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Dental Surgery Compensation Claim
Dental Surgery Injury
Edwards V Chopra (2003)
The claimant, a 57-year-old woman, received £3,250 for the advanced periodontal disease that was allowed to develop. Consequently, the claimant required root canal treatment on LL7 together with increased periodontal maintenance.
Out of Court Settlement 29/9/2003
LTLPI 18/11/2003
Document No.: AM0200531
Claimant: Female: 51 year old at date of accident; 57 years old at date of settlement.
Clinical Negligence
Clinical Negligence: In April 1993, the claimant began visiting the defendant for routine dental check-ups. Radiographs taken by the defendant in January and September 1994 showed bone-loss at LL67, UL67, UR456 and LL6. Gingival Recession at the UR3 was noted in March 1995 which suggested a deterioration in the periodontal condition.
The defendant failed to act on these indications of periodontal disease and continued to provide routine prophylaxis at six-month intervals. The claimant continued to attend the defendant during 1995 and in March 1996 she experienced pain and bleeding from the UL quadrant, which was diagnosed as a periodontal abscess on the UL7. The abscess was subsequently treated with erythromycin and the claimant was referred to the hygienist.
Progressive Bone Loss
The claimant continued to attend regularly and then in April 1997, it was noted that there was progressive bone loss in all the buccal segments and caries had developed on the distal surface of the LR5. An OPG was taken in October 1997 which further supported the extensive bone loss that had spread to the apex of the distal root of the LL6 with gross bone loss in all four buccal quadrants.
The claimant was then referred to the hygienist for three monthly appointments. In January 1998 a CPITN was recorded and indicated generalised deep pocketing. However the CPITN score appeared to be incorrectly recorded, so it was decided that a 6-point periodontal charting needed to be performed at the next visit. This was performed in June 1998 when the claimant complained of soreness between the LL6 and LL7. It revealed deep pocketing in the UR, UL and LL quadrants.
Wrong Diagnosis
In December 1998, a very deep restoration was placed in the LL6, two years after distal caries was radiographically evident in this tooth. The claimant was advised that this tooth should be extracted if there were any further problems. The claimant saw the hygienist and asked to be referred to a periodontal specialist. The claimant was referred back to the defendant.
The claimant attended the hygienist in April 1999 with a periodontal abscess on her UL7 which was treated with erythromycin and was referred to a specialist periodontist. The claimant however was forced to attend the defendant with a fractured LR6 which was repaired but she was not referred to a specialist periodontist
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Dental Injury Compensation Award
The claimant brought an action alleging that the defendant failed to:
(i) diagnose, treat or refer the claimant for advanced periodontal disease over a period of approximately ten years; and
(ii) identify and treat caries in the LL67 and LR5 regions.
Liability disputed.
Injuries: The claimant developed advanced periodontal disease and caries.
Injuries: The claimant developed advanced periodontal disease and caries.
Effects: The claimant required root canal treatment on LL7 together with increased periodontal maintenance and more extensive restorations than would have been necessary in any event at LR5 and LR6.
Out of Court Settlement: £3,250 total damages.
Out of Court Settlement: £3,250 total damages.
Background to damages: The claimant's solicitors made a CPR Part 36 offer of £14,473 with £6,000 attributable to general damages. The defendant denied liability and enclosed an expert report in support of their position.
The defendant's solicitors made a Part 36 offer of a discontinuance with each party bearing their own costs. The claimant rejected this and made a counter offer of £4,500, acknowledging that her periodontal condition had not responded well to specialist treatment, which put into doubt the question of whether she would have benefited from targeted periodontal treatment and an earlier referral.
The claimant's solicitors responded with a counter offer of £2,000 with no admission of liability prior to the due date of the defence. Negotiations were entered into and the claimant's solicitors made a further counter offer of £3,250, which the defendant accepted and the case was settled on those terms.
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