her vision
in the right eye and told Dr. Marvelli she had fallen out of bed and had struck
her right eye. Dr. Marvelli determined that the lens in the right eye had
dislocated again and had fallen through the hole in her iris tearing a section
of the iris as it fell through.
Dr. Marvelli's handwritten notes reflected that Alston was continuing to rub
her eyes. He saw Alston rubbing her eyes while in his office. Additionally, by
December of 1996, Dr. Marvelli concluded that Alston's drinking was a problem,
her smoking was indirectly contributing to the irritation of her eye, and she
was a "non-compliant patient." Alston admitted she drank anywhere from
two to six beers on a daily basis and had been a smoker for 50 years although
she had pulmonary disease and a stent implantedin an artery.
Because the lens had fallen through the sector iridectomy a second time, Dr.
Marvelli decided to remove the implant and sew the iris together to reduce the
chance of another dislocation. He performed the third surgery to remove the
implant and sutured the iridectomy shut on May 6, 1997. By August of 1997,
Alston's right eye had improved, and Dr. Marvelli performed another lens
implantation, making a wider incision with fresh tissue and removing scar tissue
to promote healing. He followed the same lens placement procedure as on the
previous occasions.
After the fourth surgery, Dr. Marvelli found increased visual acuity in the
right eye and that the incision was healing nicely. Alston's vision was
comparable to that before her second surgery. However, by the time of her visit
to him on October 2, 1997, Alston's vision