Malpractices Issues Among Dentists Today’s healthcare atmosphere is one where healthcare providers not only have to be concerned about patient care, they must also keep the potential for a medical malpractice suit at the back of their minds. Due to the nature of their work, dentists are at an increased risk of malpractice suits arising from factors that do not affect other areas of specialty. The following will examine the many different areas of malpractice risk in the dental industry.
Dental malpractice occurs when a patient is harmed as a result of dental practice during the provision of care (Nolo, 2015). In order to win a case for dental malpractice, the patient must prove four components of the case. Failure to prove anyone of them will lead to loss of the case. The first is the existence of a dentist-patient relationship. The second is what the appropriate standard of care is in the case. This can differ due to extenuating circumstances in an individual case. The third element that must be proven is how the standard of care was breached in such a way to cause harm to the patient. The fourth element is the extent of the injury (Nolo, 2015). The patient has the burden of proof and the dentist is allowed to offer defenses for each of the elements.
Examples of actions that commonly cause dental malpractice are improper teeth extractions, missed diagnoses, complications such as infection, failure to properly supervise employees, anesthesia errors, failure to refer to a specialist, and a lack of informed consent (Nolo, 2015). An examination of 242 dental malpractice cases found that tooth extractions had the highest incidence of malpractice cases associated with them (Baxter, 2015). Sinus perforation is a common cause of malpractice in extractions. Mandibular fractures also account for a larger percentage of the 51 cases related to tooth extractions.
The second leading category of malpractice suits involves endodontic procedures. These cases accounted for 22 cases of the 242 in the study (Baxter, 2015). The most common cause was instruments that broke off in the canals. Eight of them involves infections, of which four resulted in fatalities (Baxter, 2015). Substandard crown or bridge treatments were another category that caused malpractice suits. The most common cause for suits in this category were open margins, overhanging restoration, and poor occlusion (Baxter, 2015). The failure to treat or diagnose periodontal disease accounted for 19 malpractice cases (Baxter, 2015). Orthodontics were responsible for 12 claims, and dental infection were responsible for 11 claims (Baxter, 2015).
Dental injections result in malpractice cases due to damage of the lingual nerve and the inferior alveolar nerve (Baxter, 2015). In all of these cases, the dentist knew the they had hit the nerve but failed to withdraw the needle and reinject as suggested by standard procedures (Baxter, 2015). Adverse drug reactions, including two fatalities were also among the cases studied (Baxter, 2015). Other miscellaneous causes for malpractice represented the remainder of the cases. These included TMJ and orthognathic surgeries, oral cancer and miscellaneous injuries such as drill injuries, undiagnosed needle fracture, and Lidocaine injected into the patient’s eye. All of these incidents resulted in permanent injury to the patient (Baxter, 2015). This study of cases demonstrates the range of procedures that can result in malpractice lawsuits. The range of injuries in these cases resulted in permanent injury and in some cases death.
Damage awards from dental malpractice typically range in the hundreds of thousands. For instance, one case involving an improperly fitting bridge cost the dentist’s insurance $71,000 (Dentist’s Advantage, 2015). However, a lingual nerve injury during a wisdom tooth extraction cost $875,000 (Dentist’s Advantage, 2015). Settlements for failure to properly recognize and treat infections ranged from $55,500 to $295,378 (Dentist’s Advantage, 2015). These are examples from real cases that demonstrate the inconsistency in the award settlements. The amount awarded depends on the nature and extent of the injuries.
Regardless of how vigilant a dentist is with their practice, accidents to occur. The best way to prevent a malpractice case is to understand the circumstance from which they arrive and to take care to avoid them to the extent possible. Some of the more common actions by dentists that result in malpractice cases are failure to provide the proper information to patients, failed treatments and procedures, giving questionable advice, product liability, nerve damage, and misdiagnosis (Insureon, 2014). Suggestions to avoid lawsuits include never avoid the dental board’s letter, practice clear communication, always follow up with cancelled or missed appointments, do not do procedures that are outside your comfort zone, keep accurate records and never erase something in a patient’s chart (Insureon, 2014).
Reducing the potential for malpractice lawsuits begins with good risk prevention strategies in the office. Just because someone files a claim against a dentist does not necessarily mean they will win. Dentists can take precautions to protect themselves from claims in the first place and they can help to decrease the odds of the plaintiff winning if one is filed. Dental cases result in large judgements. Dental hygienists also carry a substantial risk for malpractice suits (Eldridge, 2014).
Dental insurance might seem expensive, but as one can see, the expenses involved in a dental malpractice suit can be devastating. Several different types of malpractice insurance are suggested for practitioners. These include insurance that covers management of patient records, equipment maintenance and failure, oversight of contracts and supplies. These insurance needs fall under general insurance categories of medical malpractice, business and office insurance, and employee liability insurance (Eldridge, 2014). This does not even include insurance such as Worker’s Compensation or insurance on the building and property. The insurance needs of the dental practice are complex.
In general, the insurance needs of the dental industry are similar to that of any other medical professional. Any dental procedure has the potential for resulting in a malpractice claim. Everyone should keep the best interests of the patient first and pay attention to every detail of the procedure. Sometimes things will happen that cannot be avoided. Following standard practices in the care of patients can help to reduce lawsuits significantly. This is a good strategy for assuring that even of the patient sues, their likelihood of winning is reduced. Every patient should be considered a potential lawsuit, but that by no means that the dentist should set up an atmosphere of mistrust. That in itself can increase the likelihood of a lawsuit.
It is essential to train staff in proper procedure and to provide proper supervision to make certain that staff are following the standards of care that are required. It is it always better to go above and beyond the minimums. This will not only help the practice to avoid malpractice suits, it will result in a higher level of customer satisfaction. This will help the business to grow. Malpractice suits not only cause a loss of income. They result in a loss of reputation and potential examination of one’s license to practice. A malpractice suit can place the business in jeopardy.
Malpractice lawsuits are an unfortunate consequence of dental practice. Everyone would love to believe that this is not the case, but the reality is that it is the case. Risk management practices should be a part of office policies and procedures. Having preventative policies and procedures place is one part of the equation. Following them is another. With attention and care it is possible to reduce the potential for a dental malpractice lawsuit.
- Baxter, C. (2015). A Review of Dental Negligence. Dental IQ. Retrieved from
http://www.dentistryiq.com/articles/wdj/print/volume-2/issue-8/you-and-your-practice/a-
review-of-dental-negligence.html - Dentist’s Advantage. (2015). Dentist’s Advantage Case Studies 2012-2015. Retrieved from
http://www.dentists-
advantage.com/sites/DA/rskmgt/CaseStudy/Pages/CaseStudyIndex.aspx - Eldridge, R. (2014). Dental Professionals and Malpractice. Intuitive Captive Solutions. Retrieved
from https://intuitivecaptivesolutions.com/dental-professionals-malpractice/ - Insureon (2014). Malpractice Lawsuit Tips for Dentists. Retrieved from
http://www.insureon.com/blog/post/2014/04/17/malpractice-for-dentists.aspx - Nolo. (2015). Dental Malpractice Lawsuits. Retrieved from http://www.nolo.com/legal-
encyclopedia/dental-malpractice-lawsuits.html
