Failure to Diagnose Development of Infection – Million Dollar Verdict

The plaintiff presented to the defendant with a badly decayed tooth. The plaintiff claimed that before seeing the defendant dentist, he had generally felt bad and that he had noticed slight swelling on the right side of his face along his lower jaw line. The defendant performed an exam on the plaintiff’s mouth, located the decayed tooth, took an x-ray that read as negative for infection beyond the tooth, and extracted the tooth without incident. A dental assistant noticed that the plaintiff was shivering while in the examining chair, and covered him with a blanket. The defendant did not prescribe the plaintiff any medication and sent him home.

Several hours later, the plaintiff called the defendant’s office with complaints of significant pain. The defendant telephoned a prescription for pain medication into a local pharmacy. No other medications, including an antibiotic, were prescribed at that time.

Over the next five days, the plaintiff continued to suffer swelling on the right side of his face. He mistakenly called his former dentist, who prescribed the plaintiff an antibiotic as well as another pain medication over the phone. The following morning, the plaintiff realized that he had called the wrong dentist and called the defendant’s office. The plaintiff was told to come in to the office. Upon examination, the defendant noted in the plaintiff’s chart that the plaintiff had increased swelling, was sore to swallow and that he had been able to express fluid from the extraction site. The defendant gave the plaintiff a prescription for a different antibiotic and sent him home.

That evening, the plaintiff developed a bad taste in his mouth and was taken to a local hospital. It was quickly determined that the plaintiff had a serious infection. The plaintiff was immediately transferred to a different hospital for treatment.

Despite significant surgical intervention over the next several days, the infection spread into the plaintiff’s throat and eventually into his chest. He developed necrotizing fasciitis, requiring the plaintiff to undergo multiple debridement procedures, skin grafts, and insertion of a feeding tube, which is now permanent.

During the trial, the plaintiff’s dental expert opined that the standard of care required the defendant to prescribe an oral antibiotic based on the plaintiff’s presentation. The plaintiff’s infectious disease expert opined that an oral antibiotic prescribed and taken within 48 hours after the extraction would have successfully treated the plaintiff’s local infection before it could spread and do further harm.

Defense council denied liability and contended that the plaintiff’s infection could not have existed at the time of the extraction procedure. The defendant denied that the plaintiff presented with any facial swelling prior to the extraction procedure.

The jury awarded the plaintiff several million dollars in damages.

With permission from Medical Malpractice Verdicts, Settlements & Experts; Lewis Laska, Editor, 901 Church St., Nashville, TN 37203-3411, 1-800-298-6288.