GDC ROUGH TREATMENT


MDDUS. Both he and the practice manager have spoken with Mrs K about the complaint and about the manner in which she communicates with and treats patients. She denies being aggressive or dismissive towards Mr G. An adviser offers Mr L advice and helps him draft a full response to the GDC. The GDC later responds to say that the records show no evidence to support the allegations and the case will be closed with no further action.


BACKGROUND Mr G has been regularly attending appointments with his practice’s dental hygienist, Mrs K, for several months. As a smoker, he is concerned about his general oral health and areas of brown staining in particular. During one scale and polish, Mr G experiences pain from the treatment and flinches, causing the scaler to cut slightly into his gum. Mrs K advises him to remain still to avoid any further slips. After the following appointment, Mr G again complains of painful treatment and is


concerned the hygienist has not attempted to remove the staining. He submits a formal complaint to the


practice who apologise and arrange for another hygienist to carry out future treatment. However, two weeks later the practice receive a letter from the GDC stating Mr G has complained about Mrs K’s “unprofessional” behaviour, “aggressive” treatment and dismissive manner.


ANALYSIS/OUTCOME The practice principal, Mr L, contacts


KEY POINTS ●Ensure the entire practice team are trained to effectively communicate with patients, including those who express concerns about their treatment. ●Be sure to fully address all points of a patient complaint to avoid it escalating. ●Comprehensive dental notes can provide an effective defence during GDC investigations.


CLAIM DATE OF KNOWLEDGE


BACKGROUND Mr K attends his dental surgery complaining of swelling and discomfort around his upper left canine. A periapical X-ray is taken showing infection related to a post crown with possible perforation of the root. The patient is informed and opts to keep the tooth under review. Two months later Mr K returns to the


surgery still complaining of pain and swelling around UL3. He is administered an antibiotic and is referred for an apicectomy but the prognosis is not encouraging. The patient opts for extraction and bone augmentation in preparation for an implant. Mr K asks for an explanation as to why


the tooth failed and X-rays confirm a “perforated root with a post crown”. It transpires that the post crown was placed over eight years ago by another dentist – Mr V. The patient had attended Mr V several times with ongoing concerns over UL3. A letter of claim is sent to Mr V by


solicitors acting on behalf of Mr K claiming


negligence in the root canal treatment (RCT) and post crown placement of UL3.


ANALYSIS/OUTCOME MDDUS acts on behalf of Mr V who has since retired and is no longer an active member. An adviser reviews the patient records and instructs a dental expert. In notes taken at the time Mr V refers to the need for a radiograph of the upper left canine to be taken as a prelude to replacing a bonded crown but there is nothing to suggest this was done. There is also no reference to a post-treatment radiograph to check the alignment of the post following the patient’s attendance with symptoms from UL3. The dental expert concludes that Mr V


was negligent in placing the post in UL3 as it caused a root perforation. The lack of evidence of a post-treatment radiograph in the records also casts doubts on the quality of patient care. A claim of negligence arising so long after


treatment would normally be time-barred but in this case the “date of knowledge” determines the timescale. The tooth was asymptomatic over much of the period post-RCT with Mr K only seeking treatment within the last 18 months. MDDUS in agreement with Mr V settles


the case for a sum commensurate with the single implant treatment.


KEY POINTS ●Ensure complete patient records in RCT with pre and post radiographs. ● Inform patients immediately of any issues that might compromise treatment success. ●MDDUS provides occurrence-based indemnity meaning members are eligible for assistance for events occurring while in membership no matter when the claim is made.


MDDUS INSIGHT / 17


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