Adventures in Korean Medical Malpractice

What follows is  one woman’s story of medical malpractice. Specifically, the medical procedure is Laser-Assisted in Situ Keratomileusis or what is commonly known as LASIK – the correction of nearsighted vision by laser surgery. We are not publishing this story to warn people away from LASIK, nor are we attacking the Korean medical system. Most people that have had the procedure performed have been thrilled with the results, and there are excellent doctors here who provide excellent care to their patients. The reason we’re publishing this story is to inform people of the differences in medical malpractice laws between Korea and many western countries.  This is Jen’s story, and we’ll allow her to tell it in her own words (the final paragraphs were added later, from information Jen provided after her return to the US). In order to avoid legal troubles (the slander/defamation laws here are different than home, too) we will not name the doctor or the clinic involved.

Jen’s LASIK [horror] story:

On June 25, 2012 my boyfriend and I, together with 2 Korean friends (KF1 and KF2), went to an eye clinic in Jung-gu, which had been recommended to us by KF1. At that time, my boyfriend and I both had a pre-LASIK eye exam. Dr. M told my boyfriend that he is not a good candidate for LASIK, because his cornea does not hold a perfectly round shape. I was told that I was an ideal candidate for LASIK. I had slight near-sightedness (Left: -1.75, Right: -1.50) and thick, round corneas. The doctor said that with my type of eyes, I would have the best possible result from LASIK. So, I scheduled the procedure for July 14, 2012. Dr. M said that I couldn’t wear contacts before the surgery; I had to wear my glasses.

Driving home from work before the surgery, I noticed that I had some difficulty seeing with my glasses (as they are a weaker prescription than my contacts), so I asked KF1 to call Dr. M to ask some specific questions about what my eyesight would be like after LASIK. These are the questions I asked, and the answers I was given:

Q1. Will I have vision like I have with my glasses (OK, but not great; blurry vision at night and when looking afar), or will I have vision like I have with my contacts (great vision up close and far away, no problems at night)?

A1. The doctor will use a computer to measure your prescription and to measure the LASIK cuts. The computer will shape your cornea like your contacts, so you will have vision like your contacts.

Q2. I am worried about driving. Will I have any problems driving and seeing road signs after LASIK?

A2. You will be able to drive without any problem as soon as one day after your procedure.

Since these answers seemed good to me, I had the LASIK as scheduled, on Saturday, July 14. And after the surgery, I had my first follow-up appointment on Monday, July 16. I could read the eye chart well with my left eye, but I couldn’t read well with my right eye. Dr. M examined my right eye and said, “No problem. Come back in one week.”

I went back to the clinic on Monday, July 23 with KF1. At that time (10 days after my LASIK), the doctor said that the cornea in my right eye had healed with a wrinkle. He said that he needed to do another procedure to smooth out my cornea and that after it was smoothed, I would be able to see out of my right eye with no problem. That afternoon I had the cornea smoothing procedure. At my next follow-up appointment, I could see a little better out of my right eye, but I still could not read much of the eye chart. He said that my eyes would need one month to heal, so there was nothing he can do to improve my vision until after the month had passed.

On August 21, I visited the doctor with KF1 for my 1-month follow-up appointment. I still could not read much of the eye chart with my right eye. There had been no improvement over the past month. Dr. M was satisfied with his work and told me I should be satisfied too.

I explained that not only was my vision significantly worse than it was with my contacts (it is even worse than it was with my glasses), but I also have difficulty reading road signs while driving, both during the day and at night. At this point Dr. M said, “You must be lying, because according to your sight test, you can see with no problem.” Then, my Korean friend said, “I have the same sight test result as you and I can see road signs. I don’t believe that you have a problem driving.” At that point, I referred to the questions I asked before the LASIK (Q1 and Q2) and the answers the doctor had given me (A1 and A2). Both the doctor and my friend replied with, “I don’t remember that conversation.”

The doctor finally said that he was satisfied with his work and that if I had a problem, I needed to go to another eye clinic. If another eye doctor said there was a problem with his work, and I brought him a medical report saying there was a problem with my eyes, he would give me a refund. OK, so, time to get a second opinion…

In the meantime, I asked him to write a prescription for some glasses to wear while driving. His response was, “You do not need glasses. You have no problem with your eyes.”

On August 31, I went to a new eye clinic with a new Korean friend (KF3). The new doctor said that there was a problem with my right eye. He took photos of my eyes and showed me white dots on the photo of my right eye that are absent on the photo of my left eye. He said that these white dots appeared because there is still a wrinkle in my right eye. I asked him to write a medical report stating that I have a problem with my right eye so I can get a refund from Dr. M, and become a regular patient of the new doctor.

Here is where Korean culture and law come into play…

The second doctor explained that in Korea, no doctor will ever make an official statement about another doctor’s work. He said that this is for political reasons. Korean doctors will never speak poorly of other Korean doctors’ work, even if a mistake is evident. He said that all Korean doctors know about this political “courtesy,” so Dr. M told me to get a report he knew I never could get. The new doctor told KF3 and myself, in a very politically correct way, that at his clinic, when LASIK patients visit for their next-day follow-up appointment, if the cornea is wrinkled, they do a cornea smoothing procedure right away. He explained that the longer the cornea stays wrinkled, the less chance there is that it will heal smoothly. In some cases, corneas never heal smoothly, so, in his clinic, they smooth the cornea ASAP. The new doctor said he didn’t understand why Dr. M waited 10 days to smooth my cornea, as waiting so long left some wrinkles in it. But, this doctor will never put that diagnosis in writing.

The second doctor said that there was a 40% chance that my cornea would continue to smooth and heal itself in the next 2 months. He said that he would not do any procedure until after 2 more months (3 months after my original LASIK). By this time, I will be back in the USA, so he suggested I see an eye doctor there in October, to see if there is anything that can be done to improve my vision at that time.

The second doctor also gladly wrote me a prescription for driving. My left eye is 0.0 and my right eye is -0.75. That’s only a 0.75 improvement from my pre-LASIK prescription of -1.50! And yet Dr. M said I have no problem.

Following this, I booked an appointment with a top eye doctor in Seoul. He basically said the same thing as the second doctor; there was clearly a problem with my right eye, and a cornea smoothing procedure should have been performed earlier in order to fix the wrinkling. He also added that, in his opinion,  I wasn’t a great candidate for LASIK. He said because my eye sight was not poor enough he would never have performed the procedure at his office and the risks outweighed the benefits. Unfortunately, he also refused to put anything down on paper that would officially state that Dr. M had made mistakes in treating me.

Since I had no official statement that I had a problem with my eye, Dr. M refused to give any refund or admit any fault. Through friends, I contacted a lawyer in Busan, who sent a letter requesting a settlement, but the doctor ignored it. The lawyer explained that it would cost more to bring a case against Dr. M than I would receive back, even if I won the best case scenario. Generally, Korean malpractice suits are only awarded the cost of the procedure. It would be very difficult to win the best case scenario as the doctor didn’t impair my vision to the point of disability. Also, the lawyer said if I wanted to bring a case, I’d have to return to Korea in 6 months (or possibly longer) to have a “certified” Korean doctor examine my eyes, which would postpone any possible treatment in the USA.

After returning to the USA, I had a cornea re-float procedure on my right eye. It’s the same corrective procedure that Dr. M did, but the doctor here did it more effectively. At my five-day checkup, my vision had improved beyond what it ever was in the Korean clinic – it was 20/20. After the one-month check-up, I’ll know if that quality of vision will remain, but things are hopeful at last.