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Adverse outcome

11 July 2016
Dr I
When a patient has suffered an adverse outcome, they can be very susceptible to misinformation. Dental Protection are always happy to talk through difficult conversations, and even rehearse what you might like to say to help you be better prepared when the time arises.

I was working late at night on Thursday when the patient came in with pain associated with a lower molar.  On examination, 47 was broken down and unrestorable.  I took an OPG, which showed a reasonably simple extraction with no bone loss around the tooth. I talked with the patient, and told them that if the tooth was infected, I might not be able to get it numb, but, based on what I could see I thought I would be able to get them numb and get the tooth out.  I also warned the patient that the tooth may break and require surgical extraction.

The patient was happy to try, and after a block and a buccal infiltration, the tooth was extracted in one piece with no pain.

My receptionist called on Friday, the patient was happy and feeling much better, and I will admit that I forgot all about him and thought everything was fine.

Wednesday was a different story! The patient rang up absolutely furious as he had spent 3 nights in hospital with life threatening facial swelling associated with the 47 site.  To make matters worse, the hospital doctor had told him that I should have prescribed antibiotics and that this was entirely my fault.  My receptionist told him we’d call him back and came to tell me what had happened.  I was shocked and really angry because I did not feel it was fair that this was all being blamed on me.

I called Dental Protection and they told me that the best thing to do was get the patient in, and explain what I had done and why.  The Adviser talked me through the best way to have the conversation, and we even had a practice conversation – I felt like a tool at the time, but I was so glad that I did have a practice run when the patient came in with his wife!

Everything that Adviser said would happen did happen, and because we had been through it all I didn’t panic and was prepared with how to respond.  I talked the patient through my decision making, even showing them the ‘clown book’ (Oral and Dental Therapeutic Guidelines) to demonstrate why I took the tooth out without giving antibiotics.

I won’t say the patient was happy when he left, but he certainly accepted my explanation and understood that when I said I was sorry he had had such a tough time, I was sincere.  He and his family still come to the practice now, and so I feel that this has ended as well as it could.

The Dentolegal Adviser's perspective
Dr Annalene Weston, Brisbane Office

Dr I did nothing wrong.  The treatment was appropriate and successful and in keeping with the current standard.  It is often the case however that a third party will get involved and stir the pot, and when the patient has suffered an adverse outcome, they can be very susceptible to misinformation.

We are always happy to talk through difficult conversations, and even rehearse what you might like to say to help you be better prepared when the time arises.  Please rest assured that we feel like tools too!  But it is worth it to get a great outcome!
 

These case studies are based on real events and provided here as guidance. They do not constitute legal advice but are published to help members better understand how they might deal with certain situations. This is just one of the many benefits Dental Protection members enjoy as part of their subscription. 
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