters.
Illinois' division of professional regulation has been the subject of criticism in recent years for being slow and overly lax in taking action against incompetent and dangerous doctors.
An Illinois auditor general's report in 2006 identified a slew of problems, including inadequate staffing, monitoring deficiencies, inadequate and inconsistent disciplinary actions and excessive time prosecuting cases. According to the report, half of the investigations conducted in fiscal 2004 and 2005 took longer than five months to complete, the agency's standard.
The report said, "Failure to follow up on complaints and complete investigations in a timely manner may result in a physician who has violated the Medical Practice Act not being timely detected and disciplined."
This year the Tribune reported that the regulatory agency has not disciplined physicians associated with a medical practice now known as Homefirst, despite lawsuits over three decades in which parents alleged the doctors made harmful and sometimes fatal mistakes.
In Caro's case, lawsuits, depositions and documents compiled by state regulators describe patients repeatedly seeking treatment from the doctor for painful or worrisome complications. Some patients returned to Caro a dozen or more times.
Chief medical prosecutor Lisa Stephens wrote in her complaint that Caro had "committed acts and/or omissions which constitute gross negligence in the practice of medicine." In Pucek's case, she wrote, Caro failed to perform Lasik surgery properly, to evaluate and treat Pucek's post-surgical complications and to refer Pucek to another specialist promptly.
In 2005, a jury awarded Pucek more than $800,000 for pain and suffering, loss of a normal life and future medical expenses, court records show. The division of professional regulation's review of Caro was triggered after that verdict was automatically forwarded to the state.
Reached by phone, Pucek said he is reluctant to discuss his case now that it has been settled in court.
"Ten years later I still have headaches when I read and I'm not able to do some of the things I was able to do prior to the Lasik surgery," he said.
Karen Thiel testified in her court case that Caro ruined her eyesight, forcing her to retire early because she could not see well enough to do her clerical job with the Cook County Sheriff's Department. She was 50 when she underwent Lasik in 1999.
In 2007, a jury awarded Thiel 500,000 for past and future pain and suffering, and for past and future loss of a normal life.
In an interview, she said she now has trouble seeing even when wearing glasses.
"I trip over things constantly," said Thiel, who relocated in May from southwest suburban Wilmington to Florida. "I don't see things in front of me. I don't drive at night. I don't drive in places where I don't know where I'm going because I can't read signs until I'm too close to make a turn."
Joseph Smith, 61, of Rogers Park says he also had repeated problems after a Lasik procedure in 2006 that he thought would make it easier to do his job as a painter. According to a lawsuit he filed last year, Caro's surgery left Smith with a scarred, irregular cornea that cannot be completely corrected. He required a lens removal and lens implantation.
Smith said that until another surgeon repaired some of the damage, his vision was so bad that he could no longer read the labels on paint cans.
"You go back to this guy and he's supposed to straighten everything out and you're worse than before," Smith told the Tribune.
Caro's practice attracted the attention of federal regulators in 1997, when the Food and Drug Administration said his clinic was one of three using unapproved laser equipment to treat vision problems such as nearsightedness and astigmatism. (The other clinics were in Georgia and Florida.) The agency removed the equipment from his office.
"Such unapproved lasers pose a risk to patients because their use could potentially cause serious eye injury," the agency said in a statement at the time. "The manufacturer and eye clinics had all ignored prior warnings from FDA."
Thiel said she learned of the FDA inspection and other lawsuits only after she hired a lawyer. Thinking of Caro working on people's eyes makes her livid.
Said Thiel: "Why does he still have a license? That's what's so upsetting."
Bluthardt said his agency disciplines 275 to 300 doctors a year with punishments that range from reprimands to license revocation.
"Generally I think we get it right and the process works pretty well," he said.Copyright © 2014, Los Angeles Times