Friday, February 6, 2009


Okay good news.
I called my numb patient the next day and he was fine. Totally un numb.
Okay after I got off the ground from thanking the Lord for taking this from me I had a chance to think.
I got all my assistants together and told them I will no longer be giving blocks with Septocaine.
So that is the end of that.

Did I tell you how great that REALITY thing was?
I wrote to the Forum and asked what they thought of Septocaine and I got 6 responses from "Experts". Awesome.

Anyway this little incident made me think of my malpractice insurance and attorneys and all that.
I think it is always in the back of our mind. You know...a lawsuit.
We do the best we can most of the time and treat people great. We have checks and balances to make sure our quality is always up. We hire people that understand that doing the best is of the utmost importance.
But it is always in the back of our mind.
I usually get a letter from an attorney about 4 times a year for things unrelated to my practice but every time I see letterhead from an attorney I start to sweat.
"OH, NO!! This is the big one. This is the letter that is going to change my life"
And I open it and it is an advertisement for a home in the neighborhood in foreclosure.
Or it is an attorney looking for records of a mutual patient that is investigating someone else.
I remember my father getting a hand delivered letter from an attorney and him saying out loud, "Oh no." And it was 4 sky box tickets to the Magic game given to us by one of our attorney patients. (He should no better than to send a dentist a hand delivered letter).

Have I had a couple of scares? Yes.
Do you ever make mistakes? Yes.
I mean I have broken a couple of files in teeth doing root canals.
I have left some roots in the bone because I couldn't retrieve them.
I have numbed up the wrong side.
Things like this...but one thing I ALWAYS do is tell the patient. I always tell them the truth. I always say, "This is what happened....".

But as you know there is always one.
13 years and one "real" letter.
I remember this guy like it was yesterday.
This guy was one of a kind. He really stood out. He was the type of guy you think might sue you.
I am talking about the kind of guy that doesn't respect the people trying to help them.
He was mean to my assistant and just plain rude.
This was about 7 years ago and I still remember the guy (and I have a terrible memory).
I even remember the tooth I worked on.
I remember specifically that my assistant came into my office after he was gone and said that this was the kind of guy that would sue me.
This being the case I wrote everything down. I wrote exact words he said. I wrote when his appointment was and when he showed up. EVERYTHING.

He was nasty when I was working on him and he was nasty when it was over.
I called him that night to see how he was doing and he said he was still numb. And then he even got nastier.
I worked on an upper tooth so I wasn't concerned about the type of anesthetic I used but I was just concerned for him.
I told him I wanted to keep an open line of communication with him so I can make sure he was okay.
After this conversation he never picked up the phone again.
A couple of months went by and I got a letter from an oral surgeon saying that this dude came to see him for a parathesia problem.
I called the oral surgeon and communicated that I was concerned about this patient (and inside I think I was a little concerned about myself too).
Time went on and nothing happened but I knew that you the statues of limitation (how long you have to file suit) is two years on dental work (trust me I called on this).
And for almost two years this thing was hanging over my head. I mean you know it is there but you can't let it control you.
On the 22 month, I got a letter from his attorney. Talk about butt sweat.
He wanted the records.
I was okay with this. I was resolute to this happening.
Remember the progress notes I took, well they were pretty damning to his client.
I left messages to see how he was doing, he didn't call me back. He didn't show for a bunch of appointment. Oh and he also didn't pay.
So I sent all the stuff to the attorney and in the letter I said if you see him tell him he owes me money.
After this I never heard from them again.

I do the best I can. I am honest to a fault. I treat everyone like I would like to be treated.
Do this mean I am exempt from litigation? No.
But you know what? I am at a place where I think I would be okay with it.
I love my practice. I love what I do. I love the people I work with. I love the people I work on.
And you know what...I think most of them love me too (or like me a lot).
So I am okay with one person wanting to bring me down.
It really is the world we live in.
I don't do everything perfect so if someone wants to find a crack in my armour they are going to find it.
It would really suck but one has got to do what one has got to do.
My friend says, "it is what it is."

