Doctors Behaving Badly: Ophthalmologist should have kept closer eye on patients

Here's something a doctor should hope to never hear after performing surgery:

"Doc, my eye feels like mayonnaise."

That was the assessment of an 81-year-old patient operated on by Dr. Gary W. Hall, a Phoenix ophthalmologist.

The patient had cataracts in both eyes, but her vision in her left eye was worse. For no apparent reason, Hall elected to operate on her right eye first. As the Medical Board of Arizona notes:

It is correct and customary to operate on the worse eye first unless contraindicated. Respondent, however, operated on the right eye-best vision first and failed to indicate in the records any reason justifying this decision.

The operation went badly. The posterior lens capsule ruptured and the lens was knocked loose, floating around inside the eye.

The patient's eye was bleeding and appeared to be leaking fluid, but Hall did not check for a leak, heightening the chances the patient would develop an infection and eventually lose her vision completely. The situation worsened until the patient "reported that her eye felt as if it had mayonnaise in it and was very light sensitive," the medical board wrote.

Other doctors tried to fix the damage done to the patient, identified as M.P. in board records, but Hall neglected to tell them that he'd lost the patient's lens inside her eye.

A lens left in the vitreous may cause later problems including inflammation, hemorrhage, retinal edema, retinal detachment and a variety of visual symptoms. Records from M.P.'s subsequent treatment reveal complaints of just such problems.

This was just one patient. In 2005, the board listed a string of failures on Hall's part in connection with eight other patients, many of whom left Hall's office with worse vision.

Nor was this the first time that Hall had been in trouble.

In January 1996, Hall was ordered by the Arizona Medical Board to spend three years on probation and to pay the board $10,000 to cover the costs of an investigation, the details of which are no longer on the board's site.

Just as that probation was ending, Hall was put on probation again in October 1999, for three more years. He was censured for unprofessional conduct, permanently prohibited from performing certain procedures and forced to take a course to learn others. This time, the penalty was even larger: $15,000.

After losing that lens, damaging other patients' eyes with lasers, performing more surgeries on the wrong eye and discovering a tumor in one patient's eye but failing to tell her about it, Hall seemed to be headed for an early retirement. But the Arizona Medical Board is a magnanimous organization. In April 2005, the board gave Hall yet another chance. He was put on probation for five years, with the caveat that he never perform surgery.

Somewhere along the line, though, he was caught doing just that.

And in February 2009, the board ordered Hall to pay a fine for violating the terms of his discipline. All he had to do was pay that fine, and he could have gone back to seeing patients. He couldn't come up with the money. On October 2009, the board took his license away.

Final question: Where are the case histories? Hall is exactly the kind of doctor who should have a detailed history available on the medical board's site, but for his previous disciplinary actions there are no details. Even the most recent instance of him violating his probation is presented in vague terms. If patients had been able to learn more about him and the limitations of his skills perhaps they would have chosen another doctor.