I have previously touched on, such as in the post How to Improve Your Chances to Win a Dental Malpractice Lawsuit, some of the issues surrounding medical litigation from a dental and oral surgery standpoint. In the article “Medical litigation in oral surgery practice: Lessons learned from 20 lawsuits,” by Hesham F. Marei, currently in Press at the time I have reviewed this, Journal of Forensic and Legal Medicine, 2012, an investigation into lawsuits occurring in an oral surgery setting over three years (2009-2012) in Saudi Arabia is explored.
Over 100 lawsuits were looked at with 20 fitting in the inclusion criteria. Marei states:
“The most common cause for litigation was oro-antral communication, followed by neurological deficit associated with the surgical removal of wisdom teeth and placement of dental implants. Bleeding after extraction was the third most common cause for litigation…”
In fact 17 of the 20 cases were related to either teeth extraction or surgical removal of impacted teeth. Oro-antral communication occurred in 6 cases, persistent bleeding occurred in 2 cases, wrong tooth extraction occurred in 1 case, brain death occurred in 1 case, neurological deficit occurred in 4 cases, fracture of the mandible occurred in 2 cases, and injury to adjacent teeth occurred in 1 case. The total amount of compensation for the 20 cases combined was $200,000.
Marei then goes on to discuss 5 lessons. In his first lesson he discusses how in the cases of ora-antral communication
“Most practitioners were general dentists doing a simple extraction for a maxillary tooth without obtaining informed consent for the possibility of facing a surgical procedure.”
In the second lesson Marei discusses how neurological deficit following wisdom teeth extraction or implant placement was the second most common claim. In these cases there was improper risk assessment prior to surgery because of the close proximity to the inferior alveolar nerve and a dental scan or CT scan should have been performed. Further surgeons removed too much bone and patients were not offered an option of no treatment.
The third lesson was related to persistent bleeding after extractions and was due to improper preoperative and postoperative management.
The fourth lesson dealt with a case of brain death after tooth extraction where the surgeon did not attempt to provide basic life support but instead attempted to transfer the patient by wheelchair from the dental office to the emergency room in the same hospital which was a 5 minute trip.
The fifth lesson was related to a lack of communication and rapport between the surgeon and patient.