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.


GDC LOOSE FILLINGS


BACKGROUND Mr B is a 31-year-old school teacher and contacts his dental surgery complaining of a loose temporary filling in LL4. His regular dentist Dr L is on holiday but the patient is booked in for a crown restoration of the tooth in three weeks’ time. Another partner at the practice – Dr T – advises him to make an emergency appointment if the filling falls out. Two days later this happens and the


tooth is restored by Dr T with a resin- bonded composite. Mr B is informed again of the temporary nature of the filling and also the poor aesthetics due to the size of the cavity. A day later this filling comes loose and is lost. It is again replaced by a resin-bonded composite in an emergency appointment with Dr T. Mr B attends his scheduled appointment


with Dr L and the tooth is successfully treated with a crown. The patient is however extremely dissatisfied with the treatment provided by Dr T and sends a written complaint to the practice, as well as to the General Dental Council. In his complaint to the GDC Mr B claims


16 / MDDUS INSIGHT / Q4 2017


that Dr T provided rushed and substandard treatment resulting in the loss of two fillings in the same tooth. He states that he was “in and out the dentist chair in less than five minutes” in both appointments and that Dr T displayed a poor attitude, as though he was being “inconvenienced” by the treatment failures.


ANALYSIS/OUTCOME A letter is received by Dr T from a GDC caseworker asking for more details including the patient’s dental records. MDDUS advises Dr T in compiling the relevant information and the GDC writes back saying the case has been referred to a case examiner who will determine whether the complaint amounts to potential impaired fitness to practise. MDDUS assists Dr T in submitting a


response to the allegations that he provided inadequate care on two occasions in the treatment of LL4 – including a poor standard of filling. The GDC has also noted inadequate record keeping in these consultations, including one which was not recorded at all.


The case examiner contacts Dr T two


months later to inform him that the case will not be referred to a practice committee. The letter acknowledges that although it cannot comment on the standard of the fillings it recognises that composites are moisture sensitive and prone to falling out. It notes that the treatment plan was sound, as Mr B had not complained of pain, and crown treatment was planned within weeks. The case examiner does observe that the


patient notes are brief and lacking detail. A letter of advice is thus issued to Dr T in regard to the standard of his clinical records and this will form part of his fitness to practise history.


KEY POINTS ●Ensure adequate records of all patient encounters no matter how brief. ●Be conscious of how your attitude may be perceived by a patient.


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24