Failure to Diagnose and Treat Squamous Cell Carcinoma of the Gingiva
The patient, a woman in her mid-50s, received dental care at the defendant dental clinic. The patient was treated by the two defendant general dentists during six appointments over the course of approximately one year. The patient originally presented to the clinic for a routine cleaning, then for several emergency visits for pain in the upper right side of her mouth.
At the patient’s last visit with one of the defendant dentists, the dentist referred her to a periodontist for treatment of a periodontal abscess between tooth 6 and 7. The patient was then treated by an oral surgeon, who performed an incision and drainage of the area. During this procedure, the oral surgeon noted the presence of granulation tissue, and removed some tissue for biopsy. The oral pathology report confirmed oral squamous cell carcinoma, and the patient was diagnosed with stage 1 oral cancer. Multiple surgeries, hospitalizations, and outpatient care followed.
A second biopsy taken almost two years into the patient’s treatment showed cancer in the left maxilla. Additional treatment followed. Approximately one year later, doctors found cancer a third time, this time in the patient’s pterygomaxillary space. The patient ultimately succumbed to cancer.
The plaintiff in this case was one of the patient’s surviving family members. The plaintiff faulted the defendant dentists for failing to diagnose and treat the patient’s cancer. The plaintiff claimed that the patient’s treating dentists deviated from the standard of care by failing to maintain adequate progress notes, include oral cancer as a differential diagnosis, and refer the patient for a biopsy earlier in her treatment.
Defendants’ experts asserted that oral cancer that occurs in the gingiva is especially difficult to detect because it can present as inflammatory conditions. Furthermore, it was the expert witnesses’ opinion that none of the x-rays taken of the patient during her course of treatment with the defendants included features that a provider under similar circumstances could reasonably suspect to be indication of oral cancer.
At the conclusion of a four-day trial, the court found that the plaintiff failed to prove each required element of medical malpractice and ruled in favor of the defense on all claims.
References
Colbourne v. United States, 16-CV-5606 (SN) (S.D.N.Y. Aug. 1, 2019)
Laska, L. (2021). Failure to diagnose and treat oral cancer – death – New York defense judgment. Medical Malpractice Verdicts, Settlements & Experts, 37 (1), 4.