Dental Implant Liability?
Dr. Wiggs, asks us:
Several years ago one of my patients called on the New Year Holiday weekend and said she just fractured tooth # 7 which was recently part of anterior restorations in Porcelain—-some full porcelain crowns and others porcelain laminates. My office was closed but I told her to come in–the remaining root structure could not be restored and I told her it would have to be extracted and could be replaced with a dental implant or a 3 unit fixed bridge.
She chose a dental implant without hesitation especially since she already
had a successful implant procedure in another quadrant. I called two
offices who now handle most of my dental implant procedures. Both were
closed. I called a third–a surgeon who I had worked with – and he was
open. Told us to come right over and proceeded to place a dental implant. The
patient left, pleased with what was apparently a successful procedure.
The patient called me the following week and said the area did not look
normal—the tissue around the dental implant had collapsed. We returned to
the surgeon who said he would repair the area with tissue taken from
the palate. I suggested that he have a periodontist perform the
procedure since it was in such an aesthetic-sensitive area but he
insisted he would do it. There was nothing in my past experience with
this dentist to mistrust him and so he proceeded.
Two weeks later the
area looked worse than ever and I sent her to see a periodontist who
said it would be a long and difficult series of operations to restore
the collapsed ridge—-if it could be restored. I called the surgeon
and explained what had occurred and told him about the cost and time
estimates the patient now faced. I told him that she indicated to me
that she intended to sue for damages if she did not get her money back
from him. He passed a vulgar remark about where she could go and hung
up. I explained to the patient that instead of suing she should try
peer review.
When she investigated peer review she discovered that he
did not belong to the New York Dental Society and therefore had no
obligation to participate. Apparently no lawyer would take her case
because she was not suing for enough money, so she personally took him to
court.
The bottom line is that the dental implant was not restorable, the
judge decided that the dental implant was placed into the bone within the
parameters of correct procedure despite the result and ruled in the
surgeon’s favor. There was no discussion about the aesthetic
restorability.
Where does the responsibility for a successful procedure restoration
lie when a one dentist inserts the dental implant and another dentist has to
restore it? And why is this surgeon permitted to get off free–his
insurance company offered to settle but he refused to permit that, as
his malpractice policy permitted?
