CASE FILES


These case summaries are based on MDDUS files and are published here to highlight common pitfalls and encourage proactive risk management and best practice. Details have been changed to maintain confidentiality.


CLAIM MOLAR CONFUSION


BACKGROUND Dr T receives a letter from solicitors acting on behalf of a former dental patient – Mr F – alleging clinical negligence in the root canal treatment of an upper right molar (UR6). The letter states that during the procedure in May 2011 part of a fractured dental instrument was left in the tooth causing ongoing pain and suffering. The patient subsequently attended


another dentist who advised that removal of the fragment was not possible and extraction of the tooth was recommended with replacement by an implant. A treatment plan and cost estimate for the procedure is included with the letter of claim and a further amount demanded in recompense for suffering “endured for over three years”.


ANALYSIS/OUTCOME The dentist contacts MDDUS and repudiates the claim. An examination of the records reveals that Mr F did indeed undergo root canal treatment in May 2011


16 / MDDUS INSIGHT / Q3 2017


but the procedure was not carried out by Dr T. That tooth was later extracted but again by a different dentist. The patient did attend Dr T for


treatment of a lower right molar (LR7) in June 2013. The dentist first placed a filling in the tooth but Mr F repeatedly complained of sensitivity over numerous visits. Treatment options were discussed before the patient opted for RCT of the tooth which was carried out in March 2014. In that procedure an instrument did fracture and become lodged in the tooth.


KEY POINTS ●Comprehensive record keeping is essential for a sound legal defence. ●Dental mishaps may not in themselves be considered negligent. ●Acknowledge such mishaps immediately and offer the patient options for remedial treatment.


The patient was immediately informed


of the incident and options discussed but the decision was made to “wait and see”. A month later the patient re-attended the practice complaining of pain and further options were covered, including extraction of the tooth and replacement with an implant which the patient declined. MDDUS responds with a letter


suggesting that the solicitors review the records again, as their client’s recollection is obviously incorrect. In regard to the root treatment of LR7, MDDUS contends there is no breach of duty of care on the part of Dr T as a fractured instrument is not in itself negligent. Mr F was advised of the incident at the time and options were discussed, including extraction and placement of an implant. The patient decided against this treatment option at the time. The letter states that the claim will be


robustly defended, and after further correspondence the case is subsequently dropped.


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