Do you have any stories like this one?
Have you ever been to court?
Have you ever had to call your insurance company?
I would like to know,

Have a great weekend


Anonymous said...

I do have a story. It started in '04. I can't talk about it because it is still in litigation almost 5 years later. Can you imagine? When this is over, I will be telling everything. It is one of those situations where I truly believe the patient was the master of his own demise. Even with a signed medical history, sometimes the patients are not aware of their own health or may even be lying about it. And this is a recipe for disaster.

Anonymous said...

I e-mailed you yesterday about a lawsuit I am presently involved in. It concerns a patient who was not aware of his medical history or might have even lied about it. PLEASE DO NOT REPRINT THIS E MAIL. I am concerned that it might be used against me by the prosecution. This blog is a public forum and I am sure that it has been discovered by lawyers.

Anonymous said...

I can understand your position, but I'm a patient with damage to the left lingual nerve. I don't know why the dentist kept injecting the septocaine -- evidently into the nerve -- while I thrashed in pain. By the time the needle came out, the tongue was dead numb. Now, at best, it has an unending metallic tase, there is no actual taste, stabbing pain, no cold sensation, but hypersensitivity to heat. I'm eight weeks out. According to one scholarly article, that means I have about a 30% chance of recovering. So why did he use septocaine for a simple filling, and why didn't he pull the needle when he knew (he admitted) he was in the nerve? The odds are that I will have a damaged tongue for the rest of my life, but if I were to consider a legal action, I would be vindictive and evil.

gatordmd said...

I can understand your frustration. I would be upset too if I had a numbness after a dental appointment.
BUT I think in your case it is not the Septocaine.
When a dentist gives an injection for a lower tooth 99% of the dentists will give an injection called an Inferior Alveolar. And the object really to the IA block is to go in the direction of the nerve. And the downside to "going in the direction of the nerve" is occasionally hitting it.
And when you hit it, it immediately sends a shock wave to and through your tongue.
It happens to me (and my patients) about once a year. And I don't know what to say when it happens except something stupid like, "yep, I hit the nerve"
In all my cases, the feeling has always come back.
I don't know if this helps but what happened to you is something that happens.
Does it suck? Yes.
But I don't know if you can blame the dentist for this one.

Hope that helps

Anonymous said...

Hi John,
I'm a dentist practicing in Georgia. I do have a story too. When I read yours about your lawsuit happy, mean patient, I got a flashback and started to see the actual face of my patient.. Well mine is almost an exact replica of your story with all the meanness, the failure to respond to my calls, failure to pay his bill, etc. etc., and also with the assistant saying this guy is spooky and is one to be leary of for many reasons.

This turn out to be my worst nightmare (as a dentist, you see I've had many). Although he was extremely well-behaved during the initial emergency exam, treatment planning phase and made a down-payment for root canal, core buildup and crown on tooth number 18, I thought everything would be ok, as most patients claim to "hate the dentist" but, turn out to be wonderful patients once they gets to know us.

This man refused to take the prescribed meds, he removed the rubber damn and a file from his mouth and threw them on the table, waiting for me to return to the room. Well months later he showed up on a Saturday while we were doing our annual Spring cleaning and threw his insurance card on the front counter; stating he wanted ALL the money back from the procedure and to bill it to his insurance. Of course, I couldn't do that! He began showing up in the lobby and waiting room, hollering about his tooth is hurting, wanting a full refund and a copy of his records (and on avery busy day). He even somehow found the Endodontist that wanted my jugular ripped out for not utilizing him as an ongoing referral source. The two of them worked together to "take me to the Board". So I got "lawyered" up and had to go to answer. Well those extensive notes that you mentioned, (haha!), I had those too. I even had word for word, the threats I had from the Endodontist. The Board was shocked when I was able to name that particular specialist because it was anonymous and I would not have known otherwise, if were not being truthful in my testimony. The case was dismissed, and the Board told me to suit the patient and the Endodontist. The Board exclaimed, "doctor this is an excellent rct, your diagnostics, your progress notes are ALL well above the expected standard", we see no validity to these complaints here, DISMISSED!!". Iaughed and cried happy tears all the way from Macon to Atlanta.


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